Substance use: methadone versus heroin withdrawal: practice question

A Psychiatry question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Psychiatry · Substance use: methadone versus heroin withdrawal

Sample item

Two patients stop their opioids abruptly, one after long-term heroin use and the other after long-term methadone. How will the methadone withdrawal compare with the heroin withdrawal?

AIt starts earlier and ends soonerBIt starts at the same time but is shorterCIt does not occur because methadone is long actingDIt starts later and lasts longer, with a milder peak

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. It starts later and lasts longer, with a milder peak

Heroin withdrawal begins within 6 to 12 hours, peaks at 1 to 3 days and settles within about a week. Methadone's long half-life delays onset to 24 to 48 hours or more, with a less intense but prolonged course lasting two weeks or longer.

Option by option

A. It starts earlier and ends sooner
Earlier onset belongs to short-acting drugs such as heroin.
B. It starts at the same time but is shorter
The onset is delayed with methadone, not simultaneous, and the course is longer.
C. It does not occur because methadone is long acting
Methadone dependence produces a real withdrawal syndrome when the drug is stopped.
D. It starts later and lasts longer, with a milder peak (correct)
Correct. A long half-life delays onset and prolongs the milder course.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Psychiatry question

What is the answer to this Psychiatry question?

The best answer is D, It starts later and lasts longer, with a milder peak. Heroin withdrawal begins within 6 to 12 hours, peaks at 1 to 3 days and settles within about a week.

Why is "It starts earlier and ends sooner" not the answer?

Earlier onset belongs to short-acting drugs such as heroin.

Why is "It starts at the same time but is shorter" not the answer?

The onset is delayed with methadone, not simultaneous, and the course is longer.

Why is "It does not occur because methadone is long acting" not the answer?

Methadone dependence produces a real withdrawal syndrome when the drug is stopped.

What concept does this question test?

It tests Substance use: methadone versus heroin withdrawal in Psychiatry. Methadone's long half-life delays onset to 24 to 48 hours or more, with a less intense but prolonged course lasting two weeks or longer.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Substance use: methadone versus heroin withdrawal?

Learn each diagnosis by its core features and its first-line treatment. Then use the flashcards and the other Psychiatry questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.