Addiction Medicine Certification Patient Assessment & Evaluation 2 — Questions and Answers
Question 1: Which screening tool uses a single question — 'How many times in the past year have you used an illegal drug or used a prescription medication for nonmedical reasons?' — and is validated for primary care settings?
- CAGE-AID
- DAST-10
- Single-Question Screen (Correct answer)
- AUDIT-C
Correct answer: Single-Question Screen
The Single-Question Drug Use Screen has demonstrated sensitivity and specificity comparable to longer instruments in primary care.
Question 2: During a biopsychosocial assessment, a patient reports blackouts after drinking. This symptom most directly indicates which severity marker?
- Tolerance
- Withdrawal potential
- Memory-impairing blood alcohol concentration (Correct answer)
- Alcohol-induced persisting amnestic disorder
Correct answer: Memory-impairing blood alcohol concentration
Blackouts reflect memory encoding failure at high BAC and signal heavy episodic drinking, not a distinct disorder unless persisting after abstinence.
Question 3: The Addiction Severity Index (ASI) composite score for the alcohol domain is derived from how many subscale items?
- 3 items weighted by severity
- 7 items weighted by frequency and distress (Correct answer)
- All items equally weighted
- Clinician global rating only
Correct answer: 7 items weighted by frequency and distress
The ASI alcohol composite incorporates seven items, each weighted by self-reported frequency and perceived distress over the past 30 days.
Question 4: A patient on buprenorphine-naloxone reports taking extra doses before a stressful weekend. Which assessment finding best identifies medication misuse versus undertreated cravings?
- Urine drug screen positive for buprenorphine only
- Prescription Drug Monitoring Program showing early refill requests (Correct answer)
- Patient-rated craving score above 7 on NRS
- Pill count matching prescribed quantity
Correct answer: Prescription Drug Monitoring Program showing early refill requests
PDMP data showing early refill patterns is the most objective indicator of medication misuse beyond the intended therapeutic dose.
Question 5: Which structured interview assesses both readiness to change and importance/confidence ratings across substance use domains?
- SOCRATES (Correct answer)
- DAST-10
- CRAFFT
- CIWA-Ar
Correct answer: SOCRATES
SOCRATES (Stages of Change Readiness and Treatment Eagerness Scale) measures recognition, ambivalence, and taking steps components of motivation.
Question 6: During an intake evaluation, a patient denies drug use but the urine immunoassay is positive for benzodiazepines. The most appropriate next step is to:
- Dismiss the patient for dishonesty
- Order a confirmatory GC-MS test before confronting the patient (Correct answer)
- Immediately restrict prescribing privileges
- Document result as false positive without further action
Correct answer: Order a confirmatory GC-MS test before confronting the patient
Immunoassay screens have cross-reactivity and false positives; confirmatory gas chromatography–mass spectrometry is required before clinical decisions.
Question 7: The Clinical Global Impressions–Severity (CGI-S) scale, when applied to addiction, rates the clinician's view of the patient's illness severity on a scale of:
- 0–10 numerical rating scale
- 1–7 Likert scale (Correct answer)
- 0–4 ordinal scale
- A percentage of maximum impairment
Correct answer: 1–7 Likert scale
CGI-S uses a 7-point Likert scale from 1 (normal) to 7 (among the most extremely ill), enabling standardized clinician severity ratings.
Addiction Medicine Certification Patient Assessment & Evaluation 2
Which screening tool uses a single question — 'How many times in the past year have you used an illegal drug or used a prescription medication for nonmedical reasons?' — and is validated for primary care settings?