CAADE Pharmacology of Substances 4 — Questions and Answers
Question 1: MDMA (ecstasy) primarily produces its effects by massively releasing which neurotransmitter?
- Dopamine only
- Norepinephrine only
- Serotonin (along with dopamine and norepinephrine) (Correct answer)
- Acetylcholine
Correct answer: Serotonin (along with dopamine and norepinephrine)
MDMA causes massive release of serotonin, along with dopamine and norepinephrine, producing euphoria, empathy, and increased sociability.
Question 2: Which of the following is a major health risk specific to chronic inhalant abuse?
- Liver cirrhosis
- Sudden Sniffing Death Syndrome from cardiac arrhythmia (Correct answer)
- Pulmonary fibrosis from bronchospasm
- Peripheral neuropathy from serotonin depletion
Correct answer: Sudden Sniffing Death Syndrome from cardiac arrhythmia
Sudden Sniffing Death Syndrome is a risk unique to inhalants, where cardiac sensitization to epinephrine causes fatal arrhythmia, even on first use.
Question 3: Which statement about drug half-life is most accurate for a substance abuse counselor to understand?
- Half-life measures how long a drug's subjective effects last
- Half-life is the time required for the plasma concentration of a drug to decrease by 50% (Correct answer)
- Half-life equals the duration of intoxication
- Half-life only applies to controlled substances
Correct answer: Half-life is the time required for the plasma concentration of a drug to decrease by 50%
Half-life is a pharmacokinetic measure of the time needed for drug plasma concentration to fall by half, which determines dosing frequency and detox timelines.
Question 4: A client who uses heroin also begins using alcohol heavily. This combination is especially dangerous because both are:
- CNS stimulants that cause cardiac arrest together
- CNS depressants whose respiratory depression effects are synergistic (Correct answer)
- Hallucinogens that cause psychosis when combined
- Stimulants that increase seizure risk when combined
Correct answer: CNS depressants whose respiratory depression effects are synergistic
Opioids and alcohol are both CNS depressants that synergistically suppress respiration, dramatically increasing the risk of fatal overdose when combined.
Question 5: GHB (gamma-hydroxybutyrate) is particularly dangerous when combined with alcohol because it:
- Causes severe hypertensive crisis
- Has synergistic CNS depressant effects that can cause coma or death (Correct answer)
- Triggers serotonin syndrome
- Blocks opioid receptors, causing precipitated withdrawal
Correct answer: Has synergistic CNS depressant effects that can cause coma or death
GHB and alcohol are both CNS depressants, and their combination produces synergistic sedation that can rapidly lead to coma and respiratory failure.
Question 6: Which concept explains why a person who has been abstinent and then relapses is at heightened risk for overdose?
- Reverse tolerance means less drug is needed after abstinence
- Tolerance is lost during abstinence, so the previously used dose can now be lethal (Correct answer)
- Post-acute withdrawal syndrome increases drug potency
- Sensitization causes stronger highs after abstinence
Correct answer: Tolerance is lost during abstinence, so the previously used dose can now be lethal
Tolerance decreases rapidly during abstinence; when a person relapses at their prior high dose, their reduced tolerance cannot handle it, resulting in overdose risk.
Question 7: Which schedule classification under the Controlled Substances Act indicates the highest abuse potential and no accepted medical use?
- Schedule II
- Schedule III
- Schedule I (Correct answer)
- Schedule IV
Correct answer: Schedule I
Schedule I substances (e.g., heroin, LSD) have the highest abuse potential and no currently accepted medical use in the United States.
CAADE Pharmacology of Substances 4
MDMA (ecstasy) primarily produces its effects by massively releasing which neurotransmitter?