CAC Pharmacology and Substance Knowledge 2 — Questions and Answers
Question 1: Which of the following best describes 'tolerance' in the context of substance use?
- The need for increasing amounts of a substance to achieve the same effect (Correct answer)
- The ability to function normally while intoxicated
- The absence of withdrawal symptoms upon cessation
- The body's ability to metabolize substances quickly
Correct answer: The need for increasing amounts of a substance to achieve the same effect
Tolerance is a neuroadaptive process in which the brain adjusts to repeated exposure to a substance, requiring more of it to produce the original effect.
Question 2: Acamprosate (Campral) treats alcohol use disorder primarily by:
- Reducing post-acute withdrawal symptoms such as anxiety and dysphoria that trigger relapse (Correct answer)
- Blocking the euphoric effects of alcohol
- Creating an aversive reaction to alcohol
- Stimulating dopamine release to reduce cravings
Correct answer: Reducing post-acute withdrawal symptoms such as anxiety and dysphoria that trigger relapse
Acamprosate modulates glutamate and GABA activity to restore neurochemical balance disturbed by chronic alcohol use, reducing the persistent discomfort that drives relapse.
Question 3: Cannabis withdrawal syndrome commonly includes which symptoms?
- Irritability, anxiety, insomnia, and decreased appetite (Correct answer)
- Seizures and delirium
- Hallucinations and paranoid delusions
- Sweating, tremors, and fever
Correct answer: Irritability, anxiety, insomnia, and decreased appetite
Cannabis withdrawal, officially recognized in DSM-5, includes irritability, anxiety, sleep disturbance, and reduced appetite, typically peaking in the first week of abstinence.
Question 4: Stimulant use disorder (cocaine, methamphetamine) is primarily characterized by which type of withdrawal?
- Psychological — characterized by dysphoria, fatigue, and intense cravings (crash) (Correct answer)
- Physical — characterized by seizures and autonomic instability
- No withdrawal syndrome — stimulants are not physically addictive
- Withdrawal that is medically identical to opioid withdrawal
Correct answer: Psychological — characterized by dysphoria, fatigue, and intense cravings (crash)
Stimulant withdrawal, called the 'crash,' is primarily psychological — featuring profound depression, exhaustion, and strong drug cravings — rather than the physical symptoms seen with opioids or alcohol.
Question 5: Which opioid withdrawal symptom helps a counselor assess whether a client is in early withdrawal?
- Yawning, lacrimation (tearing), and gooseflesh (piloerection) (Correct answer)
- Hallucinations and confusion
- Seizures and high fever
- Sweating and severe abdominal cramping only
Correct answer: Yawning, lacrimation (tearing), and gooseflesh (piloerection)
Early opioid withdrawal presents with yawning, tearing eyes, runny nose, gooseflesh, and restlessness — symptoms caused by the sudden rebound of noradrenergic activity.
Question 6: What is 'cross-tolerance' in pharmacology as it applies to addiction?
- Tolerance developed to one substance that also reduces the effect of a chemically similar substance (Correct answer)
- Two substances canceling each other's effects when used together
- Using one substance to manage withdrawal from another
- An increased sensitivity to all substances after prolonged use of one
Correct answer: Tolerance developed to one substance that also reduces the effect of a chemically similar substance
Cross-tolerance occurs because drugs in the same class act on the same receptors; tolerance developed with one (e.g., heroin) extends to others in the class (e.g., morphine).
CAC Pharmacology and Substance Knowledge 2
Which of the following best describes 'tolerance' in the context of substance use?