CAS Risk Management & Mitigation 2 — Questions and Answers
Question 1: A client in early recovery from opioid use disorder reports that a close friend is pushing them to attend a party where alcohol will be present. Which risk mitigation strategy is most appropriate to recommend first?
- Advise the client to end the friendship immediately
- Help the client develop a specific refusal script and exit plan for the event (Correct answer)
- Encourage the client to attend to practice resistance skills
- Suggest the client take naltrexone before attending
Correct answer: Help the client develop a specific refusal script and exit plan for the event
Developing a concrete refusal script and exit plan gives the client actionable tools to navigate high-risk social situations safely.
Question 2: Which factor most significantly increases the risk of relapse during the first 90 days of recovery?
- Attending too many support group meetings
- Unresolved withdrawal symptoms and cue-induced cravings (Correct answer)
- Starting a new employment position
- Completing a residential treatment program
Correct answer: Unresolved withdrawal symptoms and cue-induced cravings
Protracted withdrawal and conditioned cue reactivity are the strongest neurobiological drivers of early relapse.
Question 3: A CAS counselor notices a client has begun isolating, sleeping excessively, and canceling appointments. These behaviors are BEST described as:
- Normal adjustment to sobriety
- Warning signs of relapse in the emotional/behavioral stage (Correct answer)
- Indicators of a co-occurring depressive episode only
- Signs the client is ready for discharge
Correct answer: Warning signs of relapse in the emotional/behavioral stage
Isolation, sleep changes, and appointment avoidance are classic early-stage relapse warning signs that precede substance use.
Question 4: When conducting a risk assessment for a client with a history of polysubstance use, which tool is most appropriate for measuring current severity of use and relapse risk?
- Beck Depression Inventory (BDI)
- Addiction Severity Index (ASI) (Correct answer)
- Hamilton Anxiety Rating Scale (HAM-A)
- Minnesota Multiphasic Personality Inventory (MMPI)
Correct answer: Addiction Severity Index (ASI)
The ASI assesses multiple life domains affected by substance use and is validated for measuring addiction severity and treatment planning.
Question 5: A client prescribed buprenorphine/naloxone admits to occasionally using benzodiazepines obtained from a friend. The PRIMARY risk the counselor must address immediately is:
- Medication non-compliance leading to opioid cravings
- Potentially fatal central nervous system depression from the combination (Correct answer)
- Benzodiazepine dependence replacing opioid dependence
- Loss of buprenorphine prescription privileges
Correct answer: Potentially fatal central nervous system depression from the combination
Combining buprenorphine with benzodiazepines significantly increases the risk of respiratory depression and death.
Question 6: Which approach BEST characterizes harm reduction as a risk mitigation strategy for active substance users?
- Requiring abstinence before providing any services
- Reducing negative consequences of use without demanding immediate cessation (Correct answer)
- Prescribing controlled substances to replace illegal ones
- Focusing exclusively on legal consequences of drug use
Correct answer: Reducing negative consequences of use without demanding immediate cessation
Harm reduction prioritizes minimizing health and social harms of substance use while meeting clients where they are in readiness to change.
Question 7: A newly recovering client lives with an actively using partner. What is the counselor's MOST important risk mitigation recommendation?
- Immediately end the relationship
- Develop a written safety plan that includes contingencies for high-risk home situations (Correct answer)
- Move to a sober living environment without discussion
- Increase session frequency to three times per week
Correct answer: Develop a written safety plan that includes contingencies for high-risk home situations
A collaborative safety plan that acknowledges the client's living situation and outlines specific response strategies is the most clinically sound first step.
CAS Risk Management & Mitigation 2
A client in early recovery from opioid use disorder reports that a close friend is pushing them to attend a party where alcohol will be present.
Which risk mitigation strategy is most appropriate to recommend first?