CASAC Foundations of Alcohol and Substance Use Disorders 5 — Questions and Answers
Question 1: Which of the following substances produces withdrawal symptoms that can be life-threatening without medical supervision?
- Cannabis
- Cocaine
- Alcohol (Correct answer)
- Hallucinogens
Correct answer: Alcohol
Alcohol withdrawal can cause seizures, delirium tremens, and death, making it one of the few substance withdrawals requiring medical management.
Question 2: The biopsychosocial model of substance use disorders recognizes that addiction is caused by:
- Biological factors alone, primarily genetic predisposition
- Psychological distress as the sole contributing factor
- Social influences and peer pressure exclusively
- An interaction among biological, psychological, and social factors (Correct answer)
Correct answer: An interaction among biological, psychological, and social factors
The biopsychosocial model integrates biological (genetics, neurobiology), psychological (mental health, coping), and social (family, culture, environment) factors in understanding addiction.
Question 3: A CASAC counselor is reviewing a client's history and notes that the client's parent and grandparent both had alcohol use disorder. This most strongly suggests the role of:
- Purely social learning through observation
- Genetic heritability as a risk factor (Correct answer)
- Environmental determinism alone
- Random chance with no identifiable pattern
Correct answer: Genetic heritability as a risk factor
Family history across multiple generations indicates a genetic heritability component; research shows alcohol use disorder has approximately 50% heritability.
Question 4: Stimulant drugs like cocaine and methamphetamine primarily exert their effects by:
- Blocking GABA receptors and inhibiting neural activity
- Increasing dopamine, norepinephrine, and serotonin in the synapse (Correct answer)
- Binding to opioid receptors and reducing pain perception
- Activating NMDA glutamate receptors to enhance memory
Correct answer: Increasing dopamine, norepinephrine, and serotonin in the synapse
Stimulants work by blocking reuptake transporters and/or triggering release of dopamine, norepinephrine, and serotonin, producing euphoria and increased energy.
Question 5: Which of the following best illustrates negative reinforcement as a factor maintaining substance use?
- A person drinks alcohol to experience euphoria
- A person uses opioids to eliminate painful withdrawal symptoms (Correct answer)
- A person tries marijuana due to peer encouragement
- A person uses stimulants to perform better at work
Correct answer: A person uses opioids to eliminate painful withdrawal symptoms
Negative reinforcement involves removing an aversive stimulus (withdrawal pain) through substance use, which strengthens the behavior of using the substance.
Question 6: According to the ASAM definition, which of the following is NOT one of the four Cs characterizing addiction?
- Compulsive use
- Continued use despite consequences
- Chronicity (Correct answer)
- Craving
Correct answer: Chronicity
ASAM's four Cs of addiction are Craving, loss of Control, Compulsive use, and Continued use despite Consequences; 'Chronicity' describes the nature of the disease, not one of the four Cs.
Question 7: A client who began drinking at age 14 is at greater risk for developing alcohol use disorder compared to someone who began at age 21. This illustrates which risk factor?
- Pharmacokinetic variability based on body weight
- Age of onset as a developmental risk factor (Correct answer)
- The gateway drug hypothesis
- Comorbid anxiety disorder as a primary cause
Correct answer: Age of onset as a developmental risk factor
Research consistently shows that earlier age of first use is a strong predictor of developing substance use disorder, likely due to effects on the still-developing adolescent brain.
CASAC Foundations of Alcohol and Substance Use Disorders 5
Which of the following substances produces withdrawal symptoms that can be life-threatening without medical supervision?