CASAC Pharmacology & Co-Occurring Disorders 3

Question 1

A client with PTSD and alcohol use disorder asks why their therapist recommended avoiding benzodiazepines for anxiety. What is the BEST explanation?

Accepted Answer

Benzodiazepines carry high misuse potential and may worsen PTSD outcomes over time

Answer

Benzodiazepines have high addiction liability and research suggests they may interfere with fear extinction, potentially worsening long-term PTSD outcomes.

Question 2

Which medication for alcohol use disorder requires the client to be abstinent from opioids for 7–10 days before initiation?

Accepted Answer

Naltrexone (Vivitrol/ReVia)

Answer

Naltrexone is an opioid antagonist; initiating it while opioids are present will precipitate acute withdrawal, so a washout period is required.

Question 3

Cannabis use disorder co-occurring with a psychotic disorder presents which UNIQUE clinical challenge?

Accepted Answer

Cannabis use can precipitate or exacerbate psychotic symptoms, complicating diagnosis and treatment

Answer

Cannabis, especially high-THC strains, can trigger or worsen psychotic symptoms and make it difficult to differentiate substance-induced from primary psychotic disorders.

Question 4

Methadone's extended half-life (24–36 hours) is clinically significant because it:

Accepted Answer

Provides steady plasma levels that reduce peaks of euphoria and troughs of withdrawal

Answer

Methadone's long half-life produces stable plasma concentrations, blunting euphoria from illicit opioids and preventing withdrawal between doses.

Question 5

A client taking an SSRI for depression begins using cocaine heavily. The counselor should be aware that cocaine's mechanism may DIRECTLY interact with the SSRI by:

Accepted Answer

Blocking serotonin reuptake, potentially causing additive serotonin effects

Answer

Cocaine blocks monoamine reuptake transporters including SERT; combined with an SSRI, this may produce excessive serotonergic stimulation and increase risk of serotonin syndrome.

CASAC - Credentialed Alcoholism and Substance Abuse Counselor Practice Test

CASAC - Credentialed Alcoholism and Substance Abuse Counselor Practice Test

CASAC Pharmacology & Co-Occurring Disorders 3