Chemical Dependency Counselor License Exam Pharmacology of Substance Use 2

Question 1

Which neurotransmitter system is primarily responsible for the euphoric reinforcement produced by opioids?

Accepted Answer

Dopamine in the mesolimbic pathway

Answer

Opioids activate mu-receptors on GABA interneurons, disinhibiting dopaminergic neurons in the ventral tegmental area and flooding the nucleus accumbens with dopamine.

Question 2

A client taking methadone for OUD is prescribed erythromycin for a bacterial infection. The primary pharmacological concern is:

Accepted Answer

QTc interval prolongation due to combined CYP3A4 inhibition

Answer

Both methadone and erythromycin prolong the QT interval; erythromycin also inhibits CYP3A4, raising methadone plasma levels and amplifying cardiac risk.

Question 3

Which benzodiazepine property makes it most likely to produce severe withdrawal seizures upon abrupt discontinuation?

Accepted Answer

Short half-life with high potency

Answer

Short-acting, high-potency benzodiazepines (e.g., alprazolam, triazolam) produce rapid CNS re-excitation upon discontinuation, greatly increasing seizure risk.

Question 4

Cocaine's mechanism of action primarily involves:

Accepted Answer

Blocking reuptake of dopamine, norepinephrine, and serotonin

Answer

Cocaine blocks monoamine transporter proteins (DAT, NET, SERT), preventing reuptake and accumulating catecholamines in the synapse.

Question 5

Naltrexone is contraindicated in a client who:

Accepted Answer

Used heroin within the past 7–10 days

Answer

Naltrexone will precipitate acute opioid withdrawal in opioid-dependent clients; a minimum 7–10 day abstinence from short-acting opioids is required before initiation.

Chemical Dependency Counselor License Exam Practice Test

Chemical Dependency Counselor License Exam Practice Test

Chemical Dependency Counselor License Exam Pharmacology of Substance Use 2