Chemical Dependency Counselor License Exam Pharmacology of Substance Use 3

Question 1

A client maintained on buprenorphine/naloxone reports that injecting the film produces little effect. This is because:

Accepted Answer

Naloxone becomes active parenterally and precipitates withdrawal

Answer

Buprenorphine has a ceiling effect on euphoria regardless of route

Answer

The film cannot be dissolved to injectable concentration

Answer

Buprenorphine is destroyed by blood pH

Question 2

MDMA's acute toxicity most commonly causes death through which mechanism?

Accepted Answer

Hyperthermia, rhabdomyolysis, and multi-organ failure

Answer

Respiratory depression similar to opioids

Answer

Cardiac arrhythmia from potassium depletion

Answer

Acute liver failure from direct hepatotoxicity

Question 3

Which characteristic of gamma-hydroxybutyrate (GHB) makes it particularly dangerous when combined with alcohol?

Accepted Answer

Both substances are CNS depressants with synergistic effects at GABA receptors

Answer

GHB blocks alcohol metabolism, causing acetaldehyde buildup

Answer

GHB inhibits alcohol absorption in the gut

Answer

Alcohol converts GHB to a toxic metabolite

Question 4

Regarding methamphetamine neurotoxicity, long-term use is most associated with damage to:

Accepted Answer

Dopaminergic and serotonergic terminals in the striatum and prefrontal cortex

Answer

Cholinergic neurons in the hippocampus

Answer

Opioid peptide neurons in the periaqueductal gray

Answer

Glutamate receptors in the cerebellum

Question 5

The concept of 'set and setting' is most directly relevant to which substance's variable psychological effects?

Accepted Answer

LSD (lysergic acid diethylamide)

Answer

Heroin

Answer

Nicotine

Answer

Alcohol at low doses

Question 6

Tolerance to opioids develops most rapidly for which effect?

Accepted Answer

Analgesia and euphoria

Answer

Constipation

Answer

Miosis (pupil constriction)

Answer

Hormonal suppression

Question 7

A urine drug screen using immunoassay is MOST likely to produce a false positive for opioids in a client who reports taking:

Accepted Answer

Poppy seed-containing food

Answer

Ibuprofen

Answer

Quinolone antibiotics

Answer

Dextromethorphan

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