Chemical Dependency Counselor License Exam Pharmacology of Substance Use 5

Question 1

A client reports using kratom daily to manage opioid cravings without a prescription. The counselor should know that kratom's active alkaloids (mitragynine, 7-HMG) primarily act on:

Accepted Answer

Mu and delta opioid receptors

Answer

Cannabinoid CB1 receptors

Answer

Alpha-2 adrenergic receptors

Answer

Serotonin 5-HT1A receptors

Question 2

The 'kindling' phenomenon in repeated alcohol withdrawal refers to:

Accepted Answer

Each successive withdrawal episode becoming progressively more severe and seizure-prone

Answer

Tolerance developing so that more alcohol is needed to achieve intoxication

Answer

Increasing liver sensitivity to acetaldehyde over time

Answer

The gradual onset of alcohol's CNS depressant effects

Question 3

Which pharmacological feature of fentanyl makes it especially dangerous in the illicit drug supply?

Accepted Answer

Its extreme potency (50–100x morphine) meaning a lethal dose fits in a microscopic amount

Answer

Its very long half-life causing prolonged respiratory depression

Answer

Its oral bioavailability making it easy to ingest unknowingly

Answer

Its slow onset preventing users from gauging the dose

Question 4

Varenicline (Chantix) reduces tobacco cravings primarily by:

Accepted Answer

Acting as a partial agonist at alpha-4 beta-2 nicotinic acetylcholine receptors

Answer

Releasing large amounts of dopamine to simulate smoking

Answer

Blocking dopamine D2 receptors to reduce reward

Answer

Inhibiting monoamine oxidase to prolong nicotine's effects

Question 5

Protracted abstinence syndrome following cessation of heavy alcohol use is best characterized by:

Accepted Answer

Persistent anxiety, dysphoria, insomnia, and craving lasting months after acute withdrawal resolves

Answer

Acute delirium tremens lasting weeks to months

Answer

A rebound hyperalgesia to pain stimuli lasting 48–72 hours

Answer

Hypersomnolence and increased appetite for the first two weeks

Question 6

A client in opioid withdrawal is given clonidine. Its mechanism of action in this context is:

Accepted Answer

Alpha-2 adrenergic agonism that reduces noradrenergic hyperactivity from the locus coeruleus

Answer

Partial opioid agonism at mu receptors to substitute for opioids

Answer

Blocking opioid receptors so withdrawal resolves faster

Answer

GABA-B agonism to reduce autonomic instability

Question 7

Which route of drug administration produces the fastest onset of action and the highest peak plasma concentration?

Accepted Answer

Intravenous

Answer

Sublingual

Answer

Intramuscular

Answer

Transdermal