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

Kratom alkaloids are partial mu-opioid agonists and have opioid-like analgesic and euphoric effects, carrying dependence and withdrawal risks similar to traditional opioids.

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

Neural sensitization from repeated alcohol withdrawal cycles lowers the seizure threshold with each episode, making clinical management of later withdrawals more medically urgent.

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

Fentanyl's potency means a dose measured in micrograms can be lethal; small measurement errors or uneven mixing ('hot spots') in counterfeit pills or heroin cause overdoses even in experienced users.

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

As a partial agonist, varenicline provides enough receptor stimulation to reduce cravings and withdrawal while blocking full nicotine binding and blunting the reinforcement from smoking.

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

Neuroadaptive changes from chronic alcohol use take months to normalize; the resulting subclinical dysregulation of GABA, glutamate, and dopamine systems sustains craving and relapse vulnerability.

Chemical Dependency Counselor License Exam Practice Test

Chemical Dependency Counselor License Exam Practice Test

Chemical Dependency Counselor License Exam Pharmacology of Substance Use 5