CRS Substance Abuse Knowledge 5 — Questions and Answers
Question 1: Which of the following best describes 'co-occurring disorders' in the context of substance use treatment?
- Two different substance use disorders diagnosed simultaneously
- A substance use disorder alongside a mental health disorder (Correct answer)
- Physical and psychological dependence occurring together
- Tolerance and withdrawal occurring in the same client
Correct answer: A substance use disorder alongside a mental health disorder
Co-occurring disorders (dual diagnosis) refers to the simultaneous presence of a substance use disorder and a mental health disorder such as depression or PTSD.
Question 2: The ASAM (American Society of Addiction Medicine) criteria are used primarily to:
- Diagnose substance use disorders using DSM criteria
- Determine appropriate level of care placement for clients (Correct answer)
- Measure treatment outcomes over time
- Screen for co-occurring mental health disorders
Correct answer: Determine appropriate level of care placement for clients
ASAM criteria provide a multidimensional assessment framework to match clients to the most appropriate level of care based on their clinical needs.
Question 3: A client abusing prescription stimulants such as Adderall is misusing a drug classified as:
- Schedule III controlled substance
- Schedule I controlled substance
- Schedule II controlled substance (Correct answer)
- Schedule IV controlled substance
Correct answer: Schedule II controlled substance
Amphetamine-based stimulants like Adderall are classified as Schedule II controlled substances due to their high potential for abuse and dependence.
Question 4: Wernicke-Korsakoff syndrome, associated with chronic alcohol use, is caused by a deficiency of which vitamin?
- Vitamin B12 (cobalamin)
- Vitamin D
- Vitamin B1 (thiamine) (Correct answer)
- Folic acid
Correct answer: Vitamin B1 (thiamine)
Chronic alcohol use impairs thiamine (vitamin B1) absorption, leading to Wernicke encephalopathy and, if untreated, permanent Korsakoff syndrome.
Question 5: Which of the following is an example of a harm reduction strategy for people who use drugs?
- Requiring abstinence before entering treatment
- Distributing sterile syringes to reduce disease transmission (Correct answer)
- Mandating drug testing as a condition of services
- Withholding services until the client is ready to quit
Correct answer: Distributing sterile syringes to reduce disease transmission
Needle and syringe programs are evidence-based harm reduction interventions that reduce HIV and hepatitis transmission without requiring abstinence.
Question 6: Anhedonia in early recovery from stimulant use is primarily caused by:
- Increased serotonin activity in the limbic system
- Dopaminergic system dysregulation and reduced reward sensitivity (Correct answer)
- Elevated norepinephrine levels
- Overactivation of the endocannabinoid system
Correct answer: Dopaminergic system dysregulation and reduced reward sensitivity
Chronic stimulant use depletes and dysregulates dopamine systems, leading to anhedonia — the inability to experience pleasure — during early abstinence.
Question 7: Which of the following statements about relapse in substance use disorder is most accurate?
- Relapse indicates treatment failure and should restart the process
- Relapse is an uncommon event for most people in recovery
- Relapse is a normal part of the chronic disease process and a learning opportunity (Correct answer)
- A single relapse means the client cannot recover
Correct answer: Relapse is a normal part of the chronic disease process and a learning opportunity
Relapse rates for substance use disorders are similar to other chronic diseases; relapse is viewed as part of the recovery process, not a sign of permanent failure.
CRS Substance Abuse Knowledge 5
Which of the following best describes 'co-occurring disorders' in the context of substance use treatment?