SAP Substance Abuse Diagnosis 2 — Questions and Answers
Question 1: According to DSM-5, how many criteria must be met within a 12-month period to diagnose a moderate Alcohol Use Disorder?
- 2-3 criteria
- 4-5 criteria (Correct answer)
- 6-7 criteria
- 8 or more criteria
Correct answer: 4-5 criteria
DSM-5 defines moderate AUD as meeting 4-5 of the 11 diagnostic criteria within a 12-month period.
Question 2: Which of the following is NOT one of the DSM-5 diagnostic criteria for a Substance Use Disorder?
- Taking the substance in larger amounts than intended
- Experiencing a single episode of intoxication (Correct answer)
- Continued use despite persistent social problems
- Giving up important activities because of substance use
Correct answer: Experiencing a single episode of intoxication
A single episode of intoxication alone does not meet any DSM-5 criterion for a Substance Use Disorder.
Question 3: A DOT-regulated employee tests positive for marijuana metabolites. The SAP's role in diagnosis includes:
- Determining if the employee has a diagnosable Cannabis Use Disorder (Correct answer)
- Reporting the result directly to the driver's supervisor
- Waiving further evaluation if the employee has a medical marijuana card
- Prescribing treatment before completing evaluation
Correct answer: Determining if the employee has a diagnosable Cannabis Use Disorder
The SAP must conduct a face-to-face clinical evaluation to determine if a diagnosable SUD or alcohol problem exists.
Question 4: When differentiating between substance dependence and substance abuse under older DSM-IV criteria (still referenced in some training), the hallmark feature of dependence was:
- Recurrent legal problems
- Tolerance and/or withdrawal (Correct answer)
- Failure to fulfill major role obligations
- Use in physically hazardous situations
Correct answer: Tolerance and/or withdrawal
Under DSM-IV, physiological dependence marked by tolerance and/or withdrawal was the distinguishing feature of a dependence diagnosis.
Question 5: An employee presents with blackouts, morning drinking to steady nerves, and repeated failed attempts to cut down. Which DSM-5 severity level is MOST consistent with this presentation?
- Mild AUD (2-3 criteria)
- Moderate AUD (4-5 criteria)
- Severe AUD (6+ criteria) (Correct answer)
- Alcohol Intoxication, not AUD
Correct answer: Severe AUD (6+ criteria)
Multiple impaired-control, risky-use, and pharmacological criteria being met together points to severe Alcohol Use Disorder.
Question 6: Craving, as a symptom in DSM-5 Substance Use Disorder diagnosis, refers to:
- A strong desire or urge to use the substance (Correct answer)
- Withdrawal-induced physical pain requiring medication
- A court-mandated evaluation finding
- The financial cost of obtaining the substance
Correct answer: A strong desire or urge to use the substance
DSM-5 added craving—a strong desire or urge to use the substance—as one of the 11 diagnostic criteria for SUD.
Question 7: A SAP conducting a diagnosis should consider co-occurring mental health disorders because:
- DOT requires a psychiatric diagnosis before returning to duty
- Untreated mental health conditions can directly affect substance use relapse risk (Correct answer)
- Dual diagnoses automatically disqualify employees from safety-sensitive positions
- Co-occurring disorders require a psychiatrist to perform the SAP evaluation
Correct answer: Untreated mental health conditions can directly affect substance use relapse risk
Identifying co-occurring disorders is clinically important because untreated mental health conditions significantly increase relapse risk and affect treatment planning.
SAP Substance Abuse Diagnosis 2
According to DSM-5, how many criteria must be met within a 12-month period to diagnose a moderate Alcohol Use Disorder?