Page 1 of 241
ASAM EXAM BANK | {LATEST 2026/ 2027
UPDATE} COMPLETE ACTUAL AND AUTHENTIC
EXAM | BRAND NEW!
1. A 25-year-old woman who has just given birth is concerned
that her child has inherited a predisposition for smoking. She and
the child's father have recently quit smoking, but many of their
first- and second-degree family member’s smoke. The risk that
this child will smoke based on genetic factors alone is closest to
what percentage?
60%(ref: Reference: Sullivan PF, Kendler KS: The genetic
epidemiology of smoking. Nicotine Tob Res 1999;1 Suppl 2: S51-
S57.)
2. A 23-year-old man is currently undergoing treatment for
heroin dependence. He reports that his heroin dealer gave him a
small supply while he was experiencing withdrawal symptoms.
The patient will most likely perceive heroin as which of the
following?
negative reinforcement (ref: Molecular Neuropharmacology,
Nestler, et al. 2001 p. 356)
,Page 2 of 241
3. A 25-year-old man is abusing a drug of choice daily and at
relatively consistent amounts. Which of the following drugs is he
most likely using?
heroin (ref: Molecular Neuropharmacology, Nestler, et al. 2001 p.
361)
4. A 48-year-old man comes for consultation after seeing light
trails behind moving objects and having the feeling that he could
"smell colors" around him. These symptoms first occurred one
day after he began lifting weights to relieve work-related stress.
He says that he has used lysergic acid diethylamide (LSD),
cocaine, gamma-hydroxybutyrate (GHB), kava kava, and toluene
in the past. Which of the following drugs is most likely
responsible?
LSD (ref: Weaver MF, Schnoll SH. Hallucinogens and club drugs.
In M. Galanter & H. D. Klebert (Eds.), Textbook of Substance
Abuse Treatment, 4th Ed., Washington, D.C.: American Psychiatric
Press, pp 191-200, 2008)
,Page 3 of 241
5. A 48-year-old man comes for consultation after seeing light
trails behind moving objects and having the feeling that he could
"smell colors" around him. These symptoms first occurred one
day after he began lifting weights to relieve work-related stress.
He says that he has used lysergic acid diethylamide (LSD),
cocaine, gamma-hydroxybutyrate (GHB), kava kava, and toluene
in the past. Within which of the following time frames did this
patient most likely use this drug?
one year (same ref as 23)
6. A 26-year-old man is brought to the emergency department by
his roommates two hours after he became agitated and
confused. They report that he was not drinking alcohol or using
illicit drugs prior to the change in behavior. For the past six
months, he has been taking a liquid supplement obtained from a
trainer at his gym. He had used the supplement every two to four
hours daily, but stopped six hours ago because he had begun to
need more of it to achieve its calming effect and he was unable
to fall asleep without using it. He has no history of serious illness
and takes no other medications. The patient is agitated and
restless. He says he hears voices he does not recognize and
sees things "moving that are not moving." His pulse is 104/min
and blood pressure is 170/100 mm Hg. Physical examination
, Page 4 of 241
shows vertical nystagmus and a fine tremor in both of his upper
extremities. He is unable to sit through the examinatio
begin high-dose diazepam (ref: Graham et al. Principles of
Addiction Medicine: Third Edition. 2003, 686-690)
7. A 26-year-old man is brought to the emergency department by
his roommates two hours after he became agitated and
confused. They report that he was not drinking alcohol or using
illicit drugs prior to the change in behavior. For the past six
months, he has been taking a liquid supplement obtained from a
trainer at his gym. He had used the supplement every two to four
hours daily, but stopped six hours ago because he had begun to
need more of it to achieve its calming effect and he was unable
to fall asleep without using it. He has no history of serious illness
and takes no other medications. The patient is agitated and
restless. He says he hears voices he does not recognize and
sees things "moving that are not moving." High-dose diazepam is
administered. The patient does not improve and he becomes
increasingly combative. He is subdued by hospital staff and
restraints are applied. Which of the following is the most
propofol (same ref as 25)
ASAM EXAM BANK | {LATEST 2026/ 2027
UPDATE} COMPLETE ACTUAL AND AUTHENTIC
EXAM | BRAND NEW!
1. A 25-year-old woman who has just given birth is concerned
that her child has inherited a predisposition for smoking. She and
the child's father have recently quit smoking, but many of their
first- and second-degree family member’s smoke. The risk that
this child will smoke based on genetic factors alone is closest to
what percentage?
60%(ref: Reference: Sullivan PF, Kendler KS: The genetic
epidemiology of smoking. Nicotine Tob Res 1999;1 Suppl 2: S51-
S57.)
2. A 23-year-old man is currently undergoing treatment for
heroin dependence. He reports that his heroin dealer gave him a
small supply while he was experiencing withdrawal symptoms.
The patient will most likely perceive heroin as which of the
following?
negative reinforcement (ref: Molecular Neuropharmacology,
Nestler, et al. 2001 p. 356)
,Page 2 of 241
3. A 25-year-old man is abusing a drug of choice daily and at
relatively consistent amounts. Which of the following drugs is he
most likely using?
heroin (ref: Molecular Neuropharmacology, Nestler, et al. 2001 p.
361)
4. A 48-year-old man comes for consultation after seeing light
trails behind moving objects and having the feeling that he could
"smell colors" around him. These symptoms first occurred one
day after he began lifting weights to relieve work-related stress.
He says that he has used lysergic acid diethylamide (LSD),
cocaine, gamma-hydroxybutyrate (GHB), kava kava, and toluene
in the past. Which of the following drugs is most likely
responsible?
LSD (ref: Weaver MF, Schnoll SH. Hallucinogens and club drugs.
In M. Galanter & H. D. Klebert (Eds.), Textbook of Substance
Abuse Treatment, 4th Ed., Washington, D.C.: American Psychiatric
Press, pp 191-200, 2008)
,Page 3 of 241
5. A 48-year-old man comes for consultation after seeing light
trails behind moving objects and having the feeling that he could
"smell colors" around him. These symptoms first occurred one
day after he began lifting weights to relieve work-related stress.
He says that he has used lysergic acid diethylamide (LSD),
cocaine, gamma-hydroxybutyrate (GHB), kava kava, and toluene
in the past. Within which of the following time frames did this
patient most likely use this drug?
one year (same ref as 23)
6. A 26-year-old man is brought to the emergency department by
his roommates two hours after he became agitated and
confused. They report that he was not drinking alcohol or using
illicit drugs prior to the change in behavior. For the past six
months, he has been taking a liquid supplement obtained from a
trainer at his gym. He had used the supplement every two to four
hours daily, but stopped six hours ago because he had begun to
need more of it to achieve its calming effect and he was unable
to fall asleep without using it. He has no history of serious illness
and takes no other medications. The patient is agitated and
restless. He says he hears voices he does not recognize and
sees things "moving that are not moving." His pulse is 104/min
and blood pressure is 170/100 mm Hg. Physical examination
, Page 4 of 241
shows vertical nystagmus and a fine tremor in both of his upper
extremities. He is unable to sit through the examinatio
begin high-dose diazepam (ref: Graham et al. Principles of
Addiction Medicine: Third Edition. 2003, 686-690)
7. A 26-year-old man is brought to the emergency department by
his roommates two hours after he became agitated and
confused. They report that he was not drinking alcohol or using
illicit drugs prior to the change in behavior. For the past six
months, he has been taking a liquid supplement obtained from a
trainer at his gym. He had used the supplement every two to four
hours daily, but stopped six hours ago because he had begun to
need more of it to achieve its calming effect and he was unable
to fall asleep without using it. He has no history of serious illness
and takes no other medications. The patient is agitated and
restless. He says he hears voices he does not recognize and
sees things "moving that are not moving." High-dose diazepam is
administered. The patient does not improve and he becomes
increasingly combative. He is subdued by hospital staff and
restraints are applied. Which of the following is the most
propofol (same ref as 25)
