NAADAC TEST BANK MIDTERM AND FINAL EXAM
STUDY GUIDE| 300 QUESTIONS AND 100 % CORRECT
ANSWERS | RATED A QUIZ BANK | LATEST, |
1. A wife refers her husband for substance abuse counseling. His drug of choice is cocaine,
which he has been using episodically with friends at a poker game—biweekly to weekly—for
some years. She is disturbed at the illicit nature of the drug and the long-standing use. He states
that though he recreationally uses, he does not crave cocaine, does not seek it out but rather
uses with friends at the game who bring it, and he feels that other than his wife being upset
about him using, he has no other social or occupational issues. Given the information provided,
how is his use of cocaine BEST described?
a. Substance abuse
b. Cocaine intoxication
c. Cocaine use disorder
d. None of the above
D. None of the above
The DSM lists a set of eleven symptoms, 2 or more of which must have occurred at any time
during the past 12 months for a diagnosis of substance use disorder. 1) Tolerance, defined as
either the need for larger and larger amounts of the drug in question over time to achieve the
desired result, or a decrease in the effect of the drug with continued use of the same amount 2)
Withdrawal, defined by either the known withdrawal symptoms for a particular drug, or by the
fact that the drug, or a similar drug, is taken to avoid withdrawal symptoms 3) An increase in the
amount of the drug taken, or the continued use of the drug past the intended time 4) An
inability to control usage 5) A large amount of time and effort devoted to obtaining the drug in
question, using the drug in question, or recovering from its effects 6) The giving up of important
activities in order to obtain or use the drug in question, or recover from its effects 7) The
continued use of the drug in question regardless of the ill effects it has caused. 8) Craving 9)
Recurrent drug use which leads to inability to fulfil major role 10) Recurrent drug use though it
is physically harmful 11) Recurrent drug use despite it leading to continued social problems. He
1|Page
,does not meet the criteria for current intoxication either. Recreational use commonly occurs
biweekly or weekly, and the use is typically for reasons of sociality. Substance abuse counseling
is therefore not indicated. However, counseling regarding the potential for life circumstances,
stressors, or other unexpected losses or burdens to precipitate a future substance abuse
problem should be discussed.
2. What does the experienced effect of a drug depend upon?
a. The amount taken and past drug experiences
b. The modality of administration
c. Poly drug use, setting, and circumstance
d. All of the above
D: All of the Above
The amount of a drug ingested will typically affect the user's experience, with higher doses
often producing a greater effect (though potentially diminishing over time as tolerance
develops). The modality of administration can greatly influence the rate of the drug's uptake
into the system. Normally the rate of effect, from greatest to least, is: inhalation (snorting or
smoking), injection (intravenous, intramuscular, or subcutaneous), and ingestion (sublingual or
swallowing with or without food). Generally, the faster the systemic uptake, the shorter and
more intense the high experienced. Polydrug abuse greatly complicates the drug experience,
particularly if the drugs used are chemical antagonists (e.g., stimulants and depressants—such
as meth and alcohol), additive (producing a cumulative effect), synergistic (more than
cumulative), or potentiating (each enhancing each other). The setting in which the substance
use occurs is also often a significant contributor to the experience. The feelings engendered by
the surroundings, the people with whom the experience is shared, the attitudes and reactions
of others involved, as well as personal past drug experiences and individual biology all combine
to produce a drug experience.
3. How is drug tolerance BEST described?
a. The inability to get intoxicated
b. The need for more of a drug to get intoxicated
c. Increased sensitivity to a drug over time
d. Decreased sensitivity to a drug over time
D: Decreased sensitivity to a drug over time
When a drug is used regularly, the body is gradually able to adapt to the effects of the drug.
Evidence of tolerance is twofold: (1) greater doses of the drug are required to achieve previous
effects, and (2) doses that would have produced profound physiological compromise or even
2|Page
,death are now readily tolerated without untoward effects. In some cases, it has been noted that
up to ten times a lethal dosage, or even more, may be taken without any signs of significant
physiological compromise. Tolerance develops as the body seeks homeostasis, or a functional
state of equilibrium, in spite of the presence of the drug.
4. Which of the following is NOT a "drug cue"?
a. A prior drug-use setting
b. Drug use paraphernalia
c. Seeing others use drugs
d. Drug avoidance strategies
D: Drug avoidance strategies
Intense drug euphoria produces extremely intense, emotionally imprinted memory engrams,
coupled with long-term changes in the amygdala area of the brain, which operate outside of
conscious control. Key euphoric memories become integrally connected to sights, sounds,
smells, people, and places previously associated with drug use. The reappearance of any of
these past drug cues will often effectively trigger intense, amygdala-driven cravings for a drug.
Cravings are further intensified by lingering imbalances in brain metabolism patterns, receptor
availability, hormone levels, and other hypothalamus and pituitary-mediated sensations of
dysphoria and distress. The cascading nature of these effects frequently induces a drug-use
relapse.
5. What happens as tolerance for barbiturates develops?
a. The margin between intoxication and lethality increases.
b. The margin between intoxication and lethality decreases.
c. The margin between intoxication and lethality stays the same.
d. Tolerance does not develop for barbiturates.
C: The margin between intoxication and lethality stays the same.
While tolerance for barbiturates does develop, tolerance for an otherwise lethal dose only
marginally increases and never exceeds twofold. This means that the likelihood of an
unintentional fatal dose increases substantially over time as the need for the intoxicating effect
pushes that threshold ever closer to a lethal dose. Given the impairments in memory and
judgment that typically accompany CNS depressant intoxication, simple forgetfulness can lead
to a fatal overdose. Finally, using barbiturates with any other CNS depressant substance, such as
alcohol, can result in an additive CNS depression that can readily be fatal. Death most often
occurs via respiratory or cardiac suppression.
3|Page
, 6. What is the MOST common symptom of Wernicke's encephalopathy?
a. New memory formation
b. Loss of older memories
c. Psychosis
d. Confusion
D: Confusion
Other symptoms of Wernicke's encephalopathy include poor muscle coordination and
oculomotor impairment (problems moving the eyes in a controlled fashion). Wernicke's
syndrome is a short-term condition resulting from vitamin B1 (thiamine) deficiency, typically
developing after years of drinking and poor nutrition. Of those with Wernicke's syndrome, 80 to
90 percent will develop long-term psychosis and memory problems known as Korsakoff
syndrome. While poor coordination is a symptom, retrograde amnesia (loss of old memories)
and learning impairments are among the more classic hallmarks of the condition. Because they
are so often found together, the two syndromes are often referred to concurrently as Wernicke-
Korsakoff syndrome.
7. Which of the following conditions does alcohol NOT induce?
a. Steatosis
b. Nephrosis
c. Hepatitis
d. Cirrhosis
B: Hepatitis
Hepatitis refers to inflammation of the liver. Alcohol is toxic to all body tissues. Because alcohol
must be metabolized by the liver, it is particularly susceptible to the toxic effects. Consequently,
many heavy drinkers suffer from alcoholic hepatitis, characterized by abdominal pain, nausea,
vomiting, and a swollen liver. In more extreme cases, jaundice and bleeding can result. Jaundice
(a yellowing of the skin and whites of the eyes) is from bilirubin, a by-product of aging red blood
cells broken down in the liver, that should have been fully metabolized by the liver. Spontaneous
bleeding occurs because key clotting factors are made in the liver, but production is inhibited by
hepatitis. Steatosis consists of fatty deposits in the liver that, if severe, can prove fatal. Cirrhosis
refers to scarring of the liver from alcohol damage, preventing its normal functioning. High
blood toxins can also cause hepatic encephalopathy—a reversible dementia—if the toxins are
reduced.
8. What does formication refer to?
a. The creation of freebase cocaine
4|Page
STUDY GUIDE| 300 QUESTIONS AND 100 % CORRECT
ANSWERS | RATED A QUIZ BANK | LATEST, |
1. A wife refers her husband for substance abuse counseling. His drug of choice is cocaine,
which he has been using episodically with friends at a poker game—biweekly to weekly—for
some years. She is disturbed at the illicit nature of the drug and the long-standing use. He states
that though he recreationally uses, he does not crave cocaine, does not seek it out but rather
uses with friends at the game who bring it, and he feels that other than his wife being upset
about him using, he has no other social or occupational issues. Given the information provided,
how is his use of cocaine BEST described?
a. Substance abuse
b. Cocaine intoxication
c. Cocaine use disorder
d. None of the above
D. None of the above
The DSM lists a set of eleven symptoms, 2 or more of which must have occurred at any time
during the past 12 months for a diagnosis of substance use disorder. 1) Tolerance, defined as
either the need for larger and larger amounts of the drug in question over time to achieve the
desired result, or a decrease in the effect of the drug with continued use of the same amount 2)
Withdrawal, defined by either the known withdrawal symptoms for a particular drug, or by the
fact that the drug, or a similar drug, is taken to avoid withdrawal symptoms 3) An increase in the
amount of the drug taken, or the continued use of the drug past the intended time 4) An
inability to control usage 5) A large amount of time and effort devoted to obtaining the drug in
question, using the drug in question, or recovering from its effects 6) The giving up of important
activities in order to obtain or use the drug in question, or recover from its effects 7) The
continued use of the drug in question regardless of the ill effects it has caused. 8) Craving 9)
Recurrent drug use which leads to inability to fulfil major role 10) Recurrent drug use though it
is physically harmful 11) Recurrent drug use despite it leading to continued social problems. He
1|Page
,does not meet the criteria for current intoxication either. Recreational use commonly occurs
biweekly or weekly, and the use is typically for reasons of sociality. Substance abuse counseling
is therefore not indicated. However, counseling regarding the potential for life circumstances,
stressors, or other unexpected losses or burdens to precipitate a future substance abuse
problem should be discussed.
2. What does the experienced effect of a drug depend upon?
a. The amount taken and past drug experiences
b. The modality of administration
c. Poly drug use, setting, and circumstance
d. All of the above
D: All of the Above
The amount of a drug ingested will typically affect the user's experience, with higher doses
often producing a greater effect (though potentially diminishing over time as tolerance
develops). The modality of administration can greatly influence the rate of the drug's uptake
into the system. Normally the rate of effect, from greatest to least, is: inhalation (snorting or
smoking), injection (intravenous, intramuscular, or subcutaneous), and ingestion (sublingual or
swallowing with or without food). Generally, the faster the systemic uptake, the shorter and
more intense the high experienced. Polydrug abuse greatly complicates the drug experience,
particularly if the drugs used are chemical antagonists (e.g., stimulants and depressants—such
as meth and alcohol), additive (producing a cumulative effect), synergistic (more than
cumulative), or potentiating (each enhancing each other). The setting in which the substance
use occurs is also often a significant contributor to the experience. The feelings engendered by
the surroundings, the people with whom the experience is shared, the attitudes and reactions
of others involved, as well as personal past drug experiences and individual biology all combine
to produce a drug experience.
3. How is drug tolerance BEST described?
a. The inability to get intoxicated
b. The need for more of a drug to get intoxicated
c. Increased sensitivity to a drug over time
d. Decreased sensitivity to a drug over time
D: Decreased sensitivity to a drug over time
When a drug is used regularly, the body is gradually able to adapt to the effects of the drug.
Evidence of tolerance is twofold: (1) greater doses of the drug are required to achieve previous
effects, and (2) doses that would have produced profound physiological compromise or even
2|Page
,death are now readily tolerated without untoward effects. In some cases, it has been noted that
up to ten times a lethal dosage, or even more, may be taken without any signs of significant
physiological compromise. Tolerance develops as the body seeks homeostasis, or a functional
state of equilibrium, in spite of the presence of the drug.
4. Which of the following is NOT a "drug cue"?
a. A prior drug-use setting
b. Drug use paraphernalia
c. Seeing others use drugs
d. Drug avoidance strategies
D: Drug avoidance strategies
Intense drug euphoria produces extremely intense, emotionally imprinted memory engrams,
coupled with long-term changes in the amygdala area of the brain, which operate outside of
conscious control. Key euphoric memories become integrally connected to sights, sounds,
smells, people, and places previously associated with drug use. The reappearance of any of
these past drug cues will often effectively trigger intense, amygdala-driven cravings for a drug.
Cravings are further intensified by lingering imbalances in brain metabolism patterns, receptor
availability, hormone levels, and other hypothalamus and pituitary-mediated sensations of
dysphoria and distress. The cascading nature of these effects frequently induces a drug-use
relapse.
5. What happens as tolerance for barbiturates develops?
a. The margin between intoxication and lethality increases.
b. The margin between intoxication and lethality decreases.
c. The margin between intoxication and lethality stays the same.
d. Tolerance does not develop for barbiturates.
C: The margin between intoxication and lethality stays the same.
While tolerance for barbiturates does develop, tolerance for an otherwise lethal dose only
marginally increases and never exceeds twofold. This means that the likelihood of an
unintentional fatal dose increases substantially over time as the need for the intoxicating effect
pushes that threshold ever closer to a lethal dose. Given the impairments in memory and
judgment that typically accompany CNS depressant intoxication, simple forgetfulness can lead
to a fatal overdose. Finally, using barbiturates with any other CNS depressant substance, such as
alcohol, can result in an additive CNS depression that can readily be fatal. Death most often
occurs via respiratory or cardiac suppression.
3|Page
, 6. What is the MOST common symptom of Wernicke's encephalopathy?
a. New memory formation
b. Loss of older memories
c. Psychosis
d. Confusion
D: Confusion
Other symptoms of Wernicke's encephalopathy include poor muscle coordination and
oculomotor impairment (problems moving the eyes in a controlled fashion). Wernicke's
syndrome is a short-term condition resulting from vitamin B1 (thiamine) deficiency, typically
developing after years of drinking and poor nutrition. Of those with Wernicke's syndrome, 80 to
90 percent will develop long-term psychosis and memory problems known as Korsakoff
syndrome. While poor coordination is a symptom, retrograde amnesia (loss of old memories)
and learning impairments are among the more classic hallmarks of the condition. Because they
are so often found together, the two syndromes are often referred to concurrently as Wernicke-
Korsakoff syndrome.
7. Which of the following conditions does alcohol NOT induce?
a. Steatosis
b. Nephrosis
c. Hepatitis
d. Cirrhosis
B: Hepatitis
Hepatitis refers to inflammation of the liver. Alcohol is toxic to all body tissues. Because alcohol
must be metabolized by the liver, it is particularly susceptible to the toxic effects. Consequently,
many heavy drinkers suffer from alcoholic hepatitis, characterized by abdominal pain, nausea,
vomiting, and a swollen liver. In more extreme cases, jaundice and bleeding can result. Jaundice
(a yellowing of the skin and whites of the eyes) is from bilirubin, a by-product of aging red blood
cells broken down in the liver, that should have been fully metabolized by the liver. Spontaneous
bleeding occurs because key clotting factors are made in the liver, but production is inhibited by
hepatitis. Steatosis consists of fatty deposits in the liver that, if severe, can prove fatal. Cirrhosis
refers to scarring of the liver from alcohol damage, preventing its normal functioning. High
blood toxins can also cause hepatic encephalopathy—a reversible dementia—if the toxins are
reduced.
8. What does formication refer to?
a. The creation of freebase cocaine
4|Page
