,TESTBANK FOR Counseling Individuals With Co-
Occurring Addictive and Mental Disorders Holt
Notes
1- The file is chapter after chapter.
2- We have shown you few pages sample.
3- The file contains all Appendix and Excel sheet
if it exists.
4- We have all what you need, we make update
at every time. There are many new editions
waiting you.
5- If you think you purchased the wrong file You
can contact us at every time, we can replace it
with true one.
Our email:
, COUNSELING INDIVIDUALS WITH CO-OCCURRING
ADDICTIVE
AND MENTAL DISORDERS:
A COMPREHENSIVE APPROACH
Regina R. Moro, PhD, LCPC, LMHC, LCAS, NCC
Reginald W. Holt, PhD, LPC, LCPC, NCC, MAC, AADC, ICAADC
EDITORS
Chapter 1
Considerations for Treating Co-Occurring Mental and Substance Use Disorders
1. Which of the following terms are appropriate for use when referring to clients who have both a
mental disorder and a substance use disorder?
a. Mentally ill substance abusers
b. Substance abusing mentally ill
c. Mentally ill chemically addicted
*d. None of the above
Earlier terms such as mentally ill substance abusers, substance abusing mentally ill, and mentally
ill chemically addicted are outdated. Counselors identifying their clients using language such as
“having a diagnosis of co-occurring anxiety and alcohol use disorder” is a much more humanizing
and person-centered approach than adopting terminology that labels others and reinforces stigma.
2. Counselors need to receive training on screening for and detecting the presence of co-occurring
mental and substance use disorders (co-occurring disorder (CODs)) only if the following applies:
a. They work in an integrated treatment setting for CODs.
b. They work in a setting that specializes in the treatment of substance use disorders.
*c. Regardless of the treatment setting, counselors should be aware of how to screen and detect
the presence of CODs.
d. They work in a setting that specializes in the treatment of mental disorders.
Counselors-in-training who indicate they plan to only work with clients who have mental disorders
(or vice versa for substance use disorders) will be remiss if they incorrectly believe they will not
need to be cross-trained on CODs. Regardless of a counselor’s preferred client population or
specialization area, the informed clinician fully understands that all clients need to be screened for
both mental and substance use symptomatology despite the initial chief complaint and/or self-
identified presenting problem.
3. Which of the following statements regarding the etiology of CODs are inaccurate (select all that
apply)?
*a. Substance use disorders usually develops in response to self-medicating mental disorder
symptomatology.
b. Substance use may contribute to the formation of a mental illness (and vice versa), therefore, each
disorder-type will more than likely impact as well as intensify the other.
*c. Treatment needs to focus on alleviating the disorder that first developed because when the
primary disorder is successfully addressed, and then the secondary disorder will subside.
*d. Only clients who have a family history of addiction are susceptible to developing a
substance use disorder.
, Just because individuals who have a substance use disorder may also have a co-occurring mental
illness, it should not always be assumed that one disorder precipitated the other regardless of
which emerged first. However, there are many risk factors that counselors should recognize when
examining the reasons for the existence of CODs in clients. These include but are not limited to
genetic factors, lifespan development, neurobiology, and environmental factors. Even though
substance use may contribute to the formation of a mental illness (and vice versa), each disorder-
type will more than likely impact as well as intensify the other; therefore, both require counselors
to address each equally even though each disorder may not be equivalent in severity.
4. Because CODs have a bidirectional characteristic, research indicates that patterns of harmful substance
use are correlated more highly with certain mental disorders. Considering this statement, as well as
information presented in the chapter, which of the following mental disorders do not have a high
correlation with substance use?
*a. Tourette’s disorder
b. Bipolar disorder
c. Social anxiety disorder
d. Antisocial personality disorder
Research indicates that patterns of harmful substance use are correlated more highly with certain
mental disorders such as bipolar disorder, anxiety disorder (especially social anxiety disorder), and
antisocial and schizotypal personality disorders.
5. Which one of the following co-occurring personality and substance use disorders is more likely to
occur in men?
a. Paranoid personality disorder and stimulant use disorder
b. Borderline personality disorder and cannabis use disorder
c. Obsessive-compulsive personality disorder and opioid use disorder
*d. Antisocial personality disorder and alcohol use disorder
According to information presented in SAMHSA’s Substance Use Disorder Treatment for People
with Co-Occurring Disorders: Treatment Improvement Protocol 42 (2020), alcohol use disorder
is more likely to co-occur in men diagnosed with antisocial personality disorder.
6. Which of the following most accurately defines the screening process?
a. A comprehensive and thorough evaluation requiring input from every stakeholder involved in the
client’s care.
b. A process that should only be conducted by medical personnel (i.e., psychiatrists, primary care
physicians, nurses).
*c. A brief, routine process designed to identify indicators, or “red flags,” for the presence of
mental health, substance use, or other issues that reflect an individual’s need for treatment.
d. A process that requires referring the client to a counselor who specializes in the treatment of
CODs.
Simply defined, screening is a “brief, routine process designed to identify indicators, or ‘red flags,’
for the presence of mental health, substance use, or other issues that reflect an individual’s need for
treatment” (SAMHSA, 2015, p. 19). The screening procedures designed to reveal the existence of
mental and/or substance problems typically involve one or any combination of the following: (a)
conducting brief, yet focused, interviews with clients, (b) using clinician-administered or client
self-report screening instruments, and (c) obtaining information from collateral sources with the
, written consent of the client when ethically and legally applicable. The object of screening for
CODs is to ask specific questions that will yield either a “yes” or “no” response to identify warning
signs that potentially indicate the client is experiencing mental and/or substance abuse issues. And
for those clients whose responses yield positive results, the practitioner should either refer out or
follow-up with a more comprehensive assessment to determine the severity and possible diagnoses
of mental and substance use disorders.
7. Which of the following components is involved in the process of screening for mental disorders?
a. Acute safety risk
b. Past and present mental illness symptoms and disorders
c. Cognitive and learning deficits
d. Past and present victimization and trauma
*e. All of the above
According to SAMHSA (2020, p. 42), mental disorder screening in addiction treatment settings
involves four major components: (a) acute safety risk including suicide, violence to others,
inability to care for oneself, risky behaviors, and danger of physical or sexual victimization, (b)
past and present mental illness symptoms and disorders, (c) cognitive and learning deficits, and
(d) past and present victimization and trauma regardless of the treatment setting.
8. Of the three program types identified by the American Society of Addiction Medicine, which is the
most effective for treating co-occurring disorders?
a. Co-occurring-capable
b. Co-occurring-enhanced
c. Complexity-capable
d. Sequential treatment regardless of the program type
*e. Integrated treatment regardless of the program type
The American Society of Addiction Medicine identified three program types for the treatment of
CODs: (a) co-occurring-capable, (b) co-occurring-enhanced, and (c) complexity-capable. Despite
the program type, those offering integrated services for the treatment of co-occurring mental and
substance use disorders are more effective than those who address each disorder sequentially
(within the same healthcare system) or simultaneously (in separate healthcare systems).
9. Which of the following statements accurately depicts one competency area of counselors working
with clients who have co-occurring disorders?
*a. Counselors should be aware of populations who have a greater risk of developing CODs as
well as how to design interventions to address the needs of these clients.
b. Counselors only need to be knowledgeable of how to treat mental disorders because they should
always refer clients with substance use issues to a specialist.
c. Counselors working in a large treatment facility do not need to worry about ethical codes and
legal statutes because higher administration will handle issues related to these topics.
d. Counselors should not involve themselves in discussing pharmacology with clients because they
are not licensed to prescribe medications.
There are certain populations who have a greater risk of developing CODs and experiencing poorer
treatment outcomes. Included within these are military personnel (active duty and veterans), clients
who identify as women, people experiencing homeless, individuals involved in the criminal legal
system, and those of diverse racial and ethnic backgrounds. Counselors should not only be
, knowledgeable of the vulnerabilities associated with these groups, they should also know how to
design interventions that meet the complex needs of at-risk clients.
10. Research has indicated that a strong working alliance with clients is positively correlated with recovery
outcomes. To develop a therapeutic relationship with clients, SAMSHA identified 10 guidelines that
counselors can follow. Of the few that are listed below, which one does not belong?
a. Develop and use a therapeutic alliance to engage clients in treatment
*b. Use coercion with resistant clients to move them through the process of change
c. Use supportive and empathic counseling
d. Use culturally responsive methods
e. Use motivational enhancement
Arguing or using aggressive methods with clients are labeled as “resistant” only serves to interfere
with establishing a positive counselor-client relationship. The following guidelines offered by
SAMHSA can be used by counselors to maximize the development of a successful therapeutic
alliance with individuals who have CODs:
1. Develop and use a therapeutic alliance to engage clients in treatment
2. Maintain a recovery perspective
3. Ensure continuity of care
4. Address common clinical challenges (e.g., countertransference, confidentiality)
5. Monitor psychiatric symptoms (including symptoms of self-harm)
6. Use supportive and empathic counseling; adopt a multi-problem viewpoint
7. Use culturally responsive methods
8. Use motivational enhancement
9. Teach relapse prevention techniques
10. Use repetition and skill building to address deficits in functioning
, COUNSELING INDIVIDUALS WITH CO-OCCURRING
ADDICTIVE
AND MENTAL DISORDERS:
A COMPREHENSIVE APPROACH
Regina R. Moro, PhD, LCPC, LMHC, LCAS, NCC
Reginald W. Holt, PhD, LPC, LCPC, NCC, MAC, AADC, ICAADC
EDITORS
Chapter 2
Understanding Drugs of Abuse and Addiction
True/False
1. In the United States, more individuals died from drug overdoses in the year 2021 than at any
other point in recorded history.
*a. True
b. False
Over 107,000 individuals died from drug overdoses in the United States in 2021, which is the
largest number recorded for deaths by drug overdose.
2. The opioid epidemic is the only epidemic related to psychoactive substances that counselors
need to be aware of.
a. True
*b. False
While the opioid epidemic is (and has been) a crisis in the United States, it is not the only
addiction epidemic that counselors need to be concerned about. Counselors need to be
concerned about all addictive substances, not only opioids.
Multiple Choice
3. All of the following are classified as central nervous system stimulants EXCEPT:
a. Amphetamines
b. Methamphetamine
c. Cocaine
*d. Cannabis
Cannabis is not classified as a central nervous system stimulant. Although at times it may
have stimulating effects for the user, it is classified as a psychedelic.
4. Short-term effects of methamphetamine use include:
*a. A sense of euphoria, appetite suppression, increased heart rate
b. A sense of euphoria, increased appetite, slowed breathing
c. Decreased energy, decreased body temperature, and an increased heart rate
d. A sense of despair, decreased energy, decreased body temperature
Methamphetamine use will generally increase many bodily functions and lead to a general
sense of euphoria. An exception to this is a user’s appetite, which is suppressed by
methamphetamine (and other amphetamine) use.
5. All of the following are common street names for prescription stimulants:
, a. Addies
b. Vitamin R
*c. Zannies*
d. Study Buddies
“Zannies” is a street name for Xanax, a benzodiazepine which is not a stimulant, it is a
depressant.
6. Which of the following is a central nervous system depressant:
a. Alcohol
b. Heroin
c. Benzodiazepines
*d. All of the above*
Alcohol, heroin, fentanyl, morphine, and benzodiazepines are all central nervous system
depressants. In addition, there are many other substances that are classified as CNS
depressants, including many prescription medications.
7. If a user injects a substance directly into their bloodstream, how long will it take until the
effects are felt?
a. 7 to 10 seconds
*b. 15 to 30 seconds*
c. 2 to 3 minutes
d. 5 or more minutes
Injecting a substance is the second fastest way for a user to feel the effects, following
inhalation which is the fastest route.
8. Which is the only behavioral addiction to be formerly classified in the Diagnostic and
Statistical Manual?
*a. Gambling disorder*
b. Internet gaming disorder
c. Sex addiction
d. Love addiction
Gambling disorder is the only non-substance addictive disorder currently in the diagnostic
manual as of 2013.
9. Which model of addiction suggests that addiction is a consequence of a user’s own personal
choices and failings?
a. Biopsychosocial model
b. Humanistic model
c. Brain disease model
*d. Moral model*
While the moral model of addiction has become quite outdated it continues to be a
contributing factor in how individuals perceive addiction by placing blame on the
individual person. The model perpetuates stigma in this way.
10. What concept is demonstrated when a person needs to take more of a substance to gain the
same effects over time?
a. Withdrawal
b. Abstinence
*c. Tolerance*
d. Sublimation
,Tolerance is when a user needs to take more of a substance to gain the same effects over
time—something that builds with regular use (Inaba & Cohen, 2007). This can be very
dangerous as it requires more of a substance to feel the effects and puts the user at risk for
overdose.
, COUNSELING INDIVIDUALS WITH CO-OCCURRING
ADDICTIVE
AND MENTAL DISORDERS:
A COMPREHENSIVE APPROACH
Regina R. Moro, PhD, LCPC, LMHC, LCAS, NCC
Reginald W. Holt, PhD, LPC, LCPC, NCC, MAC, AADC, ICAADC
EDITORS
Chapter 3
Neuroscience of Co-Occurring Mental and Substance Use Disorders
True/False:
1. There is evidence that volume reductions in the cortical and prefrontal regions as a result of
substance use can be reversed after just a few weeks of cessation of substances.
*a. True
b. False
The most consistent findings in the small but growing neuroscience of recovery
literature provide evidence that volume reductions in cortical and prefrontal regions
common in substance use can be reversed after just a few weeks of cessation from
substances (Garavan et al., 2013). This finding is perhaps not surprising given the
need for activating the cortical control networks to sustain abstinence – and the more
you “use” a brain structure or network (via neural firing), the stronger and better
connected it becomes.
Multiple Choice:
2. Neuroscience can contribute to all of the following EXCEPT
a. Broaden assessment protocols
*b. Provide a definitive explanation of individuals’ distress
c. Deepen case conceptualization
d. Inform treatment planning
There is no definitive way to explain an individual’s distress, although neuroscience
is able to provide insight into factors that may be involved.
3. The most basic building blocks of the brain are:
a. Neurons
b. Glial cells
c. Neurotransmitters
*d. A & B
Neurotransmitters are not building blocks of the brain, despite providing a vital role.
Neurotransmitters are the chemical messengers in the brain.
4. Which brain region plays a leading role in executive functions and regulation of thoughts,
feelings, and emotions?
*a. Prefrontal cortex
b. Limbic system
c. Brainstem
d. Occipital lobe
Occurring Addictive and Mental Disorders Holt
Notes
1- The file is chapter after chapter.
2- We have shown you few pages sample.
3- The file contains all Appendix and Excel sheet
if it exists.
4- We have all what you need, we make update
at every time. There are many new editions
waiting you.
5- If you think you purchased the wrong file You
can contact us at every time, we can replace it
with true one.
Our email:
, COUNSELING INDIVIDUALS WITH CO-OCCURRING
ADDICTIVE
AND MENTAL DISORDERS:
A COMPREHENSIVE APPROACH
Regina R. Moro, PhD, LCPC, LMHC, LCAS, NCC
Reginald W. Holt, PhD, LPC, LCPC, NCC, MAC, AADC, ICAADC
EDITORS
Chapter 1
Considerations for Treating Co-Occurring Mental and Substance Use Disorders
1. Which of the following terms are appropriate for use when referring to clients who have both a
mental disorder and a substance use disorder?
a. Mentally ill substance abusers
b. Substance abusing mentally ill
c. Mentally ill chemically addicted
*d. None of the above
Earlier terms such as mentally ill substance abusers, substance abusing mentally ill, and mentally
ill chemically addicted are outdated. Counselors identifying their clients using language such as
“having a diagnosis of co-occurring anxiety and alcohol use disorder” is a much more humanizing
and person-centered approach than adopting terminology that labels others and reinforces stigma.
2. Counselors need to receive training on screening for and detecting the presence of co-occurring
mental and substance use disorders (co-occurring disorder (CODs)) only if the following applies:
a. They work in an integrated treatment setting for CODs.
b. They work in a setting that specializes in the treatment of substance use disorders.
*c. Regardless of the treatment setting, counselors should be aware of how to screen and detect
the presence of CODs.
d. They work in a setting that specializes in the treatment of mental disorders.
Counselors-in-training who indicate they plan to only work with clients who have mental disorders
(or vice versa for substance use disorders) will be remiss if they incorrectly believe they will not
need to be cross-trained on CODs. Regardless of a counselor’s preferred client population or
specialization area, the informed clinician fully understands that all clients need to be screened for
both mental and substance use symptomatology despite the initial chief complaint and/or self-
identified presenting problem.
3. Which of the following statements regarding the etiology of CODs are inaccurate (select all that
apply)?
*a. Substance use disorders usually develops in response to self-medicating mental disorder
symptomatology.
b. Substance use may contribute to the formation of a mental illness (and vice versa), therefore, each
disorder-type will more than likely impact as well as intensify the other.
*c. Treatment needs to focus on alleviating the disorder that first developed because when the
primary disorder is successfully addressed, and then the secondary disorder will subside.
*d. Only clients who have a family history of addiction are susceptible to developing a
substance use disorder.
, Just because individuals who have a substance use disorder may also have a co-occurring mental
illness, it should not always be assumed that one disorder precipitated the other regardless of
which emerged first. However, there are many risk factors that counselors should recognize when
examining the reasons for the existence of CODs in clients. These include but are not limited to
genetic factors, lifespan development, neurobiology, and environmental factors. Even though
substance use may contribute to the formation of a mental illness (and vice versa), each disorder-
type will more than likely impact as well as intensify the other; therefore, both require counselors
to address each equally even though each disorder may not be equivalent in severity.
4. Because CODs have a bidirectional characteristic, research indicates that patterns of harmful substance
use are correlated more highly with certain mental disorders. Considering this statement, as well as
information presented in the chapter, which of the following mental disorders do not have a high
correlation with substance use?
*a. Tourette’s disorder
b. Bipolar disorder
c. Social anxiety disorder
d. Antisocial personality disorder
Research indicates that patterns of harmful substance use are correlated more highly with certain
mental disorders such as bipolar disorder, anxiety disorder (especially social anxiety disorder), and
antisocial and schizotypal personality disorders.
5. Which one of the following co-occurring personality and substance use disorders is more likely to
occur in men?
a. Paranoid personality disorder and stimulant use disorder
b. Borderline personality disorder and cannabis use disorder
c. Obsessive-compulsive personality disorder and opioid use disorder
*d. Antisocial personality disorder and alcohol use disorder
According to information presented in SAMHSA’s Substance Use Disorder Treatment for People
with Co-Occurring Disorders: Treatment Improvement Protocol 42 (2020), alcohol use disorder
is more likely to co-occur in men diagnosed with antisocial personality disorder.
6. Which of the following most accurately defines the screening process?
a. A comprehensive and thorough evaluation requiring input from every stakeholder involved in the
client’s care.
b. A process that should only be conducted by medical personnel (i.e., psychiatrists, primary care
physicians, nurses).
*c. A brief, routine process designed to identify indicators, or “red flags,” for the presence of
mental health, substance use, or other issues that reflect an individual’s need for treatment.
d. A process that requires referring the client to a counselor who specializes in the treatment of
CODs.
Simply defined, screening is a “brief, routine process designed to identify indicators, or ‘red flags,’
for the presence of mental health, substance use, or other issues that reflect an individual’s need for
treatment” (SAMHSA, 2015, p. 19). The screening procedures designed to reveal the existence of
mental and/or substance problems typically involve one or any combination of the following: (a)
conducting brief, yet focused, interviews with clients, (b) using clinician-administered or client
self-report screening instruments, and (c) obtaining information from collateral sources with the
, written consent of the client when ethically and legally applicable. The object of screening for
CODs is to ask specific questions that will yield either a “yes” or “no” response to identify warning
signs that potentially indicate the client is experiencing mental and/or substance abuse issues. And
for those clients whose responses yield positive results, the practitioner should either refer out or
follow-up with a more comprehensive assessment to determine the severity and possible diagnoses
of mental and substance use disorders.
7. Which of the following components is involved in the process of screening for mental disorders?
a. Acute safety risk
b. Past and present mental illness symptoms and disorders
c. Cognitive and learning deficits
d. Past and present victimization and trauma
*e. All of the above
According to SAMHSA (2020, p. 42), mental disorder screening in addiction treatment settings
involves four major components: (a) acute safety risk including suicide, violence to others,
inability to care for oneself, risky behaviors, and danger of physical or sexual victimization, (b)
past and present mental illness symptoms and disorders, (c) cognitive and learning deficits, and
(d) past and present victimization and trauma regardless of the treatment setting.
8. Of the three program types identified by the American Society of Addiction Medicine, which is the
most effective for treating co-occurring disorders?
a. Co-occurring-capable
b. Co-occurring-enhanced
c. Complexity-capable
d. Sequential treatment regardless of the program type
*e. Integrated treatment regardless of the program type
The American Society of Addiction Medicine identified three program types for the treatment of
CODs: (a) co-occurring-capable, (b) co-occurring-enhanced, and (c) complexity-capable. Despite
the program type, those offering integrated services for the treatment of co-occurring mental and
substance use disorders are more effective than those who address each disorder sequentially
(within the same healthcare system) or simultaneously (in separate healthcare systems).
9. Which of the following statements accurately depicts one competency area of counselors working
with clients who have co-occurring disorders?
*a. Counselors should be aware of populations who have a greater risk of developing CODs as
well as how to design interventions to address the needs of these clients.
b. Counselors only need to be knowledgeable of how to treat mental disorders because they should
always refer clients with substance use issues to a specialist.
c. Counselors working in a large treatment facility do not need to worry about ethical codes and
legal statutes because higher administration will handle issues related to these topics.
d. Counselors should not involve themselves in discussing pharmacology with clients because they
are not licensed to prescribe medications.
There are certain populations who have a greater risk of developing CODs and experiencing poorer
treatment outcomes. Included within these are military personnel (active duty and veterans), clients
who identify as women, people experiencing homeless, individuals involved in the criminal legal
system, and those of diverse racial and ethnic backgrounds. Counselors should not only be
, knowledgeable of the vulnerabilities associated with these groups, they should also know how to
design interventions that meet the complex needs of at-risk clients.
10. Research has indicated that a strong working alliance with clients is positively correlated with recovery
outcomes. To develop a therapeutic relationship with clients, SAMSHA identified 10 guidelines that
counselors can follow. Of the few that are listed below, which one does not belong?
a. Develop and use a therapeutic alliance to engage clients in treatment
*b. Use coercion with resistant clients to move them through the process of change
c. Use supportive and empathic counseling
d. Use culturally responsive methods
e. Use motivational enhancement
Arguing or using aggressive methods with clients are labeled as “resistant” only serves to interfere
with establishing a positive counselor-client relationship. The following guidelines offered by
SAMHSA can be used by counselors to maximize the development of a successful therapeutic
alliance with individuals who have CODs:
1. Develop and use a therapeutic alliance to engage clients in treatment
2. Maintain a recovery perspective
3. Ensure continuity of care
4. Address common clinical challenges (e.g., countertransference, confidentiality)
5. Monitor psychiatric symptoms (including symptoms of self-harm)
6. Use supportive and empathic counseling; adopt a multi-problem viewpoint
7. Use culturally responsive methods
8. Use motivational enhancement
9. Teach relapse prevention techniques
10. Use repetition and skill building to address deficits in functioning
, COUNSELING INDIVIDUALS WITH CO-OCCURRING
ADDICTIVE
AND MENTAL DISORDERS:
A COMPREHENSIVE APPROACH
Regina R. Moro, PhD, LCPC, LMHC, LCAS, NCC
Reginald W. Holt, PhD, LPC, LCPC, NCC, MAC, AADC, ICAADC
EDITORS
Chapter 2
Understanding Drugs of Abuse and Addiction
True/False
1. In the United States, more individuals died from drug overdoses in the year 2021 than at any
other point in recorded history.
*a. True
b. False
Over 107,000 individuals died from drug overdoses in the United States in 2021, which is the
largest number recorded for deaths by drug overdose.
2. The opioid epidemic is the only epidemic related to psychoactive substances that counselors
need to be aware of.
a. True
*b. False
While the opioid epidemic is (and has been) a crisis in the United States, it is not the only
addiction epidemic that counselors need to be concerned about. Counselors need to be
concerned about all addictive substances, not only opioids.
Multiple Choice
3. All of the following are classified as central nervous system stimulants EXCEPT:
a. Amphetamines
b. Methamphetamine
c. Cocaine
*d. Cannabis
Cannabis is not classified as a central nervous system stimulant. Although at times it may
have stimulating effects for the user, it is classified as a psychedelic.
4. Short-term effects of methamphetamine use include:
*a. A sense of euphoria, appetite suppression, increased heart rate
b. A sense of euphoria, increased appetite, slowed breathing
c. Decreased energy, decreased body temperature, and an increased heart rate
d. A sense of despair, decreased energy, decreased body temperature
Methamphetamine use will generally increase many bodily functions and lead to a general
sense of euphoria. An exception to this is a user’s appetite, which is suppressed by
methamphetamine (and other amphetamine) use.
5. All of the following are common street names for prescription stimulants:
, a. Addies
b. Vitamin R
*c. Zannies*
d. Study Buddies
“Zannies” is a street name for Xanax, a benzodiazepine which is not a stimulant, it is a
depressant.
6. Which of the following is a central nervous system depressant:
a. Alcohol
b. Heroin
c. Benzodiazepines
*d. All of the above*
Alcohol, heroin, fentanyl, morphine, and benzodiazepines are all central nervous system
depressants. In addition, there are many other substances that are classified as CNS
depressants, including many prescription medications.
7. If a user injects a substance directly into their bloodstream, how long will it take until the
effects are felt?
a. 7 to 10 seconds
*b. 15 to 30 seconds*
c. 2 to 3 minutes
d. 5 or more minutes
Injecting a substance is the second fastest way for a user to feel the effects, following
inhalation which is the fastest route.
8. Which is the only behavioral addiction to be formerly classified in the Diagnostic and
Statistical Manual?
*a. Gambling disorder*
b. Internet gaming disorder
c. Sex addiction
d. Love addiction
Gambling disorder is the only non-substance addictive disorder currently in the diagnostic
manual as of 2013.
9. Which model of addiction suggests that addiction is a consequence of a user’s own personal
choices and failings?
a. Biopsychosocial model
b. Humanistic model
c. Brain disease model
*d. Moral model*
While the moral model of addiction has become quite outdated it continues to be a
contributing factor in how individuals perceive addiction by placing blame on the
individual person. The model perpetuates stigma in this way.
10. What concept is demonstrated when a person needs to take more of a substance to gain the
same effects over time?
a. Withdrawal
b. Abstinence
*c. Tolerance*
d. Sublimation
,Tolerance is when a user needs to take more of a substance to gain the same effects over
time—something that builds with regular use (Inaba & Cohen, 2007). This can be very
dangerous as it requires more of a substance to feel the effects and puts the user at risk for
overdose.
, COUNSELING INDIVIDUALS WITH CO-OCCURRING
ADDICTIVE
AND MENTAL DISORDERS:
A COMPREHENSIVE APPROACH
Regina R. Moro, PhD, LCPC, LMHC, LCAS, NCC
Reginald W. Holt, PhD, LPC, LCPC, NCC, MAC, AADC, ICAADC
EDITORS
Chapter 3
Neuroscience of Co-Occurring Mental and Substance Use Disorders
True/False:
1. There is evidence that volume reductions in the cortical and prefrontal regions as a result of
substance use can be reversed after just a few weeks of cessation of substances.
*a. True
b. False
The most consistent findings in the small but growing neuroscience of recovery
literature provide evidence that volume reductions in cortical and prefrontal regions
common in substance use can be reversed after just a few weeks of cessation from
substances (Garavan et al., 2013). This finding is perhaps not surprising given the
need for activating the cortical control networks to sustain abstinence – and the more
you “use” a brain structure or network (via neural firing), the stronger and better
connected it becomes.
Multiple Choice:
2. Neuroscience can contribute to all of the following EXCEPT
a. Broaden assessment protocols
*b. Provide a definitive explanation of individuals’ distress
c. Deepen case conceptualization
d. Inform treatment planning
There is no definitive way to explain an individual’s distress, although neuroscience
is able to provide insight into factors that may be involved.
3. The most basic building blocks of the brain are:
a. Neurons
b. Glial cells
c. Neurotransmitters
*d. A & B
Neurotransmitters are not building blocks of the brain, despite providing a vital role.
Neurotransmitters are the chemical messengers in the brain.
4. Which brain region plays a leading role in executive functions and regulation of thoughts,
feelings, and emotions?
*a. Prefrontal cortex
b. Limbic system
c. Brainstem
d. Occipital lobe
