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Addiction Counselor's Desk Reference: Chapter 1 - Opiates, Depressants, and Stimulants, Exams of Social Psychology

A comprehensive overview of various psychoactive drugs, including opiates, depressants, and stimulants. It delves into their chemical properties, mechanisms of action, routes of administration, and associated health risks. The document also explores the effects of these drugs on the brain and body, including their impact on neurotransmitters, behavior, and overall health. It is a valuable resource for students and professionals in the field of addiction counseling, providing a detailed understanding of the substances commonly encountered in addiction treatment.

Typology: Exams

2023/2024

Available from 02/26/2025

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CADC Exam Prep Ch 1 (Addiction
Counselor's Desk Reference) ||
Questions & Answers (Graded A+)
Opiates - ANSWER - A category of psychoactive drugs that are chemically similar to
morphine and have strong pain-relieving properties.
- Opiates cross into blood-brain barrier to produce a rush/feelings of euphoria.
- Significant respiratory complications, death, cardiac depression.
- Physical dependence develops dramatically as soon as regular use begins
(sometimes even when its administered clinically appropriate).
Withdrawal symptoms include: restlessness, irritability, nausea, diarrhea, sweating, and
gooseflesh.
Subcutaneous - ANSWER - Injection of medication in a liquid form underneath the skin
into the subcutaneous tissue
GABA - ANSWER - inhibitory neurotransmitter slows or calms things down.
Heroin (Opiate) - ANSWER - - Naturally occurring substance extracted from seedpod of
various poppy plants.
- 1898 - commercially marketed as new pain remedy
- 1914 - designated as controlled substance under the Harrison Narcotic Act
- Schedule 1 drug.
- Route of administration: smoked, snorted, or IV. Greatest intensity and most rapid
onset of euphoria (7-8 sec) from IV. Peak effects felt by 10-15 min.
- Crosses the blood-brain barrier, converts to morphine, and rapidly binds to opioid
receptors in brain.
- Serious adverse health side effects: fatal OD, collapsed veins, cardiac depression,
and blood-borne infectious diseases (HIV/AIDS, Hep C) + societal consequences such
as disruptions in family, work place, etc.
- Significant increase of OD (slow, shallow breathing, convulsions, coma) &/or death.
- Street heroin often cut with various other substances (sugar, starch, strychnine, etc)
that do not dissolve when injected and cause more issues in body.
- Major withdrawal symptoms peak btw 48-72 hours after last dose. Subside in about a
week.
Fentanyl (Rx Opiate) - ANSWER - - Commonly used and abused agent
- Exists in 2 formulations: 1. Injectable form used with other agents during anesthesia, &
2. A skin patch used as a sustained-release form to treat pain.
Various other Rx Opiates - ANSWER - - Morphine, meperidine (Demerol), fentanyl:
most commonly appear as prepared injection forms that have been diverted from legal
medical use. May be injected either IV or subcutaneously (skin popping).
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CADC Exam Prep Ch 1 (Addiction

Counselor's Desk Reference) ||

Questions & Answers (Graded A+)

Opiates - ANSWER - A category of psychoactive drugs that are chemically similar to morphine and have strong pain-relieving properties.

  • Opiates cross into blood-brain barrier to produce a rush/feelings of euphoria.
  • Significant respiratory complications, death, cardiac depression.
  • Physical dependence develops dramatically as soon as regular use begins (sometimes even when its administered clinically appropriate). Withdrawal symptoms include: restlessness, irritability, nausea, diarrhea, sweating, and gooseflesh. Subcutaneous - ANSWER - Injection of medication in a liquid form underneath the skin into the subcutaneous tissue GABA - ANSWER - inhibitory neurotransmitter slows or calms things down. Heroin (Opiate) - ANSWER - - Naturally occurring substance extracted from seedpod of various poppy plants.
  • 1898 - commercially marketed as new pain remedy
  • 1914 - designated as controlled substance under the Harrison Narcotic Act
  • Schedule 1 drug.
  • Route of administration: smoked, snorted, or IV. Greatest intensity and most rapid onset of euphoria (7-8 sec) from IV. Peak effects felt by 10-15 min.
  • Crosses the blood-brain barrier, converts to morphine, and rapidly binds to opioid receptors in brain.
  • Serious adverse health side effects: fatal OD, collapsed veins, cardiac depression, and blood-borne infectious diseases (HIV/AIDS, Hep C) + societal consequences such as disruptions in family, work place, etc.
  • Significant increase of OD (slow, shallow breathing, convulsions, coma) &/or death.
  • Street heroin often cut with various other substances (sugar, starch, strychnine, etc) that do not dissolve when injected and cause more issues in body.
  • Major withdrawal symptoms peak btw 48-72 hours after last dose. Subside in about a week. Fentanyl (Rx Opiate) - ANSWER - - Commonly used and abused agent
  • Exists in 2 formulations: 1. Injectable form used with other agents during anesthesia, &
  1. A skin patch used as a sustained-release form to treat pain. Various other Rx Opiates - ANSWER - - Morphine, meperidine (Demerol), fentanyl: most commonly appear as prepared injection forms that have been diverted from legal medical use. May be injected either IV or subcutaneously (skin popping).
  • Codeine, propoxyphene: Lower potency and usually appear in pill form and taken orally. Depressants - ANSWER - Drugs (such as alcohol, barbiturates, and opiates) that reduce neural activity and slow body functions.
  • Prescribed to help relieve anxiety, irratibility, and tension.
  • Normally called "downers" because they calm users down.
  • With regular use, high potential for abuse and development of tolerance.
  • Effects are exacerbated when various kinds of depressants mix (alcohol + barbs = not good).
  • Small amounts cause calmness and relaxed muscles while large amounts cause slurred speech, impaired judgment, and loss of motor coordination. Larger amounts may cause decreased breathing rate, coma, and death. Alcohol - ANSWER - - Consumption effects: The more drinks consumed the more depressed and adversely affected one's brain activity becomes ,e.g. Cerebrum (controls advanced functions such as recognition, vision, reasoning, and emotion). Lowest levels: impacts inhibition and judgment. Increased levels: impacts vision, movement, speech (.01% to .30 % BAC).
  • Impacts part of the brain in charge of movement - causing problems with coordination, reflexes, and balance (.15% to .35% BAC). Impacts Medulla (controls basic survival functions i.e. breathing & heartbeat) resulting ij the reduction of brains ability to control respiration and heart rate.
  • Death can result at .30% BAC> Alcohol absorption - ANSWER - - Absorption: 20% absorbed in stomach, 80% absorbed in small intenstine. -Alcohol absorption depends on:
  1. Alcohol concentration - the greater the concentration, the faster the absorption.
  2. The type of drink: Carbonated beverages tend to speed up the absorption of alcohol.
  3. Full or empty stomach: Food slows down alcohol absorption. Alcohol excretion - ANSWER - Alcohol leaves body in 3 ways:
  4. Kidney eliminates 5% of alcohol in urine
  5. Lungs exhale 5% of alcohol
  6. Liver breaks down the remaining 90% of alcohol into acetic acid. Barbiturates (depressants) - ANSWER - - EX: Seconal, Nembutal.
  • the "al" endings.
  • Usually in pill or sometimes in liquid form or suppositories.
  • Affect the central nervous system (CNS) by slowing or decreasing neurological activity in the mind/body. -Prescribed for treatment for sleeplessness, anxiety, tension, epileptic seizures.
  • Short term effects: Lasting 15 hours after ingestion (include relief of tension, anxiety, sleepiness, feeling of intoxication, slurred speech, memory impairment, emotional instability, and inability to control simple bodily functions.

Crack (stimulants) - ANSWER - - processed from hydrochloride with ammonia or sodium bicarbonate (baking soda) and water, heated to remove the hydrochloride. Freebase is the result.

  • Popular in mid 1980's due to almost immediate high and cheapness.
  • Smoking crack delivers large amounts of drug to the lungs, producing effects comparable to IV use.
  • When cocaine and crack are used together the liver combines them to manufacture a third substance, cocaethylene.
  • Prolonged use of cocaine and crack can trigger paranoia and aggression. When use is stopped, depression ensues. Amphetamines (stimulants) - ANSWER - - Drugs that stimulate neural activity, causing sped-up body functions and associated energy and mood changes.
  • History: First used on nasal decongestants and bronchial inhalers for teh tx of narcolepsy, obesity, and ADD. Methamphetamines (stimulants) - ANSWER - - A powerfully addictive drug that stimulates the central nervous system, with speeded-up body functions and associated energy and mood changes; over time, appears to reduce baseline dopamine levels.
  • Route of admin: oral, intranasally, IV, smoking. Oral ingestion takes about 20 min while smoking takes about 5 min. Oral/intranasal produces euphora (a high but not a rush) vs. smoking produces an intense sensation (a rush or flash).
  • Releases high levels of dopamine in the brain and stimulates cells that enhance mood, pleasurable feelings, and body movements with effects lasting up to 12 hours. -Neurotoxic effects -> damaging brain cells that contain dopamine and serotonin. Overtime levels of dopamine are reduced which can result in sx similar to Parkinson's disease (severe movement disorder).
  • Effects: wakefulness/insomnia, increased physical activity, decreased appetite, hyperthermia, ^ respiration, respiratory problems, euphoria. CNS effects: irritability, confusion, tremors, convulsions, anxiety, paranoia, and aggressiveness. ^ Heart heart and blood pressure which can cause irreversible damage to blood vessels in the brain, producing strokes. Possible cardiovascular collapse, death.
  • Chronic use can cause psychotic behaviors that includes intense paranoia, visual/auditory hallucinations, "out of control" violent rage episodes. Cannabis - ANSWER - - Hemp plant. Marijuana, hasish (made from marijuana resin found in tops of flowering marijuana plants where THC is most concentrated), hashish oil, tetrahydrocannabinol (THC).
  • Routes of admin: smoked or taken orally.
  • THC stronger now than 30 years ago. THC levels range between 7-20%.
  • THC triggers brain cells to release dopamine.
  • THC finds neurons (brain cells) called cannabinoid receptors and binds to them. When attached to neuron, THC interferes with the normal communication between neurons.
  • Hippocampus (controls learning and control), cerebellum (controls balance and coordination), basal ganglia (controls movement), and cerebral cortex all have a high concentration of cannabinoid receptors.
  • Chronic smokers can experience withdrawal sx such as irritability, depressed mood, anxiety, panic attacks, and cravings. Hallucinogens - ANSWER - - A diverse group of drugs that have powerful effects on mental and emotional functioning, marked most prominently by distortions in sensory and perceptual experience (thinking, emotions, self-awareness).
  • Some are natural from plants (mescaline from peyote cactus) and others are synthetic (LSD). Lysergic Acid Diethylamide (LSD) - ANSWER - - History: 1938 Swiss chemist synthesixed LSD as a circulatory and respiratory stimulant. Later used as a possible medical treatment for schizophrenia. 1960's recreational using. No medical use even under supervision. -Schedule 1. -Odorless/colorless with bitter taste sold on street in tablets or capsules orally consumed or inliquid form applied to blotter paper, sugar cubes, etc.
  • Effects are often unpredictable and depends on amount taken, the surroundings of which it is used, and user's personality/mood/expectations. (ex: good trip vs. bad trip_
  • Not considered addictive drug, does not produce drug seeking behaviors. Tolerance CAN be developed though.
  • 30 to 90 minutes after ingestion, user feels first effects of drug and can last for an extended period of time (clearing around 12 hours).
  • Powerful visual hallucinations and delusions that may cause acute panic reactions when user cannot control them.
  • Synthesia can occur ( the blending of different senses, such as "seeing" sounds
  • Some users can experience flashbacks of their experience without taking the drug again. Psilocybin ("Mushrooms"), peyote, mescaline - ANSWER - - Psilocybin: mushroom typically eaten or smoked.
  • Members of Native American Church legally use peyote for religious ceremonies.
  • Mescaline is the active ingredient in peyote cacti.
  • Use to alter consciousness and/or to have a mystical or spiritual experiences. "Entheogen" = "god within" is a term that has been used to describe this class of drugs.
  • boundary between self and others disappears and a connectedness with other and universe may be experienced. Feelings of elation, awe, & bliss. Inhalants - ANSWER - - Household and commercial products with substances whose fumes are sniffed and inhaled to achieve a mind altering effect.
  • Easy accessibility, low cost, and ease of concealment makes these popular among teens.
  • Most slow body's functions producing effects similar to anesthetics and in some cases can cause heart failure.
  • Permanent effects can cause hearing loss, peripheral neuropathies (limb spasms), CNS/brain damage, bone marrow damage. LIver/kidney damage.
  • Small amounts can result in loss of attention span, learning ability, and memory.
  • Higher amounts can cause delirium, amnesia, high blood pressure, depression and severe breathing problems. Gamma Hydroxybutyrate (GHB) - ANSWER - - designer drug. Small amounts induce relaxation but large doses can result in coma or death. Rohypnol - ANSWER - - Date rape drug. May cause amnesia.
  • Tasteless, odorless, mixes well in carbonated beverages.
  • Effects: dizziness, low blood pressure, drowsiness, confusion, stomach upset. Control schedules for abused drugs - ANSWER - Schedule I: heroin, hallucinogens, marijuana, methaqualone (Quaalude) are considered as having high potential for abuse with no legally recognized medical use. Schedule 2: Opium or morphine, codeine, synthetic opiates (such as meperidine or "Demerol"), barbiturates such as secobarbital (Seconal), amphetamines, methylphenidate (Ritalin), PCP, cocaine, methadone, and methamphetamine have high potential for abuse but are currently accepted for medical use with severe restrictions. Cannot by prescribed by phone and no refills allowed. May lead to severe psychological and/or physical dependence. Schedule 3: Anabolic steroids, codeine, and hydrocodone with aspirin or tylenol, and some barbs that have an abuse potential less than Schedules 1 & 2 and currently have an accepted medical use in US. Requires new Rx after 6 months or 5 refills. May lead to moderate or low physical dependence and/or high psychological dependence. Schedule 4: Chlordiazepam (Librium),propxyphene (Darvon), equanil, xanax, valium, have low abuse potential compared to Schedule 3 drugs and currently have an accepted medical use in US. Abuse may lead to limited physical dependence and/or psychological dependence. Schedule 5: Narcotic-atropine (Lomotil) and codeine mixtures (less than 200 mg) have a low potential for abuse relative to Schedule 4 drugs and currently have an accepted medical use. MA recognizes Schedule 6 drugs to be adhesives, glues, and medications (ibuprofen, penicillin) that have little or no addictive potential. What is the main value of "ugly reminders in recovery? A. They keep negative consequences in mind. Correct Answer B. They keep a client from switching substances C. They remind a client of others' trauma - ANSWER - A. They keep negative consequences in mind. Correct Answer Which of the following is not a popper? A. Nitrous oxide B. Amyl nitrite

C. Butyl nitrite - ANSWER - A. Nitrous oxide Nitrous oxide is an inhalant commonly used in dental medicine. Amyl nitrite and butyl nitrite come in dosages called loppers" used mainly as enhancements to sexuality. In the context of motivating patients in substance abuse treatment, is it acceptable to offer advice? A. Yes B. No, under no circumstances C. Yes, if the patient is in recovery - ANSWER - A. Yes. Getting advice from a reasonable, informed source may be one of the main reasons the client sought treatment in the first place and can be empowering. Which of the following is not associated with the use of MDMA? A. Paranoia B. Euphoria C. Psychosis - ANSWER - C. Psychosis What kind of prescription drugs are used to treat those who are addicted to depressant and sedative-type substances? A. The class of drug is not significant B. Drugs in a different class C. Drugs in the same class - ANSWER - C. Drugs in the same class. How should a therapist handle asking non-substance abuse clients about substance use. A. The therapist should let the client bring it up. B. The therapist should ask during assessment. C. The therapist should ask periodically. - ANSWER - C. When there are potential consequences to a patient for revealing information about substance use, what is the impact? A. There is no real impact of potential consequences on a patient's honesty. B. Potential consequences for revelation make revelation more likely. C. Potential consequences for revelation inhibit revelation. - ANSWER - C. Which of the following is the most important element of effective treatment planning? A. Individuality B. Transferability C. Flexibility D. Accountability - ANSWER - A. Individuality. It is what makes it the most effective, by "meeting a client where they are" and establishing milestones that are relevant to that patient. Which type of supervision is most concerned with giving and receiving feedback about performance? A. Evaluative

"Closing one's eyes" to the existence of a threatening aspect of reality. - ANSWER - Denial (defense mechanism) Actively expressing the opposite impulse when confronted with a threatening impulse. - ANSWER - Reaction Formation (defense mechanism) 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 - ANSWER - D. Drug avoidance strategies What does formication refer to? A. The creation of freebase cocaine B. Sex between two unmarried individuals C. A sensation of bugs crawling under the skin D. Extrapyramidal symptoms of agitation - ANSWER - C. A sensation of bugs crawling under the skin What is/are the organ(s) most damaged by cocaine abuse? A. The brain B. The lungs C. The kidneys D. The heart - ANSWER - D. The heart Which form of substance abuse is naltrexone used to treat? A. Alcohol dependence B. Opioid dependence C. Both A and B D. Neither A or B - ANSWER - C. Both A and B The likelihood of developing a substance abuse disorder fluctuates throughout the life course. What is the most likely period in life for a substance abuse problem to begin? A. Middle age B. Young adulthood C. Adolescence D. Childhood - ANSWER - C. Adolescence The MAST screening test is a twenty-five question instrument that is used to explore the degree and severity of a client's problem with which type of abuse? A. Cocaine abuse B. Mescaline abuse C. Methamphetamine abuse D. Alcohol abuse - ANSWER - D. Alcohol abuse

Members of the lesbian, gay, bisexual, and transgender (LGBT) community face many challenges, including issues of discrimination. Regarding substance abuse as compared with the general population, how is the LGBT community likely to act? A. Less likely to use alcohol or drugs B. About as likely to use alcohol or drugs C. More likely to use alcohol or drugs D. Insufficient data to make these comparisons - ANSWER - C. More likely to use alcohol or drugs Staff familiarity with twelve-step program facilitation important because of all of the following EXCEPT that A. Clients feel more pressure to attend twelve-step programs by these staff B. Clients are more easily motivated into twelve-step programs by these staff C. Clients' concerns are more meaningfully resolved by these staff D. Clients generally remain abstinent longer with twelve-step involvement. - ANSWER - A. Clients feel more pressure to attend twelve-step programs by these staff In 1965, Bruce Tuchman proposed a model of group development that included five phases. What is the one phrasing that is NOT part of Tuckman's model? A. Performing B. Storming C. Framing D. Norming - ANSWER - C. Framing "Referral" means: - ANSWER - Assisting a client to utilize the support systems and community resources available ___________________ are a problem associated with consuming alcohol and valium together. - ANSWER - Synergistic effects ___________________ is the belief that ones own culture is superior to others. - ANSWER - Ethnocentrism "Excessive use of alcohol is a result of personal choice and therefore should be punished." This statement is consistent with the __________________ model of addiction. - ANSWER - Moral A common problem for beginning counselors is: - ANSWER - Failing to identify an approach that is appropriate to the client A counselor wants to record a counseling session with a client so that the counselor could listen to the tape, along with her supervisor, as part of ongoing training. According to ethical best practices, the counselor's plans are: - ANSWER - Ethical, as long as the client granted permission beforehand.

groups for Vets with PTSD. The counselor then made arrangements for Jackie to be attend these groups while he is still in primary treatment for substance abuse. The counselor's actions are BEST described as: - ANSWER - Case Management Methadone maintenance programs can BEST be described as: - ANSWER - Harm reduction request Niko is a client who has ben gaining weight steadily since entering treatment. When confronted about his constant snacking and lack of activity, he told his counselor that he needed to eat this way in order to keep his mind off of his DOC. He felt that he deserved to indulge, since he was giving up the primary source of satisfaction he had used for years. The counselor would rightly conclude that the ego defense mechanism of __________ is at work here. - ANSWER - Rationalization One basic principle of documentation requires the counselor to: - ANSWER - Record material in a manner that allows a new counselor to understand the general progress of any client. Rajish is avoiding social situations which involve drinking or drugs. He is worried that others may encourage him to drink. The counselor suggests that they act-out such a situation in order to develop responses if such a situation arises. This counseling technique is: - ANSWER - Role-play Rates of opioid use are higher in __________ than in ____________. - ANSWER - Males; Females Reinforcement and punishment are associated with ________________ Therapy. - ANSWER - Behavior Some researchers have concluded that no one pattern of dysfunctional substance abuse exists. They also conclude that there more than one personality type that is more prone to addiction than some others. This multivariate focus is MOST consistent with the: - ANSWER - Biopsychosocial model Studies have linked substance abuse among African Americans to three factors: economic deprivation, stress and __________________. - ANSWER - Racism The concept of informed consent requires that before agreeing to accept treatment, clients should know ________________, their rights and obligations, fees for services and limits of confidentiality. - ANSWER - The goals of therapy The cultural philosophy of "noninterference" is associated with alcohol-related problems among: - ANSWER - Native Americans The DSM-5 includes criteria sets specific to intoxication for each substance category except for _______________. - ANSWER - Tobacco

The first step of Alcoholics Anonymous requires: - ANSWER - An admission that one's life is unmanageable The initial stage of crisis intervention involves: - ANSWER - Recognizing the crisis The primary goal of a mental status exam is to measure the client's orientation to ___________, ___________, and ______________. - ANSWER - Person; Place; Time The primary principles behind Alcoholics Anonymous are spirituality, self-improvement and _____________________. - ANSWER - Service to others Which core function of counseling is related to the term "didactic"? - ANSWER - Client education Which neurotransmitter is most closely associated with feelings of well-being, appetite and mental alertness? - ANSWER - Serotonin Which of the following is a CNS depressant? - ANSWER - Xanax Which of the following is an SSRI? - ANSWER - Prozac Which of the following is most closely associated with involuntary confinement, such as a prison setting? - ANSWER - Gestalt Therapy Which of the following is the BEST definition of a "slip"? - ANSWER - An episode of substance abuse following a period of abstinence Which of the following is the BEST definition of denial? - ANSWER - An ego defense mechanism that allows one to pretend a problem is not real Which of these is the BEST example of a substance-induced disorder? - ANSWER - Methamphetamine psychosis Which statement is TRUE regarding counselor self-exploration? - ANSWER - Counselors should not rule out therapy for their own personal issues. With the new DMS-5 nomenclature, clinicians will now specify severity of the addiction using ratings of: - ANSWER - Mild, Moderate, and Severe You are seeing a patient whom you suspect may be suicidal. Which of the following facts most suggests that the risk of suicide is high? - ANSWER - The patient's depressive symptoms have recently improved CASE STUDY: What part of the treatment process was interrupted by the client's wife? - ANSWER - Orientation