Chemical Dependency

Self-Study Examination

Instructions: After studying the text answer the following true/false or multiple choice questions.  Remember, there's only one answer to each question.

1. Alcohol can cause euphoria and depression.

a) True
b) False

2. Alcohol epidemiology studies are useful for they can tell us:

a) how many people are alcoholic and whether overall drinking levels are increasing or decreasing;
b) how much and what types of alcoholic beverages Americans are drinking;
c) the scope of various health and social problems from alcohol abuse.
d) a and b above
e) a, b and c

3. Study of epidemiology of alcoholism tells us many things. Which of the following is a true statement?

a) Studies in the general population indicate that an equal number of women and men drink.
b) A larger proportion of black women drink heavily compared to white women.
c) Married women are more likely to drink heavily than women who have never married.
d) Female alcoholics have death rates 50 to 100 percent higher than those of male alcoholics.

4. Women alcoholics encounter different conditions than men that facilitate or dicourage their entry into treatment. Select the correct statement from below:

a) Women are more likely to seek treatment because of family problems.
b) Women are encouraged by parents or children to pursue therapy whereas men are en- couraged to pursue therapy by their wives.
c) Fewer women than men reach treatment through the criminal justice system.
d) all of the above

5. There are two types of alcoholism-screening instruments available. Which of the following tests can detect pathophysiology associated with excessive alcohol consumption?

a) Clinical test to measure liver enzyme aspartate aminotransferase (AST)
b) CAGE questionnaire
c) Michigan Alcoholism Screening Test (MAST)
d) Self-Administered Alcoholism Screening Test (SMST)
e) Alcohol Dependence Scale (ADS)

6. Sensitivity and specificity, key proerties of every screening test, are related to validity. Which one is useful in identifying people who do not have the disease?

a) sensitivity
b) specificity

7. Of the two types of alcoholism-screening instruments available, which has greater sensitivity and specificity?

a) blood tests for biochemical markers
b) self-report interviews and questionnaires

8. Which of the following correctly defines moderate drinking?

a) social drinking
b) drinking that generally does not cause problems, either for the drinker or for the society
c) no more than 2 drinks a day
d) on the average 7 drinks per week

9. Women become more intoxicated than men at an equivalent dose of alcohol because

a) women generally drink alone, hidden from others.
b) men have less body water than women.
c) women have smaller physique.
d) of the significant difference in activity of an enzyme in stomach tissue of males and females.
e) men have higher tolerance for alcohol.

10. When a woman plays multiple roles, such as wife, mother, breadwinner, she's likely to have higher rates of alcohol problems than a woman who does not have multiple roles.

a) True
b) False

11. Women become intoxicated after drinking smaller quantities of alcohol than men.
Select the correct reason for this:

a) Women have lower total body water content than men of comparable size.
b) They have greater fat-to-muscle ratio.
c) Women have higher metabolism rate of alcohol in the stomach.
d) Men are socially conditioned to tolerate alcohol better.

12. Alcohol-related problems affect women differently than men. Select the correct statement from the following:

a) Marriage creates its own stress and strife. Unmarried or divorced women are less likely to drink heavily and experience alcohol-related problems than married women.
b) White women are more likely to abstain from alcohol than black women.
c) Chronic alcohol abuse exacts a greater physical toll on women than men. Female alcoholics have death rates 50 to 100 percent higher than those of male alcoholics.
d) More women than men reach treatment through the criminal justice treatment.

13. Women alcoholics seek treatment less readily than men alcoholics because women are better at hiding their problems and there's a greater stigma attached to women alcoholics.

a) True
b) False

14. The proportion of women to men in alcoholism treatment centers is

a) 50/50
b) 75/25
c) 25/75
d) 10/90

15. Compared with men, women are more likely to develop alcohol-induced liver disease over a shorter period of time and after consuming less alcohol.

a) True
b) False

16. Which of the following is a correct statement of our understanding of fetal alcohol syndrome (FAS)?

a) Malformation associated with FAS is a result of malnutrition.
b) The risk of FAS is independent of ethnic background.
c) Alcohol consumption during the first trimester poses little risk of fetal abnormalities.
d) Episodic binge drinking (as opposed to heavy alcohol consumption thoughout pregnancy) causes no fetal syndrome.
e) Because we do not know at what point alcohol damage begins it is prudent to recommend that pregnant women abstain from alcohol throughout pregnancy.

17. The influence of FAS is highest for

a) Asians
b) Hispanics
c) Native Americans
d) whites
e) blacks

18. Children raised in alcoholic families experience developmental losses and stressors that are similar to those experienced by children in other types of dysfunctional families.

a) True
b) False

19. Children raised in alcoholic families have different life experiences than children raised in non-alcoholic families. All of the following are true statements except one:

a) Children of alcoholics are four times more likely than non-coAs to develop alcoholism.
b) There is a relationship between parental alcoholism and child abuse.
c) Population studies show that children of alcoholics, having experienced the abuse from an alcoholic parent, avoid marrying into families in which alcoholism is prevalent.
d) COAs tend to score lower on tests that measure cognitive and verbal skills.
e) In general, COAs appear to have lower self-esteem than non-COAs in childhood, adolescence and young adulthood.

20. Current research findings suggest that the children of alcoholics are at risk for a range of cognitive, emotional and behavioral problems. Which of these problems is observed most frequently in the COAs?

a) cognitive
b) emotional
c) behavioral

21. Of the two components of total alcohol-related health costs, which accounts for a greater portion?

a) costs of treating alcoholism
b) costs related to the medical consequences of alcohol use_trauma, cirrhosis, pancreatitis, and so forth

22. Which population group has the highest alcohol use in the U.S.?

a) blacks
b) Hispanics
c) American Indians
d) Asians
e) whites

23. "Flushing" reaction to alcohol appears to _______ certain minority groups from becoming alcoholic.

a) predispose
b) protect
c) have no effect on

24. Studies have shown that drinking rates of successive generation of immigrants approach those of the general population. The proper term for this trend is

a) assimilation
b) flushing
c) acculturation
d) alienation
e) Americanization

25. During Operations Desert Shield and Desert Storm in the Middle East, there was among the U.S. military personnel (select the correct response):

a) increased drinking due to the acute stress of the conflict.
b) decreased drinking due to the cultural and religious prohibition against alcohol in the Islamic society.

26. There are many factors that contribute to employee drinking in the workplace. Select the incorrect response from the following:

a) boring, stressful work
b) availability of alcohol in the workplace
c) female-dominated occupation
d) limited work supervision
e) nonexistence of alcohol policy

27. Drinking influences smoking more than smoking influences drinking.

a) True
b) False

28. Quitting smoking while undergoing alcoholism treatment is not generally recommended since the stress of quitting smoking might cause relapse.

a) True
b) False

29. There are several theories to explain the concurrent use of tobacco and alcohol. Select the least correct response from the following:

a) Nicotine and alcohol both bring about the release of dopamine, reinforcing the desired effect of each drug.
b) Nicotine alters the metabolism of the alcohol, affecting its absorption, distribution or elimi- nation from the body.
c) Long-term smoking induces tolerance to the rewarding effects of alcohol, requiring in- creased consumption of alcohol.
d) Nicotine's stimulating effects mitigate alcohol-induced loss of mental alertness, allowing greater consumption of alcohol.
e) Alcohol's sedating effects compensate for the stimulating effects of nicotine, facilitating continued tobacco use.

30. A number of medical conditions have been found to be comorbid with alcoholism.
Identify the condition that's most prevalent with alcoholism:

a) fatty liver
b) alcoholic hepatitis
c) cirrhosis
d) chronic pancreatitis
e) malabsorption of nutrients

31. Alcoholism is associated with several psychiatric disorders. Identify the disorder that's most likely to be present in alcoholics?

a) mania
b) schizophrenia
c) antisocial personality disorder
d) anxiety disorders

32. Alcoholism and other drug abuse often go hand-in-hand. Which of the following drugs are alcoholics most likely to abuse?

a) marijuana
b) cocaine
c) sedatives
d) opioids
e) hallucinogens

33. Epidemiologic data have shown that one of the following groups has a significantly lower CHD incidence:

a) abstainers
b) moderate drinkers
c) heavy drinkers

34. Assuming equivalent levels of alcohol consumption, which of the following beverages affords the most CHD protection?

a) beer
b) wine
c) liquor
d) they all provide equal protection

35. The three alcohol-induced liver conditions are fatty liver, alcoholic hepatitis and cirrhosis.
Which condition is not reversible with abstinence?

a) fatty liver
b) alcoholic hepatitis
c) cirrhosis

36. Daily drinkers are at a higher risk of developing alcoholic cirrhosis than are binge drinkers.

a) True
b) False

37. The single most important component of treatment for alcohol liver disease is

a) abstinence.
b) surgery.
c) liver transplantation.
d) diet and nutrition.

38. There are many ways in which alcohol can damage the liver. Select the most correct response from the following:

a) Alcohol hinders the metabolic function of the liver.
b) Long-term alcohol consumption leads to excess production of free radicals, which can destroy healthy liver tissue.
c) Alcohol consumption decreases cytokine levels, leading to infection and cell damage.
d) Alcohol diminishes scarring_an essential part of the wound-healing process.

39. The strongest link between alcohol and cancer involves cancers of the

a) upper digestive tract.
b) liver.
c) breast.
d) colon.
e) stomach.

40. There's a dose-dependent association between alcohol consumption and certain types of cancer:
As alcohol consumption increases, so does the risk of developing these cancers.

a) True
b) False

41. The connection between alcohol, HIV infection and AIDS is indeed a complex one.
Select from the following the correct response:

a) Drinking increases vulnerability to HIV infection among people exposed to the virus.
b) Among people who are already HIV infected, alcohol-induced immunosuppression adds to HIV-induced immunosuppression, and speeds the onset of AIDS-related illness.
c) Alcohol is associated with high-risk sexual activity that potentially can result in exposure to HIV.
d) all of the above

42. Which of the following defines tolerance?

a) After continued drinking consumption of a constant amount of alcohol produces a lesser effect.
b) Increasing amounts of alcohol are necessary to produce the same effect.
c) both of the above

43. Tolerance that results when brain functions adapt to compensate for disruption caused by alcohol in both the behavioral and bodily functions is called

a) functional tolerance.
b) metabolic tolerance.

44. In treating alcoholism functional tolerance is a desired goal because the drinker does not experi- ence significant behavioral impairment as a result of drinking.

a) True
b) False

45. Functional tolerance is categorized as acute tolerance, environment-dependence tolerance, learned tolerance and environment-independent tolerance. Which of the following describes learned tolerance?

a) tolerance to alcohol's effects when alcohol is administered in the same environment
b) tolerance to most alcohol effects observed within a single drinking session
c) development of tolerance as a result of exposure to large quantities of alcohol
d) development of tolerance by practicing a task while under the influence of alcohol

46. After chronic alcohol consumption, the drinker often develops tolerance to alcohol's effects. Which of the following is a true statement as it applies to alcohol and tolerance?

a) Functional tolerance means inability to function physically and mentally at acceptable levels.
b) When a person develops functional tolerance to alcohol, he or she may be able to do tasks requiring mental functions but may have trouble doing tasks requiring eye-hand co- ordination.
c) When a person develops tolerance to the pleasurable, but not to the unpleasant, effects of alcohol he or she may consume alcohol at progressively higher level.
d) People who have developed tolerance to alcohol do not require treatment for alcohol abuse.

47. People who have developed metabolic tolerance suffer alcohol's intoxicating effects for a ______time.

a) shorter
b) longer

48. Korsakoff's psychosis refers to

a) alcohol amnestic disorder (memory disorder).
b) dementia associated with alcoholism.

49. Evidence suggests that cognitive impairment in alcoholics is reversible with abstinence.

a) True
b) False

50. Select the correct statement:

a) Drinking alcohol produces physiological stress.
b) People drink to relieve stress caused by economic, job or marital problems.
c) both of the above
d) none of the above

51. Which of the following statements correctly describes the effect of alcohol on sleep?

a) Alcohol consumed at bedtime decreases the time required to fall asleep.
b) Alcohol consumed withing an hour of bedtime appears to disrupt the second half of the sleep period.
c) both of the above
d) none of the above

52. The problem of alcohol and other drug abuse among the elderly is likely to worsen in the coming decade.

a) True
b) False

53. Alcohol and aging produce many combined effects as listed below. Select the incorrect response:

a) higher incidence of hip fractures
b) alcohol-involved traffic crashes
c) loss of protective effect against heart disease even with moderate drinking
d) adverse interactions with medications
e) depressive disorders

54. Does aging increase ______ to alcohol?

a) sensitivity
b) tolerance

55. Several theories have attempted to explain why the elderly appear to drink less alcohol. Select the most appropriate response:

a) Older persons cannot metabolize alcohol as efficiently.
b) There is less sensitivity to alcohol in older persons.
c) Elderly have less stress.
d) Because alcohol abuse is a major cause of mortality, early mortality among life long abusers leaves a surviving older population that consumes less alcohol.

56. Cocaine is generally ingested by snorting, injecting or smoking. Users who smoke or inject cocaine may be at even greater risk than those who snort it.

a) True
b) False

57. In the United States, cocaine use is significantly more prevalent today than it was during the early 1980s.

a) True
b) False

58. The typical heroin user consumes more heroine today than just a decade ago. The principal reason for this is:

a) Due to advances in the manufacture of heroin heroin is more readily available now.
b) Due to abundance of supply, the cost of heroin is significantly lower.
c) Availability of high purity heroin allows users to snort or smoke instead of injecting it, which has a greater stigma attached to it.
d) Criminal penalties for the use of heroin have been lowered.

59. THC, the chemical responsible for most of the psychoactive effect sought by users, is found in

a) cocaine
b) heroin
c) methamphetamine
d) marijuana
e) LSD

60. LSD-related emergency incidents have significantly declined during the past several years.

a) True
b) False

61. Users of Ecstasy say that it produces profoundly positive feelings, elimination of anxiety, and extreme relaxation. When used with alcohol these effects are substantially enhanced.

a) True
b) False

62. PCP is commercially available for use as a veterinary anesthetic.

a) True
b) False

63. The drug generally known as a date-rape drug is chemically known as

a) MDMA (Ecstasy)
b) Methylphenidate
c) Flunitrazepam
d) Ketamine
e) Gamma hydroxybutyrate

64. According to the principles of effective drug treatment, the treatment will not achieve its goals if it is not (select the incorrect response)

a) readily available.
b) customized to meet each individual's particular problems.
c) voluntary.
d) a combination of behavioral and medications approach.
e) of optimum duration.

65. Research indicates that most patients need to stay in drug addiction treatment at least ______ in order for additional treatment to produce further progress toward recovery.

a) 1 week
b) 2 weeks
c) 1 month
d) 3 months

66. Possible drug use during treatment must be monitored continuously. The objective of such monitoring is (select the inappropriate response):

a) It helps the patient resist drugs.
b) Early evidence of drug use allows the counselor to make changes in the treatment plan.
c) It provides feedback to the patient.
d) It helps the program director to remove offending patients from the treatment.

67. There is ample scientific and clinical evidence to support the conclusion that drug addiction treat- ment is as effective as are treatments for most other similarly chronic medical conditions.

a) True
b) False

68. Research indicates that if the patient has not made significant improvement in the first 3 months of treatment, additional treatment is unlikely to be effective.

a) True
b) False

69. Drug addiction treatment can include behavioral therapy, medications, or their combination. When a person's drug-related behavior places him or her at higher risk for AIDS or other infectious diseases, the proper approach would be

a) behavioral therapy
b) medications
c) combination of both

70. Most addicted individuals are unable to stop using drugs on their own. The primary reason they fail to achieve long-term abstinence is

a) psychological stress from work.
b) significant changes in brain function due to long-term drug use.
c) family problems.
d) association with other drug-using individuals.
e) environment.

71. According to several studies, drug treatment reduces drug use by

a) 10 to 20 percent.
b) about 30 percent.
c) 40 to 60 percent.
d) nearly 100 percent.

72. In the methadone maintenance program, the minimum duration of treatment should be

a) 4 weeks.
b) 90 days.
c) 6 months.
d) 12 months.

73. Effectiveness of drug treatment is measured by all of the following except

a) levels of criminal behavior
b) family functioning
c) employability
d) medical condition
e) reduction in drug dealing in the neighborhood

74. Whether a patient stays in the drug addiction treatment depends on factors associated with both the individual and the program. Select the most important factor from the following:

a) affordability
b) pressure from the criminal justice system
c) quality of the program
d) physical facilities at the treatment center
e) other participants in the program

75. Methadone has been used successfully in the maintenance treatment for heroin. Select the correct reason:

a) Methadone is cheaper than heroin.
b) Methadone is safe and legal.
c) Methadone does not produce the "rush" or "crash" associated with heroin.
d) Pharmacological effects of methadone are similar to those of heroin except less devastating on the body.

76. Research has shown that individuals who enter drug treatment under legal pressure have significantly less favorable outcome than individuals who enter treatment voluntarily.

a) True
b) False

77. One of the drug treatments for opiate addicts is narcotic antagonist treatment using naltrexone. Which of the following is a true statement concerning naltrexone?

a) Naltrexone has serious side effects.
b) It is addictive and there's a potential for abuse.
c) Patients generally accept it because it produces euphoria, albeit minor, similar to the one produced by common opiates.
d) It must be injected intravenously three times a day.
e) Patients stabilized on naltrexone can hold a job, avoid crime and violence, and reduce their exposure to HIV.

78. Outpatient drug-free treatment programs are generally suitable for

a) employed individuals with family support.
b) individuals who do not have extensive social supports.
c) patients with severe addiction problems with co-occurring mental health problems.
d) individuals in the criminal justice system.

79. Supportive-expressive psychotherapy is a time-limited, focused psychotherapy that has been adapted for heroin- and cocaine-addicted individuals. Which of the following is the main component of this therapy?

a) provide support and reinforcement of coping skills, yielding better long-term outcomes
b) anticipate the problems patients are likely to meet and help them develop effective coping strategies
c) involve family members and other people important in helping patients avoid drugs
d) help patients feel comfortable in discussing their personal experiences and work through interpersonal relationship issues

80. Studies have shown that the treatment that incorporates financial rewards for abstinence generally fails to achieve sustained drug abstinence.

a) True
b) False

81. Rate and duration of drug activity play major roles in drug abuse, addiction and treatment. Only one of the following statements correctly describes these mechanisms:

a) The eupohoria produced by heroin or cocaine can be attributed to the drug's rapid rate of action which in turn makes it more liable to be abused.
b) Snorted cocaine produces greater eupohoria than smoked or intravenous cocaine.
c) Cocaine once it reaches brain has a long duration of action that allows frequent abuse.
d) The potential usefulness of methadone as a treatment compound lies in its fast dissipation action.

82. In determining the abuse potential of a drug, which plays a more important role?

a) rate of action
b) duration of action

83. Research suggests that women become more quickly addicted than men to certain drugs, such as crack cocaine, even after casual or experimental use.

a) True
b) False

84. Many drug-using women do not seek treatment because

a) a vast majority of drug-abusing women have histories of physical and sexual abuse.
b) they fear reprisal from their spouses or boyfriends.
c) There are few programs designed to treat women drug-addicts.
d) women who use drugs have low self-esteem.

85. One of the more well-developed behavioral techniques in drug abuse treatment is contingency management. Which of the following statements best describes this technique?

a) Patients are taught new ways of acting and thinking that will help them stay off drugs.
b) A system of rewards and punishments is instituted to make abstinence attractive and drug use unattractive.
c) Patients are urged to avoid situations that lead to drug use and to practice drug refusal skills.
d) Patients are asked to make plans to prevent relapses, and in the event of a relapse follow a pre-set procedure to get back to abstinence.

86. In order to be effective, prevention programs should have certain characteristics. Select the correct strategy from the following:

a) Prevention programs should avoid targeting multiple drug abuse, such as tobacco, alcohol, marijuana, etc. They should concentrate on a single drug abuse.
b) Since drug abuse is found predominantly in dysfunctional families, prevention efforts should focus on parents only or children only, not both.
c) For cost effectiveness, prevention programs should address general nature of the drug abuse problem in the community, leaving specifics to the family.
d) Prevention programs should be long-term, with repeat interventions to reinforce the original prevention goals.

87. Prevention programs cost more than drug abuse treatment and counseling.

a) True
b) False

88. Drug Abuse Treatment Outcome Study (DATOS) studied treatment outcomes involving thou- sands of patients. What is the major challenge facing treatment systems in the country?

a) decline in the funding for services such as medical, legal, employment and financial help for the patients
b) ineffectiveness of drug abuse treatment programs
c) inadequate training programs for drug counselors
d) public's general apathy toward repeated drug abusers

89. According to a survey, patients reported that it took them about ________ after they first used their primary drug to enter treatment.

a) 90 days
b) 6 months
c) 1 year
d) 7 years

90. All but one of the following are key features of brief intervention for alcohol problems:

a) Brief intervention is generally restricted to four or fewer sessions, each session lasting from a few minutes to 1 hour.
b) Brief intervention is conducted by counselors specializing in alcohol abuse treatment.
c) It is most often used with patients who are not alcohol dependent, but report drinking at levels considered "risky" or "hazardous."
d) The goal of brief intervention is generally moderate drinking rather than abstinence.

91. There are several elements of brief intervention that make the strategy effective in the treatment of alcohol abuse. Which element is probably the best predictor of changes in the drinking behavior of the patient?

a) physician telling the patient that his or her drinking may be contributing to a certain medi- cal problem, such as hypertension
b) physician telling the patient to take responsibility and make a choice for reducing drinking
c) warm, reflective and understanding style of counseling
d) offereing a variety of strategies to reduce drinking
e) patient's readiness to change