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1. Which of the following is a feature that make alcohol, illicit drugs, and over-the-counter drugs important to public health and safety?
A. Many people use and misuse these substances.
B. Individuals can use these substances in a manner that causes harm to the user or those around them.
C. Prolonged, repeated misuse of any of these substances can produce changes to the brain that can lead to a substance use disorder, an independent illness that significantly impairs health and function and may require specialty treatment.
D. All of the above.
2. A medical illness caused by repeated misuse of a substance or substances is known as:
A. A substance use disorder
B. Addiction
C. Substance use
D. Substance misuse
3. Many people who misuse substance do not meet the diagnostic criteria for a substance use disorder.
A. True
B. False
4. Seventy-six percent of alcohol overdose deaths occur among those between ages 15 and 35, and 76% of those who die from alcohol overdose are women.
A. True
B. False
5. Over-prescription of powerful opioid pain relievers beginning in the 1990’s led to a rapid escalation of use and misuse of these substances by a broad demographic of men and women across the country, which led to a resurgence of heroin use, as some users transitioned to using this cheaper street cousin of expensive prescription opioids.
A. True
B. False
6. Recent systematic reviews have found that substance use is:
A. A risk factor for intimate partner violence.
B. A consequence of intimate partner violence.
C. Both (A) and (B).
D. None of the above.
7. Which of the following single factors will determine whether an individual will develop a substance misuse problem or disorder?
A. Easy access to inexpensive alcohol and other substances.
B. Low parental monitoring.
C. Low involvement in school.
D. None of the above.
8. Neither risk nor protective factors can be modified through preventive programs or policies to reduce vulnerability.
A. True
B. False
9. Although substance misuse problems and disorders may occur at any age, adolescence and young adulthood are particularly critical at-risk periods.
A. True
B. False
10. Among the last brain regions to reach maturity, and an area of the brain that is one of the most affected regions in a substance use disorder, the _____ is primarily responsible for “adult” abilities, such as delay of reward, extended reasoning, and impulse control.
A. Thalamus
B. Prefrontal cortex
C. Broca’s area
D. Amygdala
11. Tolerance and withdrawal are major clinical symptoms and are the deciding factor in whether an individual has an addiction.
A. True
B. False
12. Confrontational intervention approaches in general, though once the norm even in many behavioral treatment settings, have not been found effective and may backfire by heightening resistance and diminishing self-esteem on the part of the targeted individual.
A. True
B. False
13. The presence of a substance use disorder often _____ the odds for the subsequent development of chronic and expensive medical illnesses, such as arthritis, chronic pain, heart disease, stroke, hypertension, diabetes, and asthma.
A. Doubles
B. Triples
C. Quadruples
D. None of the above
14. To address the problem of fatal medication errors due to interactions between a prescribed medication for a diagnosed medical condition and patient substance use, researchers suggest:
A. Screening patients for use of alcohol and/or street drugs.
B. Taking extra precautions when prescribing medicines with known dangerous interactions with alcohol and/or street drugs.
C. Teaching the patient the risks of mixing medicines with alcohol and/or street drugs.
D. All of the above.
15. All of the following statements are true with regard to neuroadaptations, except for:
A. They compromise brain function.
B. They drive the transition from controlled, occasional substance use to chronic misuse, which can be difficult to control.
C. They diminish shortly after an individual stops using substances.
D. They may produce continued, periodic craving for the substance that can lead to relapse.
16. Addiction is an inevitable consequence of substance use.
A. True
B. False
17. The addiction cycle disrupts the normal functions of some neuronal networks.
A. True
B. False
18. Which of the following key component regions is involved in stress and the feelings of unease, anxiety, and irritability that typically accompany substance withdrawal?
A. The basal ganglia
B. The extended amygdala
C. The prefrontal cortex
D. All of the above
19. The dorsal striatum, a sub-region of the basal ganglia, is involved in motivation and the experience of reward.
A. True
B. False
20. The stage at which one seeks substances again after a period of abstinence is known as:
A. The preoccupation / anticipation stage of addiction.
B. The Binge / intoxication stage of addiction.
C. The withdrawal / negative affect stage of addiction.
D. None of the above.
21. Positive and negative reinforcement is driven solely by the effects of the drugs.
A. True
B. False
22. Dopamine is released in the brains of people addicted to cocaine when they are exposed to cues they have come to associate with cocaine, and occurs even though cocaine itself causes less dopamine to be released in these individuals compared to those who are not addicted to cocaine.
A. True
B. False
23. The negative feelings associated with withdrawal are thought to come from:
A. Diminished activation in the reward circuitry of the basal ganglia.
B. Activation of the brain’s stress systems in the extended amygdala.
C. Both (A) and (B).
D. None of the above.
24. Which neurotransmitter plays a key role in the negative feelings associated with withdrawal and in stress-triggered substance use?
A. Corticotropin-releasing factor
B. Norepinephrine
C. Dynorphin
D. All of the above
25. Taking drugs or alcohol to lessen the symptoms of withdrawal that occur during a period of abstinence actually causes those symptoms to be even worse the next time a person stops taking the substance, making it even harder to maintain abstinence.
A. True
B. False
26. People with alcohol, cocaine, or opioid use disorders show impairments in executive function, including disruption of decision-making and behavioral inhibition, which parallel changes in the prefrontal cortex and suggest greater activity of the _____ in response to substance-related stimuli.
A. Stop system
B. Go system
C. Both (A) and (B)
D. None of the above
27. Cannabis addiction follows a pattern similar to:
A. Opioids
B. Alcohol
C. Stimulants
D. None of the above
28. Evidence-based prevention interventions, carried out before the need for treatment, are critical because they can delay early use and stop the progression from use to problematic use or to a substance use disorder, all of which are associated with costly individual, social, and public health consequences.
A. True
B. False
29. When does the likelihood of substance use peak?
A. Adolescence
B. Twenties
C. Thirties
D. Forties
30. At the policy level, research shows that higher alcohol prices do not reduce alcohol misuse and related harms.
A. True
B. False
31. Research has shown that binge drinking is more common among individual in:
A. Higher income households
B. Lower income households
C. Equally between higher and lower income households
D. None of the above
32. Which category of prevention intervention is targeted to individuals who are already using substances but have not developed a substance use disorder?
A. Universal
B. Selective
C. Indicated
D. All of the above
33. Which of the following is the target audience for selective interventions?
A. Families living in poverty.
B. Children of depressed or substance-using parents.
C. Children who have difficulties with social skills.
D. All of the above.
34. The Classroom-Centered Intervention, which combined the Good Behavior Game with additional models of teacher instruction, reduced rates of _____ in middle and high school.
A. Cocaine and heroin use
B. Alcohol initiation
C. Marijuana initiation
D. All of the above
35. A 10% increase in the price of alcohol is expected to decrease binge drinking by 9.5% among women and 35.4% among men aged 18 to 21.
A. True
B. False
36. Policies that increase alcohol prices:
A. Delay the time when young people start to drink.
B. Slow the progression towards drinking larger amounts.
C. Reduce heavy drinking and the volume of alcohol drunk on each occasion.
D. All of the above.
37. Banning sales of alcohol on Sundays has been recognized as a cost-effective strategy.
A. True
B. False
38. Through which of the following city- or county-level laws can adults be held responsible for underage drinking parties held on their property, regardless of whether they directly provided alcohol to minors?
A. Zero tolerance laws
B. Criminal social host liability laws
C. Civil social host liability laws
D. Use / lose laws
39. One study found that for every additional advertisement seen by youth per month, they drank _____ more.
A. 1%
B. 3%
C. 9%
D. 12%
40. One study followed people from age 13 to 38 and found that those who began marijuana use in their teens and developed a persistent cannabis use disorder had up to _____ point drop in IQ, even if they stopped using in adulthood.
A. A four
B. An eight
C. A twelve
D. A sixteen
41. EBIs that are poorly implemented tend to have weak or no effect on participants.
A. True
B. False
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