Answer Key - Substance Abuse Quiz  

Question 1 – The DSM-5 has eliminated Axis V and has adopted which of the following instruments used in assessing the severity of a mental or physical disability?

ChoicesCorrect Answer  Rationale 
A. SSI – 2 (Symptom Severity Index – 2)  
B. SOFAS 4R (Social and Occupational Functioning Assessment Scale-R)  
C. WHODAS 2.0 (World Health Organization Disability Assessment Screen)XThe DSM-5 has eliminated the rating scale called the GAF (Axis V) and has identified the WHODAS which has various forms that will assess an individual’s performance in multiple domains.
D. CGI  (Clinical Global Impression Scale)  

Question 2 - In the DSM-5, the threshold diagnosis of Substance Use Disorder is: 

ChoicesCorrect Answer Rationale
A. 2 of 11 criteriaX11 criteria have been identified within four categories related to a Substance Use Disorder. Those categories include; Impaired Control, Social Impairment, Risky Use, and Pharmacological criteria.  If 2 or 3 criteria are identified, then a Substance Use Disorder is diagnosed with a specifier as “mild”, if 4 or 5 criteria are identified then a Substance Use Disorder is diagnosed with a specifier of “moderate,”  if 6 or more criteria are identified then a Substance Use Disorder with a specifier of  “severe” is diagnosed. 
B. 6 of 12 criteria  
C. 1 of 4 criteria  
D. 3 of 7 criteria  

Question 3- Which of these is NOT a specifier for Substance Use Disorder?

ChoicesCorrect Answer Rationale
A. Sustained remission  
B. In a controlled environment  
C. Early remission  
D. With social controlsXA, B, and C are specifiers used to identify the length of time a person may be in recovery, or whether or not there are social controls which restrict use of substances. Social controls are methods that a clinician can use to decide if “in a controlled environment” is a specifier in the current diagnosis. In close supervision, substance free jails, in therapeutic community, locked hospitals are among the social controls that may contribute to a specifier for Substance Use Disorder. 

Question 4 - A clinical picture of intoxication depends on: 

ChoicesCorrect Answer Rationale
A. The substance, the dose, the route of administration  
B. Tolerance, expectations, context  
C. Both of the aboveXIntoxication depends on an individual’s history with a substance, what potency or amount of the substance is used, how the substance is used (route), what physiological or psychological tolerance is present, and what is the context (triggers or use pattern) of the user of the substance. 
D. None of the above  

Question 5 - DXM is a

ChoicesCorrect Answer Rationale 
A. Synthetic cathinone with psychoactive properties  
B. Non-opioid antitussive with dissociative properties XThere are 10 categories of substances identified for Substance Use Disorder with one of the categories listed as “Other.”  DXM (Dextromethorphan) is often used for its dissociative effect by persons who enjoy the intoxicated state, persons that wish to get high but are subject to urinalysis testing, or are underage substance abusers and cannot legally utilize alcohol for intoxication.
C. Energy drink with alcohol related depressive properties and stimulant properties  
D. Brand of bath salts with psychedelic properties   

Question 6 - The E in CAGE-AID stands for 

ChoicesCorrect Answer Rationale 
A. Eye Opener early morning or upon rising use of a substanceXThe CAGE-AID is modified from the previously well documented screening device called the CAGE and adopted for the use in screening for drugs or alcohol. The same four question screening tool seeks to identify if there is the presence of a use pattern that may require an assessment to render a diagnosis.  The CAGE letters are related to use and consequence patterns. C stands for Cut down attempts. A stands for a query of others being Annoyed by the patient’s drinking, G stands for the patient feeling Guilty, E stands for early morning or upon rising use. The E is the Eye Opener that keeps withdrawals from taking place.  
B. End Stage indicating dependence and serves as a trigger for referral to treatment  
C. Early Intervention indicating a problem and serves as a trigger for referral for assessment   
D. Emergency indicating referral for laboratory screening and Primary Care Provider  intervention  

Question 7 - The primary psychiatric symptom of synthetic cathinone use in patients admitted to the Emergency Room has been identified through research as: 

ChoicesCorrect AnswerRationale
A. Chest pain  
B. Paranoia  
C. Violent behavior  
D. AgitationXCathinone is essentially a stimulant drug.  Synthetic cathinone drugs mimic a stimulant effect and when an emergency room presentation takes place, Agitation is the most common symptom identified. 

Question 8 - Which of the following is true? Synthetic marijuana 

ChoicesCorrect Answer Rationale 
A. Contains zohai  
B. Contains cannabis  
C. Does not contain cannabisXResearch has shown that synthetic cannabis is made of compounds that mimic cannabinoids and the products marketed as synthetic marijuana do not contain cannabis.   
D. Can be sold legally in the U.S.   

Question 9 - Intense activation of the reward system for a dialysis patient could cause problems 

ChoicesCorrect Answer Rationale
A. Following a renal diet  
B. Taking medication appropriately  
C. Attending to regular treatment   
D. All of the aboveXWhen substance use becomes a significant part of a dialysis or transplant patient’s activities, the addictive and craving process can affect all components of treatment compliance within behavioral and motivational spheres. 

Question 10 - A diagnosis of Substance Induced Mental Disorder

ChoiceCorrect Answer Rationale 
A. Is an independent disorder  
B. Does not require substantiating evidence  
C. Both of the above  
D. None of the aboveXTo diagnose a patient with a Substance Induced Disorder, the following components are part of that diagnosis: clinically significant presentation of a mental disorder; evidence by history; labs (or related observable data) or by physical examination; capable of producing observable mental disorder; and onset is during or within 1 month of use; persists for substantial time after use (which one would not expect); is not an independent mental disorder; and substance use preceded onset of the disorder.