CADC Alcohol and Drug Counselor Co-Occurring Disorders 2 — Questions and Answers
Question 1: A client with bipolar disorder reports drinking heavily only during manic episodes. Which treatment priority best addresses this pattern?
- Treat the bipolar disorder first before addressing alcohol use
- Stabilize mood with medication while concurrently providing SUD counseling (Correct answer)
- Focus exclusively on sobriety before mood stabilization
- Defer psychiatric care until the client achieves 90 days of abstinence
Correct answer: Stabilize mood with medication while concurrently providing SUD counseling
Integrated concurrent treatment of both disorders is the evidence-based standard for co-occurring bipolar disorder and AUD.
Question 2: Which validated screening tool is specifically designed to assess trauma symptoms in clients with co-occurring substance use disorders?
- PHQ-9
- AUDIT-C
- PTSD Checklist (PCL-5) (Correct answer)
- CAGE questionnaire
Correct answer: PTSD Checklist (PCL-5)
The PCL-5 is a widely used, validated tool for assessing PTSD symptom severity, which commonly co-occurs with SUD.
Question 3: A counselor notices a client with schizophrenia uses cannabis to 'self-medicate' hallucinations. What should the counselor recognize about this behavior?
- Cannabis reliably reduces psychotic symptoms and should be allowed as harm reduction
- Self-medication with cannabis often worsens psychotic symptoms over time (Correct answer)
- This is adaptive coping and does not require intervention
- The client likely has a correct insight about their medication needs
Correct answer: Self-medication with cannabis often worsens psychotic symptoms over time
Cannabis use in individuals with schizophrenia is associated with increased psychotic symptom severity and more frequent relapses.
Question 4: In the Sequential treatment model for co-occurring disorders, what is a primary criticism?
- It treats both disorders simultaneously, causing client confusion
- Clients often fall through the gaps between separate treatment systems (Correct answer)
- It is too expensive for most treatment settings
- It relies exclusively on peer support without clinical oversight
Correct answer: Clients often fall through the gaps between separate treatment systems
Sequential treatment addresses one disorder at a time, which often leads to clients being discharged from one system before the other is ready, causing treatment gaps.
Question 5: Which neurotransmitter system is most implicated in both depression and alcohol use disorder, making them particularly likely to co-occur?
- Dopamine and the reward pathway
- Serotonin dysregulation (Correct answer)
- Acetylcholine and the cholinergic system
- Histamine regulation
Correct answer: Serotonin dysregulation
Serotonin dysregulation underlies both major depressive disorder and alcohol use disorder, contributing to their high rate of co-occurrence.
Question 6: A client with co-occurring ADHD and stimulant use disorder is assessed. Which approach is most appropriate regarding ADHD medication?
- Withhold all ADHD medication until 12 months of abstinence is achieved
- Consider non-stimulant ADHD medications and monitor closely with an integrated team (Correct answer)
- Prescribe stimulants freely as ADHD treatment takes priority
- Diagnose ADHD only after complete withdrawal from stimulants is confirmed
Correct answer: Consider non-stimulant ADHD medications and monitor closely with an integrated team
Non-stimulant medications like atomoxetine can treat ADHD while minimizing abuse potential, and close monitoring within an integrated team is best practice.
Question 7: When a client with co-occurring disorders experiences symptom exacerbation after stopping substance use, what term describes this phenomenon?
- Kindling effect
- Protracted withdrawal
- Rebound psychiatric symptoms (Correct answer)
- Post-acute withdrawal syndrome (PAWS)
Correct answer: Rebound psychiatric symptoms
Rebound psychiatric symptoms occur when substances that were masking underlying mental health symptoms are removed, causing those symptoms to re-emerge or intensify.
CADC Alcohol and Drug Counselor Co-Occurring Disorders 2
A client with bipolar disorder reports drinking heavily only during manic episodes.
Which treatment priority best addresses this pattern?