CASAC Cheat Sheet 2026

The 30 highest-yield CASAC facts, distilled from real exam questions. Print it, save it as a PDF, or study it here — free, no sign-up.

1. A client on methadone maintenance asks if they can drink alcohol socially. The most clinically appropriate counselor response is to: → Advise complete abstinence due to dangerous CNS depression risk
2. A client in recovery from opioid use disorder is seeking employment. The CASAC counselor BEST assists by: → Connecting the client to vocational rehabilitation or workforce services
3. A client with alcohol use disorder is also prescribed warfarin for a heart condition. The counselor should be aware that alcohol: → Chronic heavy use decreases warfarin efficacy; acute intoxication increases bleeding risk
4. The 'ruler technique' used in MI asks clients to rate their readiness to change on a scale from 0 to 10. This is primarily used to: → Assess motivation and elicit change talk by exploring the client's rating
5. When a client presents with a co-occurring disorder, documentation of the treatment plan should: → Integrate goals addressing both the substance use and mental health conditions
6. In Marlatt and Gordon's cognitive-behavioral model of relapse, what is the first step in the relapse process? → An encounter with a high-risk situation
7. Which of the following is a warning sign of impending relapse that a CASAC counselor should address immediately? → Reconnecting with friends who use substances
8. The concept of 'ambivalence' in addiction counseling refers to: → Simultaneous conflicting feelings about changing substance use behavior
9. A counselor notices a supervisee consistently avoids confronting clients about relapse. This pattern is best addressed through: → Clinical supervision focused on countertransference
10. Aftercare planning for a client leaving residential treatment should PRIMARILY focus on: → Identifying ongoing support services to maintain recovery
11. The branch of pharmacology that deals with the biological, biochemical, and physical characteristics of natural drugs is: → Pharmacognosy.
12. When documenting a mandated reporter incident involving suspected child abuse, the counselor should: → Document the report made to the appropriate authority and the information disclosed
13. What is a common side effect of disulfiram in treating alcohol dependence? → Nausea and vomiting when alcohol is consumed
14. Which co-occurring disorder is most commonly associated with substance use disorders across all substance categories? → Anxiety disorders and depressive disorders
15. The concept of 'locus of control' is MOST relevant to which counseling theory when applied to addiction recovery? → Reality therapy
16. Under 42 CFR Part 2, a CASAC counselor can share substance use disorder records with another program's treatment provider if: → The client has provided a written consent that meets 42 CFR Part 2 requirements
17. Which of the following is a benzodiazepine with a long half-life often used for alcohol detoxification due to self-tapering properties? → Chlordiazepoxide (Librium)
18. Which principle of Motivational Interviewing is MOST applicable when a client in crisis is ambivalent about accepting help? → Rolling with resistance by exploring the ambivalence non-judgmentally
19. The biopsychosocial model of substance use disorders recognizes that addiction is caused by: → An interaction among biological, psychological, and social factors
20. Which of the following behaviors by a counselor would be MOST inconsistent with the principles of Motivational Interviewing? → Offering unsolicited advice and telling the client what to do
21. The Addiction Severity Index (ASI) covers how many problem areas in its composite scoring? → 7
22. What is the primary pharmacological difference between methadone and buprenorphine in treating opioid use disorder? → Methadone is a full agonist; buprenorphine is a partial agonist with a ceiling effect
23. Which of the following BEST describes the difference between a lapse and a relapse? → A lapse is a brief return to use; a relapse is a full return to problematic use patterns
24. A substance abuse counselor is documenting a client's treatment plan. Which of the following represents a properly written measurable treatment goal? → Client will attend at least three 12-step meetings per week for the next 30 days
25. A client scores 20 on the AUDIT. What level of intervention does this score typically indicate? → Referral to specialist
26. A CASAC counselor is documenting a client's progress note using the DAP format. What does the 'A' stand for? → Assessment
27. A 16-year-old client presents for assessment after a school referral for marijuana use. Which screening tool is MOST appropriate for this population? → CRAFFT
28. According to Yalom's model of group therapy, which therapeutic factor is MOST unique to group treatment and cannot be replicated in individual therapy? → Interpersonal learning through peer feedback and interaction
29. When administering the CAGE questionnaire, a positive response to how many questions suggests the need for further assessment of alcohol use? → Two or more positive responses
30. The CIWA-Ar (Clinical Institute Withdrawal Assessment for Alcohol-Revised) is used to assess which of the following? → The severity of alcohol withdrawal symptoms to guide pharmacological management