CASAC - Credentialed Alcoholism and Substance Abuse Counselor Pharmacology & Co-Occurring Disorders Questions and Answers

Question 1

A client with a dual diagnosis of Opioid Use Disorder (OUD) and Major Depressive Disorder (MDD) is being treated with buprenorphine.
The client reports a significant reduction in both cravings and depressive symptoms.
Which pharmacological property of buprenorphine is most likely contributing to the antidepressant effect?

Accepted Answer

Antagonism at kappa-opioid receptors

Answer

Partial agonism at mu-opioid receptors

Answer

Full agonism at delta-opioid receptors

Answer

Blockade of serotonin reuptake

Question 2

A CASAC is working with a client who is taking disulfiram (Antabuse) for Alcohol Use Disorder (AUD). The client reports accidentally using a mouthwash that contained alcohol and is now experiencing nausea, flushing, and a throbbing headache. What is the most important piece of information for the CASAC to reinforce with the client?

Accepted Answer

The disulfiram-alcohol reaction can occur with even small amounts of alcohol from unexpected sources and can last for up to 14 days after the last dose.

Answer

These symptoms are a sign of an allergic reaction and require immediate medical attention.

Answer

The client should drink plenty of water to flush the alcohol from their system.

Answer

The client likely needs a higher dose of disulfiram to prevent this from happening again.

Question 3

A client in a methadone maintenance program has a co-occurring Panic Disorder and is prescribed a benzodiazepine by their psychiatrist. The CASAC should be aware that the concurrent use of methadone and benzodiazepines significantly increases the risk of which of the following?

Accepted Answer

Respiratory depression and overdose

Answer

Hypertensive crisis

Answer

Serotonin syndrome

Answer

Acute liver failure

Question 4

Which of the following medications for Alcohol Use Disorder (AUD) works by reducing the rewarding, euphoric effects of alcohol, thereby decreasing cravings, by acting as an opioid receptor antagonist?

Accepted Answer

Naltrexone (Vivitrol, Revia)

Answer

Acamprosate (Campral)

Answer

Disulfiram (Antabuse)

Answer

Buprenorphine (Sublocade)

Question 5

A client with Alcohol Use Disorder (AUD) and co-occurring anxiety has recently completed detoxification and is motivated to maintain abstinence. They have a history of liver problems. The medical provider is considering acamprosate (Campral). For the CASAC, what is a key counseling point about this medication?

Accepted Answer

Acamprosate helps restore chemical balance in the brain and is generally considered safe for patients with liver issues as it is not metabolized by the liver.

Answer

The medication will cause severe sickness if the client has even a small amount of alcohol.

Answer

It primarily works by blocking the pleasurable effects of alcohol, making relapse less likely.

Answer

It is an opioid-based medication that will also help reduce the client's anxiety symptoms directly.

Question 6

When working with a client who has a co-occurring anxiety disorder and a Substance Use Disorder (SUD), an integrated treatment approach is considered best practice. From a pharmacological standpoint, what does this primarily involve?

Accepted Answer

Coordinating care with medical providers to ensure medications for both disorders are managed safely and concurrently.

Answer

Treating the SUD first, and only addressing the anxiety with medication once sobriety is achieved.

Answer

Using benzodiazepines as a first-line treatment for anxiety to provide immediate relief.

Answer

Focusing solely on non-pharmacological interventions for anxiety to avoid potential for addiction.