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 in recovery from opioid use disorder is seeking employment. The CASAC counselor BEST assists by: → Connecting the client to vocational rehabilitation or workforce services
2. 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
3. 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
4. Which of the following is a warning sign of impending relapse that a CASAC counselor should address immediately? → Reconnecting with friends who use substances
5. The concept of 'ambivalence' in addiction counseling refers to: → Simultaneous conflicting feelings about changing substance use behavior
6. Aftercare planning for a client leaving residential treatment should PRIMARILY focus on: → Identifying ongoing support services to maintain recovery
7. The branch of pharmacology that deals with the biological, biochemical, and physical characteristics of natural drugs is: → Pharmacognosy.
8. What is a common side effect of disulfiram in treating alcohol dependence? → Nausea and vomiting when alcohol is consumed
9. Which co-occurring disorder is most commonly associated with substance use disorders across all substance categories? → Anxiety disorders and depressive disorders
10. 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
11. 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
12. 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
13. 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
14. 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
15. What is a common psychological factor that contributes to substance use disorders? → Trauma or stress
16. Which MI strategy involves the counselor asking clients to explore the positive aspects of their substance use before discussing the negatives? → Eliciting change talk through decisional balancing
17. Which document outlines ethical standards for substance abuse counselors? → The NAADAC Code of Ethics
18. What is the primary difference between screening and assessment? → Screening is quick and broad, while assessment is comprehensive and detailed
19. Which medication is FDA-approved for both opioid and alcohol use disorders? → Naltrexone
20. In MI, 'sustain talk' refers to: → Client statements that favor maintaining the status quo or not changing
21. What is the primary goal of diagnosis in substance abuse counseling? → To identify the specific disorder and guide treatment planning
22. What is the ethical response if a counselor realizes they lack the competence to treat a specific client? → Refer the client to a qualified professional
23. What is the importance of using standardized tools during assessment? → They ensure objectivity and consistency in evaluation
24. The Precontemplation stage in the Transtheoretical Model is best characterized by: → The client having no intention to change in the foreseeable future
25. Which of the following is an example of an internal high-risk situation for relapse? → Experiencing negative emotions such as anger or loneliness
26. Which of the following medications is used to reduce alcohol cravings? → Acamprosate
27. Which type of therapy focuses on helping clients recognize and change negative thought patterns related to substance use? → Cognitive Behavioral Therapy (CBT)
28. A formal relapse prevention plan should include which of the following elements? → Identification of triggers, coping strategies, and emergency contacts
29. Which of the following is an example of an 'affirmation' in Motivational Interviewing? → 'It sounds like you have made some difficult decisions to protect your health.'
30. During assessment, how should co-occurring mental health disorders be addressed? → Identify and incorporate them into an integrated treatment plan