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8. Substance-Related and Addictive Disorders Multiple-Choice Questions 1. The two substances that have caused the most death through sickness and accident are ______. A. heroin and cocaine B. opium and heroin C. alcohol and cocaine D. alcohol and tobacco Answer: D 2. In the United States, 1 in _________ adults smoke cigarettes. A. 2 B. 5 C. 8 D. 11 Answer: B 3. The DSM-5 classifies substance-related disorders into ______ major categories. A. two B. three C. four D. five Answer: A 4. According to the DSM-5, the two main types of ______ disorders include substance intoxication and substance withdrawal. A. substance use B. substance induced C. substance reaction D. psychoactive Answer: B 5. Alvin drank alcohol chronically for years until he developed a type of dementia called Korsakoff’s syndrome. His dementia would be classified by the DSM-5 as a ______ disorder. A. substance induced B. substance use C. substance reaction D. psychoactive Answer: A 6. The chemical actions of psychoactive drugs which result in a person feeling "drunk" or "high" are called substance ______. A. tolerance B. intoxication C. withdrawal D. potentiation Answer: B 7. __________ is a substance-induced disorder involving a cluster of symptoms that occur when a person abruptly stops using a particular substance following a period of prolonged and heavy use. A. Tolerance B. Intoxication C. Withdrawal D. Potentiation Answer: C 8. Abstinence syndrome is another name for ______. A. dependence B. withdrawal C. addiction D. potentiation Answer: B 9. Physical habituation to a drug so that frequent usage necessitates higher and higher dosages to attain similar effects is called ______. A. dependence B. tolerance C. addiction D. potentiation Answer: B 10. Gina has been using heroin for two years. Lately, she has found she must inject higher and higher dosages of the drug to get the same "high" she has come to expect from her drug use. Her need for higher dosages is best described as ______. A. dependence B. addiction C. tolerance D. potentiation Answer: C 11. Theresa suffers from alcoholism. When she goes too long without a drink she begins to feel anxious, physically weak, and agitated. Often, she begins shaking and can feel her heart racing. Theresa's symptoms are typical of what is called ______. A. dependence B. tolerance C. addiction D. abstinence syndrome Answer: D 12. Which of the following represent withdrawal symptoms from alcohol abuse? A. dryness in the mouth B. low blood pressure C. hyperactivity D. low respiration rate Answer: B 13. Chronic, heavy users of alcohol who dramatically lower their alcohol intake after many years of heavy drinking may enter a withdrawal state known as ______. A. delirium tremens B. disorientation C. tachycardia D. potentiation Answer: A 14. Which of the following psychoactive substances can lead to withdrawal syndrome when use is discontinued? A. LSD B. opioids C. phencyclidine (PCP) D. inhalants Answer: B 15. The "DTs" are usually limited to ______ who dramatically ______ their intake of alcohol. A. casual drinkers, increase B. moderate drinkers, increase C. chronic sufferers of alcoholism, increase D. chronic sufferers of alcoholism, decrease Answer: D 16. Burt has just gone "on the wagon" and has quit using alcohol "cold turkey." He is now experiencing sweating, tachycardia, mental confusion, incoherent speech, disorientation, terrifying hallucinations, and extreme restlessness. His symptoms are typical of ______. A. alcohol overdose B. alcohol tolerance C. delirium tremens D. hypnagogic shock Answer: C 17. __________ is a state of mental confusion characterized by incoherent speech, disorientation, and extreme restlessness. A. Cross-tolerance B. Delirium C. Amnesia D. Dementia Answer: B 18. Which of the following is known to produce a withdrawal syndrome? A. PCP B. marijuana C. LSD D. inhalants Answer: B 19. The DSM-5 diagnosis of a substance use disorder requires _________ specific features or symptoms occurring during the preceding ________ period. A. two or more; six month B. three or more; six months C. three or more; one year D. two or more; one year Answer: D 20. According to the DSM-5, ______ are patterns of maladaptive use of psychoactive substances that lead to significant levels of impaired functioning or personal distress. A. substance use B. substance induced C. substance reaction D. psychoactive Answer: A 21. In the DSM-5, having persistent problems cutting back or controlling alcohol use despite wanting to do so is a symptom of a substance ______. A. dependence disorder. B. withdrawal disorder. C. use disorder. D. misuse disorder. Answer: C 22. Jim drinks alcohol and occasionally drives while intoxicated above what is considered the legal limit. His use of alcohol in situations that pose a risk to his or others’ safety would warrant the DSM-5 diagnosis of ______. A. substance dependence disorder B. substance abuse disorder C. substance misuse disorder D. substance use disorder Answer: D 23. In the DSM-5, tolerance and withdrawal syndromes are associated with ______ A. substance addiction disorders. B. substance dependence disorders. C. substance use disorders. D. substance misuse disorders. Answer: C 24. According to the DSM-5, substance abuse and substance dependence are no longer considered distinct categories and are both classified as ______ disorders. A. substance use B. substance induced C. substance reaction D. psychoactive Answer: A 25. The DSM-5 allows clinicians to designate the severity of substance use disorders by specifying whether they are _________. A. mild, moderate, or chronic B. intermittent, continuous, or addicted C. normal, mild, or severe D. mild, moderate, or severe Answer: D 26. An estimated ______ percent of adults in the United States develop a substance abuse disorder at some point in their lives. A. 1 B. 10 C. 20 D. 30 Answer: B 27. African Americans and Latinos have ________ rates of substance use disorders compared to European Americans. A. much higher B. higher C. about the same D. lower Answer: D 28. The DSM-5 includes ________.as a new diagnostic category under Substance Use and Addictive Disorders. A. kleptomania B. gambling disorder C. sexual addiction D. pyromania Answer: B 29. Which of the following is no longer considered an Impulse Control Disorder in the DSM-5? A. kleptomania B. shopping addiction C. sexual addiction D. gambling disorder Answer: D 30. ______ means that one's body has changed as a result of regular usage of a substance, as shown by the development of tolerance for the substance, by a withdrawal syndrome, or both. A. Psychological dependence B. Physiological dependence C. Potentiation D. Emotional dependence Answer: B 31. The habitual or compulsive use of a drug that is accompanied by signs of physiological dependence is called ______. A. substance misuse B. substance abuse C. tolerance D. addiction Answer: D 32. Sophie has used heroin to the point that she has developed a tolerance to it and experiences withdrawal symptoms when she tries to quit using it. She has become ______ heroin. A. psychologically dependent on B. physiologically dependent on C. emotionally dependent on D. psychologically abusive of Answer: B 33. The DSM-5 uses the term “substance use disorder” rather than the term “addictive disorder” because ______. A. the use of the term addiction is rarely used by professionals B. the use of the term addiction is rarely used by laypeople C. the term addiction is less stigmatizing D. the term substance use disorder is less stigmatizing Answer: D 34. Withdrawal symptoms in individuals with nonchemical addictions are typically ________. A. physiological B. psychological C. physiological and psychological D. non-existent Answer: B 35. Jan has used cocaine to the point where she has impaired control over her use of it. While she experiences no withdrawal symptoms when she stops using it, she wants it so badly she cannot She has become ______ cocaine. A. psychologically dependent on B. physiologically dependent on C. physiologically abusive of D. emotionally attached to Answer: A 36. Which of the following is true? A. Persons can become psychologically dependent on drugs in the absence of emotional dependence. B. Persons cannot become physically dependent on drugs in the absence of psychological dependence. C. Persons cannot become simultaneously psychologically and physically dependent on drugs. D. Persons who are physically dependent on drugs are by definition also psychologically dependent. Answer: D 37. The pathway to drug dependence includes all but which of the following stages? A. experimentation B. routine use C. addiction or dependence D. toxic use Answer: D 38. People who use drugs to "feel good" on an occasional basis and believe they are in control and can stop at any time are on the ______ pathway to drug dependence. A. routine use B. addiction or dependence C. experimentation D. toxic use Answer: C 39. When people begin to structure their lives around the pursuit and use of drugs, they are on the ______ pathway to drug dependence. A. experimentation B. addiction or dependence C. routine use D. toxic use Answer: C 40. When people feel powerless to resist drugs, either because they want to experience the effects of the drugs or they want to avoid the consequences of withdrawal, they are on the ______ pathway of drug dependence. A. toxic use B. addiction or dependence C. routine use D. experimentation Answer: B 41. Jay uses drugs at parties, and sometimes at home. He does not use them daily, only on "special" occasions. The drugs make him feel good, even euphoric at times, but the effects do not last. He feels in control and believes he can stop at any time. He is in the ______ stage of drug dependence. A. experimentation B. routine use C. addiction or dependence D. toxic use Answer: A 42. Tony has begun to structure his life around the pursuit and use of drugs. He denies that he has a problem and tries to cover up the behavioral problems he is having because of his drug use. His friends and family now take a distant second place to his drug habit. He is in the ______ stage of drug dependence. A. experimentation B. routine use C. addiction or dependence D. toxic use Answer: B 43. Greg has been using drugs for three years. He feels powerless to resist his cravings for drugs. His whole life revolves around his next "high." Nothing else matters to him. He has lost his job. His wife and children have left him, and all he can say is "They didn't understand!" Now he is robbing banks to get money to support his $7,000 per week habit. He is in the ______ stage of drug dependence. A. experimentation B. routine use C. addiction or dependence D. toxic use Answer: C 44. Drugs of abuse are classified within three major groupings. Which of the following is one of the groupings? A. depressants B. anesthetics C. cholengerics D. neuroleptics Answer: D 45. Depressants generally act by curbing the activity of the ______. A. central nervous system B. peripheral nervous system C. parasympathetic system D. endocrine system Answer: A 46. The most widely abused substance in the world is ______. A. alcohol B. heroin C. nicotine D. opium Answer: A 47. The most widely abused substance in the United States is ______. A. alcohol B. heroin C. nicotine D. marijuana Answer: A 48. Alcohol, in large quantities, usually kills by ______. A. poisoning brain cells B. depressing heart rate C. depressing breathing D. causing severe convulsions Answer: C 49. Alcohol is classified as a(n) ______. A. depressant B. stimulant C. hallucinogenic D. opiate Answer: A 50. Alcohol has biochemical effects similar to those of a class of ______. A. antidepressants B. anticoagulants C. minor tranquilizers D. major tranquilizers Answer: C 51. Alcohol is classified a depressant and has biochemical effects similar to those of a class of antianxiety drugs that would include which of the following? A. MAO inhibitors B. SSRIs C. Phenothiazines D. Benzodiazepines Answer: D 52. The most widely held view of alcoholism is the ______ model. A. addiction B. psychological C. physical D. disease Answer: D 53. The personal and social costs of alcoholism ______. A. are somewhat less than those associated with nicotine use B. are similar to those associated with chronic marijuana use C. are exceeded only by the costs associated with illicit drug use D. exceed those of all illicit drugs combined Answer: D 54. Alcohol is implicated in about one in ______ reported suicides. A. three B. five C. seven D. nine Answer: A 55. Alcohol is implicated in about one in ______ deaths due to unintentional injury, such as motor vehicle accidents. A. two B. three C. four D. five Answer: B 56. Of the 100,000 people in the U.S. who die from alcohol-related causes each year, the most frequent are from motor vehicle accidents and alcohol-related ______. A. arson B. homicides C. diseases D. suicides Answer: C 57. More teenagers and young adults die from ______ than from any other cause. A. suicide B. violent crime C. illicit drug use D. alcohol-related motor vehicle accidents Answer: D 58. ______ is the drug of choice among young people today. A. Alcohol B. Marijuana C. Cocaine D. LSD Answer: A 59. The most popular drug on college campuses is ______. A. alcohol B. marijuana C. nicotine D. cocaine Answer: A 60. The highest rates of alcohol use and highest proportions of problem drinkers occurs in the ______ age rage. A. 18 to 24 B. 25-30 C. 20 to 40 D. 40 to 45 Answer: C 61. Men are over ______ times more likely than women to be diagnosed with an alcohol use disorder. A. 2 B. 5 C. 10 D. 14 Answer: A 62. Which of the following is true regarding alcohol's effects on women? A. Women have more of an enzyme that breaks down alcohol in the stomach than men do. B. Alcohol may hit women harder because they weigh less than men. C. Most women find the taste of alcohol unpleasant and thus drink less. D. Women may be less likely to develop alcoholism because of the “flushing” response to drinking it. Answer: A 63. Which of the following disorders is a predictor of alcoholism? A. generalized anxiety disorder B. bipolar affective disorder C. antisocial personality D. conversion disorder Answer: C 64. The BEST predictor of alcoholism or problem drinking in adulthood is ______. A. family history of alcohol abuse B. ethnic background C. antisocial personality D. social class Answer: A 65. Which of the following is a risk factor in alcoholism? A. educational attainment B. age C. intelligence level D. region of the country one resides in Answer: C 66. Which of the following is the BDOC (Big Drug On Campus) among college students? A. amphetamines B. marijuana C. cocaine D. alcohol Answer: D 67. Alcohol use disorders tend to develop somewhat ______ in women than in men, and are more common among people living ______. A. earlier, alone B. later, alone C. earlier, with someone else D. later, with someone else Answer: B 68. Alcohol dependence is generally more common among people of ______ income levels and ______ education levels. A. lower, lower B. lower, higher C. higher, lower D. higher, higher Answer: A 69. Which of the following people has the highest risk of developing alcoholism? A. a wealthy, well-educated 30-year-old female B. a poor, well-educated 60-year-old female C. a wealthy, uneducated 50-year-old male D. a poor, uneducated 25-year-old male Answer: D 70. Which of the following groups is at lowest risk of developing alcoholism? A. Native Americans B. African Americans C. Jewish Americans D. Irish Americans Answer: C 71. Which American ethnic group has the lowest rate of alcoholism? A. Asian Americans B. Hispanic Americans C. African Americans D. European Americans Answer: A 72. Many Asian Americans ______ when they drink which may curb excessive alcohol intake and reduce their risk of developing alcoholism. A. become nauseous B. pass out C. develop heart palpitations D. show a flushing response Answer: D 73. Hispanic American men are ______ as likely as non-Hispanic White males to drink alcohol and develop alcohol use disorders. A. half B. equally C. twice D. four times Answer: B 74. Compared to non-Hispanic White women, Hispanic women are ______ likely to drink alcohol and are ______ likely to develop alcohol use disorders. A. less, less B. more, less C. less, more D. more, more Answer: A 75. Which of the following people is least likely to use alcohol and develop alcohol use disorders? A. a Hispanic American male B. a non-Hispanic White male C. a Hispanic American female D. a non-Hispanic White female Answer: C 76. The prevalence of cirrhosis of the liver among African Americans is about ______ of that among non-Hispanic White Americans. A. half B. the same C. twice D. four times Answer: C 77. Compared to non-Hispanic White Americans, African Americans are ______ likely to develop alcohol abuse or dependence, and are ______ likely to develop cirrhosis. A. less, less B. less, more C. more, less D. more, more Answer: B 78. A degenerative, potentially fatal liver disease is ______. A. cirrhosis B. anemia C. Korsakoff’s syndrome D. melanoma Answer: A 79. Which of the following ethnic groups is at highest risk of developing alcoholism? A. Italian Americans B. Native Americans C. Hispanic Americans D. German Americans Answer: B 80. Many Native Americans believe _______________ is largely responsible for their high rates of drinking-related problems. A. discrimination and prejudice from more dominant racial groups B. loss of their traditional culture C. lack of access to stimulating activities on reservations D. poverty and lack of access to good health care Answer: B 81. ________________ appear to explain why African American males have a higher rate of alcohol-related health issues yet a lower rate of alcohol dependence compared to European American males. A. Genetics B. Choice of alcoholic beverage C. Socioeconomic factors D. Cultural practices Answer: B 82. With increasing acculturation, alcohol use and abuse by Hispanic American women in the United States is becoming more similar to __________ women. A. Asian American B. African American C. European American D. Native American Answer: C 83. Approximately ______ of college students today have engaged in binge drinking during the past 30 days. A. one out of two B. two out of three C. one out of four D. two out of five Answer: D 84. Approximately ______ percent of adults today have engaged in binge drinking during the past 30 days. A. 7 B. 17 C. 27 D. 37 Answer: B 85. Leslie, a University of Virginia student, described in the text, died from binge drinking as a result of ______. A. liver failure B. a motor vehicle accident C. falling down stairs D. mixing the alcohol with Tylenol Answer: C 86. Debbie is a college sophomore who binge drinks. According to the profiles developed by Ham and Hope, Debbie is probably drinking because ______. A. she will enjoy the social results B. it is a regular part of her sorority life C. her friends drink D. it will soothe her feelings of anxiety and depression Answer: D 87. Anton is a college sophomore who binge drinks. According to the profiles developed by Ham and Hope, he is probably drinking because ______. A. it helps him sleep better at night B. it is a regular part of his fraternity life C. it helps him pass the time when he is alone D. it will soothe his feelings of anxiety and depression Answer: B 88. Alcohol is most similar in its biochemical effects to ______. A. marijuana B. methamphetamines C. opiates D. benzodiazepines Answer: D 89. Alcohol affects us by ______. A. increasing central nervous system activity B. reducing sensitivity of the parasympathetic nervous system C. heightening activity of GABA D. increasing sensitivity of norepinephrine receptor sites Answer: C 90. Alcohol appears to heighten the activity of the neurotransmitter ______. A. GABA B. endorphin C. serotonin D. dopamine Answer: A 91. Which of the following is true of alcohol's effects? A. It encourages people to talk more openly and honestly. B. It lowers people's ability to envision the consequences of misbehavior. C. It directly increases people's sexual responsiveness. D. It makes it easier for people to sleep. Answer: B 92. Which drug is most likely to be implicated in cases of domestic violence and sexual assaults? A. Xanax B. marijuana C. alcohol D. Prozac Answer: C 93. Increasing amounts of alcohol use can ______ sexual performance. A. delay B. impair C. enhance D. arouse Answer: B 94. Chronic alcohol abuse is connected with which of the following? A. cancer B. increased aerobic capacity C. anemia D. arthritis Answer: D 95. A potentially fatal disorder in which healthy liver cells become supplanted with scar tissue is ______. A. alcoholic hepatitis B. cirrhosis of the liver C. Korsakoff’s syndrome D. Wernicke's syndrome Answer: B 96. Cirrhosis of the liver is linked to ______. A. direct death of liver cells from long-term alcohol poisoning B. protein deficiencies related to long-term alcohol abuse C. vitamin deficiencies related to long-term alcohol abuse D. carbohydrate deficiencies related to long-term alcohol abuse Answer: B 97. A liver disease which involves a serious and potentially life-threatening inflammation of the liver is called _______. A. alcoholic hepatitis B. cirrhosis of the liver C. Korsakoff’s syndrome D. Wernicke's syndrome Answer: A 98. Korsakoff’s syndrome is linked to ______. A. direct death of brain cells from long-term alcohol poisoning B. protein deficiencies related to long-term alcohol abuse C. vitamin deficiencies related to long-term alcohol abuse D. carbohydrate deficiencies related to long-term alcohol abuse Answer: C 99. ______ is characterized by glaring confusion, disorientation, and memory loss for recent events. A. Broca's syndrome B. Wernicke's syndrome C. Korsakoff’s syndrome D. Klinefelter's syndrome Answer: C 100. Habitual drinkers tend to be ______. A. hyperactive B. underachievers C. malnourished D. obese Answer: C 101. Mothers who drink place the fetus at risk for which of the following? A. infant mortality B. development of Alzheimer’s disease later in life C. low vision D. later infertility Answer: D 102. Fetal alcohol syndrome has been found among children of mothers who drank as little as ______ of alcohol per week. A. a drink and a half B. 3 drinks C. five drinks D. seven drinks Answer: A 103. A childhood disorder characterized by facial features such as a flattened nose, widely spaced eyes, an underdeveloped upper jaw, mental retardation, and social skills deficits is ______. A. Korsakoff’s syndrome B. infantile autism C. fetal alcohol syndrome D. Reye’s syndrome Answer: C 104. Correlational studies indicate that where drinking alcohol is concerned, ______ most beneficial to one's health. A. abstinence is B. moderate levels of drinking are C. heavy levels of drinking are D. very heavy levels of drinking are Answer: B 105. Light drinking appears to incur some positive health benefits through ______. A. a protective effect on the heart and circulatory system, B. raising levels of LDL C. increasing overall metabolism D. decreasing overall metabolism Answer: A 106. Moderate alcohol use is defined as about ______ for women. A. 1 to 3 drinks per week B. 1 drink per day C. 2 to 4 drinks per day D. 4-6 drinks per month Answer: B 107. Moderate alcohol use is defined as about ______ for men. A. 3 drinks per week B. 2 drinks per day C. 4 drinks per day D. 10 drinks per month Answer: B 108. Amobarbital, Secobarbital, Phenobarbital, and Pentobarbital are ______. A. opiates B. stimulants C. barbiturates D. hallucinogenics Answer: C 109. Barbiturates are ______. A. opiates B. sedatives C. antidepressants D. stimulants Answer: B 110. Barbiturates are ______. A. opiates B. depressants C. hallucinogens D. stimulants Answer: B 111. Barbiturates ______ create psychological dependence and ______ create physiological dependence. A. do not, do not B. quickly, do not C. do not, quickly D. rapidly, quickly Answer: D 112. High doses of barbiturates produce effects similar to those of ______. A. hallucinogenics B. alcohol C. cocaine D. methamphetamines Answer: B 113. The effects of barbiturates last about ______ hours. A. 1 to 3 B. 3 to 6 C. 6 to 9 D. 9 to 12 Answer: B 114. Barbiturate use results in the development of ______. A. neither tolerance nor withdrawal B. tolerance but not withdrawal C. withdrawal but not tolerance D. both tolerance and withdrawal Answer: D 115. Which of the following is true of barbiturates? A. They have few side effects when used in the long-term treatment of insomnia. B. They rarely create psychological and physiological dependence. C. They are stimulating and can produce a mild state of euphoria. D. Abrupt withdrawal from barbiturates after tolerance has developed can produce fatal seizures. Answer: D 116. Barbiturates have synergistic effects when combined with ______. A. cocaine B. marijuana C. PCP D. alcohol Answer: D 117. A mixture of barbiturates and alcohol is about ______ times as powerful as either drug used by itself. A. two B. four C. six D. eight Answer: B 118. Marilyn Monroe and Judy Garland died at least in part due to ingesting a combination of alcohol and ______. A. antidepressants B. mood stabilizers C. barbiturates D. stimulants Answer: C 119. Drugs that are used medically for pain relief but that have strong addictive potential are ______. A. stimulants B. hallucinogens C. narcotics D. neuroleptics Answer: C 120. Which of the following is an opioid? A. codeine B. phencyclidine C. propofol D. modafanil Answer: A 121. Opioids are classified as ______. A. narcotics B. mild tranquilizers C. stimulants D. hallucinogens Answer: A 122. The major medical application for opioids is ______. A. tranquilization B. disinfection C. CNS arousal D. analgesia Answer: D 123. Endorphins are similar in chemical structure and lock into the same receptor sites as ______. A. barbiturates B. opioids C. hallucinogenics D. stimulants Answer: B 124. Endorphins function chiefly to ______. A. increase metabolic rate B. regulate states of pleasure and pain C. decrease central nervous system functioning D. increase GABA sensitivity Answer: B 125. Natural substances that function as neurotransmitters in the brain and are similar in their effects to morphine are ______. A. catecholamines B. neuroleptics C. endorphins D. antigens Answer: C 126. Initial withdrawal symptoms associated with opioids include ________. A. high blood pressure and cramps B. vomiting, insomnia, and diarrhea C. tremors and hot and cold flashes D. anxiety, irritability, and cravings Answer: D 127. After a few days following the last dose of an opioid, withdrawal symptoms include ________. A. cravings B. anxiety C. hot and cold flashes D. irritability Answer: C 128. The withdrawal syndrome associated with opioids usually begins within ________ hours of taking the last dose. A. 1-2 B. 4-6 C. 8-12 D. 20-24 Answer: C 129. ______ was introduced in the United States around the time of the Civil War and was used o deaden pain from wounds. A. Morphine B. Heroin C. Opium D. Codeine Answer: A 130. In the 19th century, physiological dependence on ______ became known as "soldier's disease." A. codeine B. morphine C. opium D. heroin Answer: B 131. Morphine’s name is derived from Morpheus, the Greek god of ______. A. pleasure B. pain C. poetry D. dreams Answer: D 132. The most widely used opiate is ______. A. morphine B. opium C. heroin D. methadone Answer: C 133. Heroin is usually ______. A. injected B. swallowed C. snorted D. smoked Answer: A 134. The positive effects of heroin ______. A. are immediate B. take several minutes to develop C. vary greatly from user to user D. take several hours to develop Answer: A 135. Heroin is a ______. A. stimulant B. hallucinogen C. depressant D. designer drug Answer: C 136. Heroin produces a powerful rush that lasts from ______. A. 5 to 15 seconds B. 5 to 15 minutes C. 5 to 15 hours D. 5 to 15 days Answer: B 137. Psychoactive substances that increase nervous system activity are called ______. A. opioids B. hallucinogens C. stimulants D. depressants Answer: C 138. Which of the following is an amphetamine? A. Brotizolan B. Methedrine C. Benzodiazepine D. Phencyclidine Answer: B 139. Amphetamines are used in high doses for their ______. A. pain-killing properties B. calming effects C. euphoric rush D. appetite enhancing qualities Answer: C 140. An amphetamine which is smoked in a rather pure form is known as ______. A. crack B. bennies C. speed rush D. crystal meth Answer: D 141. The most potent form of amphetamine is ______. A. liquid methamphetamine B. amphetamine sulfate C. dextroamphetamine D. methylphenidate Answer: A 142. Which of the following is true of amphetamines? A. Psychological dependence on amphetamines is rare. B. Amphetamine users do not show an abstinence syndrome when they stop usage. C. High doses can cause delusions, hallucinations, and insomnia. D. Amphetamine users do not suffer the “crash” experience that cocaine users typically report of when the drug wears off. Answer: C 143. Amphetamine psychosis most closely resembles ______. A. disorganized schizophrenia B. dissociative personality disorder C. paranoid schizophrenia D. catatonic schizophrenia Answer: C 144. ______, a designer drug that is chemically similar to amphetamines, became a popular illicit drug during the 1990s at clubs and “raves.” A. MXR B. PCP C. Ecstasy D. Crystal meth Answer: C 145. Ecstasy is chemically similar to ______. A. nicotine B. endorphins C. alcohol D. amphetamine Answer: D 146. Teen use of ecstasy ______ in the early years of the new millennium. A. dropped significantly B. increased significantly C. stayed the same D. varied unpredictably Answer: A 147. Ecstasy can produce which of the following psychological effects? A. increased alertness B. relaxation and calm C. psychosis D. drowsiness Answer: C 148. Clark has used ecstasy several times during high school. Which cognitive function could be impaired when Clark enters college? A. concentration B. memory C. perceptual motor coordination D. organizational ability Answer: B 149. Which of the following statements is true? A. In lower doses, ecstasy improves concentration and arousal. B. Ecstasy can deplete dopamine levels in the brain. C. Ecstasy is chemically similar to cocaine. D. When mixed with other stimulants, cause low blood pressure. Answer: B 150. Cocaine is a(n) ______. A. stimulant B. depressant C. opioid D. hallucinogen Answer: A 151. Withdrawal symptoms for cocaine are usually ______ in duration and involve a period of ______ depression. A. brief, mild B. extended, mild C. brief, intense D. extended, intense Answer: C 152. Crack contains about ______ percent pure cocaine. A. 35 B. 55 C. 75 D. 95 Answer: C 153. The most habit-forming street drug available is ______. A. 'srooms B. crack C. purple drank D. angel dust Answer: B 154. A method which intensifies the rush of cocaine by heating it with ether and then smoking it is called ______. A. snorting B. mainlining C. freebasing D. downstreaming Answer: C 155. Next to marijuana, ______ is the most widely used illicit drug in the United States. A. heroin B. alcohol C. methamphetamine D. cocaine Answer: D 156. Which of the following is a complication of cocaine use? A. permanent dopamine depletion B. fatal, irregular heart rhythms C. decreased heart rate D. decreased blood pressure Answer: C 157. Cocaine is associated with which of the following? A. psychosis B. obesity C. hypochondriasis D. diabetes Answer: A 158. Which of the following is cited as a complication of cocaine use? A. ulcers of the nostrils B. cancer of the throat C. diabetes D. pancreatic damage Answer: D 159. Habitual smoking of nicotine creates an ______ addiction to a ______ drug. A. psychological, depressant B. physical, stimulant C. physical, depressant D. psychological, stimulant Answer: B 160. Over ______ people die each year in the United States from smoking-related illnesses. A. 200,000 B. 300,000 C. 400,000 D. 500,000 Answer: C 161. Smoking ______ the risk of dying in mid-life. A. reduces B. has no effect on C. slightly increases D. doubles Answer: D 162. About ______ people die around the world annually from smoking-related illnesses. A. 750,000 B. 1 million C. 2 million D. 3 million Answer: D 163. About ______ percent of Americans smoke today. A. 5 B. 10 C. 15 D. 20 Answer: D 164. More women die of ______ cancer than any other form of cancer. A. cervical B. breast C. uterine D. lung Answer: D 165. By quitting smoking, one can reduce one’s risk of having cancer _________. A. to rates below that of individuals who never smoked B. to lower rates but not to rates as low as that of someone who never smoked C. is undetermined due to the fact that all of the research is correlational D. to rates equal to that of individuals who never smoked Answer: B 166. Which of the following ethnic groups has the highest percentage of individuals who smoke? A. African Americans B. Asian Americans C. Native Americans D. Caucasian Americans Answer: C 167. Walt is a novice smoker. As he smokes, his skin becomes cold and clammy, and he feels nauseous, dizzy, and faint. Later on he develops diarrhoea. His symptoms are directly due to the action of ______ in his cigarettes. A. carbon monoxide B. carbohydrates C. hydrocarbons D. nicotine Answer: D 168. The stimulant in tobacco smoke which gives cigarettes their "kick" is ______. A. carbon monoxide B. the carbohydrates C. the hydrocarbons D. nicotine Answer: D 169. Nicotine stimulates the body by causing a discharge of ______. A. estrogen B. testosterone C. epinephrine D. dopamine Answer: C 170. Nicotine creates pleasurable feelings by causing the release of ______. A. endorphins B. enkaphalins C. catecholamines D. cortisol Answer: A 171. Nicotine use leads to ______. A. neither tolerance nor withdrawal B. tolerance but not withdrawal C. withdrawal but not tolerance D. tolerance and withdrawal Answer: D 172. About ______ of tobacco users who quit for two or more days show evidence of tobacco withdrawal disorder. A. 25% B. 90% C. 50% D. 30% Answer: C 173. Hallucinogens are also known as ______. A. opioids B. depressants C. stimulants D. psychedelics Answer: D 174. Drugs that produce sensory distortions or hallucinations as their primary psychoactive effect are called ______. A. opioids B. stimulants C. barbiturates D. hallucinogens Answer: D 175. Which of the following is classified as a hallucinogenic drug? A. marijuana B. Meow-meow C. methamphetamine D. cocaine Answer: A 176. Research indicates ______ to hallucinogens. A. that there is no evidence of the development of tolerance or withdrawal syndrome B. that tolerance may develop but there are no withdrawal syndrome C. no support for the development of tolerance but a clearly identified withdrawal syndrome D. the development of tolerance and a clearly identified withdrawal syndrome Answer: B 177. Which of the following is true of LSD? A. Only experienced, heavy users of LSD report "bad trips." B. Some users of LSD report flashbacks. C. Many LSD users claim that it improves attention to detail. D. LSD trips are somewhat unpredictable with first-time users but become predictable with repeated use. Answer: B 178. Flashbacks can occur days, weeks, or even years after taking ______. A. cocaine B. marijuana C. hashish D. LSD Answer: D 179. The street name "angel dust" refers to ______. A. LSD B. THC C. PCP D. DDT Answer: C 180. “Angel dust” was developed in the 1950s as ______. A. an anesthetic B. an analgesic C. a neuroleptic D. a minor tranquilizer Answer: A 181. Ben feels as if there is some sort of barrier or wall between himself and his environment, as if he were an outsider watching the rest of the world go by without him. He is also experiencing some extremely hostile and aggressive urges, perceptual distortions, and paranoia. He has most likely been using ______. A. LSD B. THC C. PCP D. DDT Answer: C 182. Which of the following hallucinogens is classified as a deliriant? A. LSD B. THC C. DDT D. PCP Answer: D 183. The major psychoactive ingredient in marijuana is ______. A. PCB B. THC C. PCP D. LSD Answer: B 184. Marijuana is considered a ______. A. depressant B. deliriant C. hallucinogen D. major tranquilizer Answer: C 185. Hashish is very similar in its effects to ______. A. marijuana B. LSD C. PCP D. cocaine Answer: A 186. Approximately ______ percent of Americans age 12 and over have tried marijuana at least once. A. 20 B. 40 C. 60 D. 80 Answer: B 187. About ______ percent of the U.S. adult population suffers from a marijuana use disorder. A. 1.5 B. 2.5 C. 3.5 D. 4.5 Answer: A 188. Which of the following people is MOST likely to be dependent on marijuana? A. an 18-year-old male B. a 24-year-old female C. a 32-year-old male D. a 47-year-old female Answer: A 189. Which of the following people is LEAST likely to be dependent on marijuana? A. an 18-year-old male B. a 24-year-old female C. a 32-year-old male D. a 47-year-old female Answer: D 190. ______ is the nation's most popular substance among teenagers. A. Cocaine B. Alcohol C. Marijuana D. LSD Answer: C 191. About ______ percent of U.S. twelfth graders reported using marijuana during the previous year. A. 12 B. 24 C. 36 D. 48 Answer: C 192. Which of the following is an effect of marijuana at stronger levels of intoxication? A. It may produce feelings of heightened sexual sensations. B. It can cause smokers to become agitated. C. It can make time seem to pass more quickly. D. It appears to produce more physiological than psychological dependence. Answer: A 193. Which of the following is true of marijuana? A. It may produce tolerance over long periods of heavy use. B. A specific withdrawal syndrome is not associated with its use. C. Over time, smoking one joint of marijuana daily presents 1/3 the risk of developing cancer compared to smoking one cigarette daily. D. It impairs short-term memory and slows learning. Answer: D 194. Some chronic marijuana users report developing sensitization, which is defined as ________ A. developing skin rashes and mouth sores with long-term use B. becoming less sensitive to the drug’s effects with repeated use C. becoming more sensitive to the drug’s effects with repeated use D. a withdrawal symptom similar to what is experienced with alcohol withdrawal Answer: C 195. For most adolescents, alcohol is used primarily to ______. A. be accepted by their peers B. prove they are adults C. get “high” D. avoid social anxiety Answer: C 196. Anxious people may be drawn to which of the following types of drugs? A. antipsychotics B. cocaine C. marijuana D. psychedelics Answer: C 197. There appears to be a common pathway in the brain involving the neurotransmitter ______ hat may explain the pleasure-inducing effects of many drugs. A. cortisol B. dopamine C. acetylcholine D. norepinephrine Answer: B 198. When the body becomes habituated to opioids, it ceases production of ______. A. testosterone B. endorphins C. prostaglandins D. norepinephrine Answer: B 199. Twin studies have found ______. A. no significant correlation for rates of alcoholism in monozygotic or dizygotic twins B. a greater concordance rate of alcoholism for monozygotic twins than for dizygotic wins C. a greater concordance rate of alcoholism for dizygotic twins than for monozygotic wins D. an equal concordance rate of alcoholism for monozygotic and dizygotic twins Answer: B 200. Cocaine works on the brain’s use of ______________. A. serotonin B. epinephrine C. norepinephrine D. dopamine Answer: D 201. Cocaine interferes with the process of reuptake by which excess molecules of __________ are reabsorbed by the transmitting neuron. A. serotonin B. dopamine C. epinephrine D. norepinephrine Answer: B 202. Research evidence suggests that a genetic vulnerability to alcohol may involve a combination of getting ______ pleasure from the drug and a ______ biological tolerance for the drug. A. less, lower B. greater, lower C. less, greater D. greater, greater Answer: D 203. Charlie is at a high genetic risk for alcoholism. However, he grew up in a family in which neither parent ever abused alcohol. The history of his family’s drinking behavior ______ the likelihood of his becoming an alcoholic. A. reduces B. nullifies C. increases D. would not affect Answer: A 204. Learning theories stress that the most powerful factor in people becoming dependent on drugs such as cocaine is ______ reinforcement. A. positive B. negative C. social D. delayed Answer: A 205. According to learning theorists, which of the following is true? A. Substance-related behaviors cannot be unlearned due to the powerful genetic influences of addictive processes. B. Emotional stress often sets the stage for development of substance abuse. C. Drugs may become habitual because of the body’s increased need for the drug. D. Substance abuse is actually a disease. Answer: B 206. According to learning theorists, which of the following is one of the reasons why people initially use an illegal drug? A. trial and error B. medical need C. genetic vulnerability D. physiological drive Answer: A 207. The tension reduction theory proposes that ______. A. the more often one drinks to reduce tension, the stronger the habit becomes B. the more often one drinks to reduce tension, the weaker the habit becomes C. the less often one drinks to reduce tension, the stronger the habit becomes D. the less often one drinks to reduce tension, the weaker the habit becomes Answer: A 208. Which type of drug may be used as a form of self-medication for depression? A. alcohol B. LSD C. nicotine D. heroin Answer: A 209. Once people become physiologically dependent on a drug, the drug habit is maintained by ______. A. positive reinforcement B. negative reinforcement C. classical conditioning D. negative punishment Answer: B 210. Jean played pool while drinking beer at the local bars during college. Years later, whenever Jean plays pool, she is overwhelmed with cravings to drink beer. In the classical conditioning model, her cravings represent the _______. A. unconditioned stimulus B. unconditioned response C. conditioned stimulus D. conditioned response Answer: D 211. Paul played pool while drinking beer at the local bars during his time in college. Years later, whenever Paul plays pool, he is overwhelmed with cravings to drink beer. In the classical conditioning model, “playing pool” represents the _______. A. unconditioned stimulus B. unconditioned response C. conditioned stimulus D. conditioned response Answer: C 212. Susie completed a semester abroad during her junior year of college. Every evening she ate pasta and drank large amounts of red wine with her companions. After returning to the US, Susie finds she craves red wine whenever she eats pasta. In the classical conditioning model, the red wine represents a(n)__________. A. unconditioned stimulus B. unconditioned response C. conditioned stimuli D. conditioned response Answer: A 213. Whenever Tina drinks alcohol, she is overwhelmed with feelings of pleasure and relaxation. In the classical conditioning model, the pleasurable and relaxing feelings which accompany her ingestion of alcohol represent ______. A. unconditioned stimuli B. an unconditioned response C. conditioned stimuli D. a conditioned response Answer: B 214. For some substances users,, cravings may represent a conditioned response to ________ associated with prior use of the substance. A. positive reinforcement B. negative operants C. environmental cues D. physiological cues Answer: C 215. Research shows that ______ exhibit increased salivation to the sight and smell of alcohol. A. neither people with alcoholism nor non-alcoholic B. people with alcoholism, but not non-alcoholic C. non-alcoholic, but not people with alcoholism D. both people with alcoholism and non-alcoholic Answer: B 216. Cue exposure training involves the use of ______ to treat alcohol dependence. A. punishment B. intrinsic rewards C. extinction procedures D. aversive conditioning Answer: C 217. An alcohol dependence treatment technique which exposes a person to alcohol related stimuli while preventing the person from drinking is called ______. A. intoxication prevention therapy B. symptom substitution therapy C. classical conditioning training D. cue exposure training Answer: D 218. Which of the following is a strong cognitive predictor of adolescent drinking? A. family history B. outcome expectancies C. self-efficacy expectancies D. social class Answer: B 219. Charlize drinks alcohol because she believes that it reduces tension, helps her relax, become more sociable and, in general, have a good time. She believes that people like her better when she's had a few drinks and feels she can make more friends when she's drunk than when she's sober. Charlize's beliefs about what alcohol can do for her represent ______. A. outcome expectancies B. behavioral contingencies C. self-efficacy expectancies D. behavioral cues Answer: A 220. James believes that he needs alcohol to help him relax when he talks to people. The ______ model would explain James’s motivation for drinking. A. outcome expectancy B. self-efficacy C. tension reduction D. paradoxical intention Answer: B 221. Personal expectancies we hold about our ability to successfully perform tasks are ______ expectancies. A. self-efficacy B. attributional C. hardiness D. outcome Answer: A 222. When we insist on seeing the world in black and white rather than shades of Gray (for example, as either complete successes or complete failures), we may be engaging in what Aaron Beck calls _________. A. expectancy outcome B. magnification C. overgeneralization D. absolutist thinking Answer: D 223. The one-drink hypothesis exemplifies what Aaron Beck calls ______. A. emotional thinking B. impulsive thinking C. relativistic thinking D. absolutist thinking Answer: D 224. According to psychodynamic theory, alcoholism reflects an ______ personality. A. oral-dependent B. oral-aggressive C. anal-retentive D. anal-expulsive Answer: A 225. According to psychodynamic theorists, smoking is a(n) ______. A. oral fixation B. anal fixation C. phallic conflict D. genital fixation Answer: A 226. Cognitive theorists explain the "one-drink" effect as a ______. A. biochemical process B. self-awareness model C. cognitive lapse D. self-fulfilling prophecy Answer: D 227. ______ is generally associated with abstinence from alcohol. A. Being married B. Working as a dentist C. Working as a bartender D. Attending church Answer: D 228. Teenagers who start drinking before age 15 are ______ people who begin drinking at a later age to develop alcohol dependence in adulthood. A. half as likely as B. just as likely as C. twice as likely as D. five times as likely as Answer: D 229. Which of the following is true of treating people with substance abuse and dependency problems? A. They are eager to enter treatment but typically lack health insurance or the financial means to support the treatment. B. Helping substance abusers through withdrawal is usually the most complicated and difficult part of treatment. C. Substance abusers often have trouble relating to other substance abusers who abuse substances that are different from the ones they abuse. D. Substance abusers often have other psychological problems in addition to their substance abuse problems. Answer: D 230. In many, if not most, cases, people with drug dependencies ______ want to stop and ______ seek treatment on their own. A. do not, do not B. do, do not C. do not, do D. do, do Answer: A 231. Biological treatments for people with chemical dependencies often begin with ______. A. electroconvulsive therapy B. behavioral counseling C. in toxification D. detoxification Answer: D 232. The process of ridding the system of alcohol or other drugs under supervised conditions is known as ______. A. abstinence B. detoxification C. withdrawal D. symbiosis Answer: B 233. In detoxification, patients are sometimes given ______ to help mute withdrawal symptoms. A. opioids B. stimulants C. antianxiety drugs D. hallucinogenic Answer: C 234. Substance abuse counsellors may use the technique of __________ to increase their clients’ readiness to make changes in their lives. A. direct confrontation B. motivational interviewing C. behavioral interviewing D. peer processing Answer: B 235. Eddie suffers from social anxiety disorder as well as an addiction to alcohol. As part of his treatment, Eddie receives social skills training and individual therapy along with the standard activities of his treatment for chemical dependence. Clients like Eddie, who have both chemical dependence and psychological issues, are said to have a __________. A. self-medication duality B. dual diagnosis C. primary psychological disorder D. secondary addiction Answer: B 236. Jean has been given a drug that makes her violently ill if she drinks alcohol. The drug she is most likely to have been given is ______. A. naloxone B. disulfiram C. methadone D. diazepam Answer: B 237. Which of the following statements about antabuse is true? A. It causes high blood pressure when taken with alcohol. B. Antabuse has a no effect on people with liver disease. C. Patients who want to drink merely suffer through the physical reaction if they elect to drink while on antabuse. D. Little evidence supports the efficacy of the drug in the long run. Answer: D 238. ______ have shown some promise in stemming some abusers' cravings for cocaine. A. Antidepressants B. Stimulants C. Tranquilizers D. Opiates Answer: A 239. An antidepressant used to blunt cravings for nicotine is ______. A. Xanax B. Zyban C. Naloxone D. Luvox Answer: B 240. Which of the following drugs used in cessation-smoking treatment is linked to serious complications, such as increased risks of depression and suicidal behaviors ? A. bupropion ( trade name Zyban) B. varenicline (trade name Chantix) C. benzodiazepine (trade name Zanex) D. disulfiram (trade name Antabuse) Answer: B 241. Which of the following has been shown to be MOST effective in getting smokers to successfully quit smoking? A. nicotine replacement therapy by itself B. behavior therapy by itself C. behavior therapy combined with psychodynamic therapy D. nicotine replacement therapy combined with behavior therapy Answer: D 242. Methadone is a(n) ______. A. opiate B. barbiturate C. stimulant D. hallucinogenic Answer: A 243. Ann is trying to overcome an addiction to heroin. She has been given an alternative drug that is slower acting than heroin and does not provide the "rush" provided by heroin. It does, however, protect her from the painful abstinence syndrome usually associated with the cessation of heroin use. She is most likely taking ______. A. disulfiram B. naloxone C. methadone D. diazepam Answer: C 244. Methadone is ______ addictive. A. not B. slightly C. moderately D. highly Answer: D 245. Buprenorphine, and levomethadyl are both used to treat ______. A. heroin addiction B. alcoholism C. nicotine dependency D. barbiturate withdrawal effects Answer: A 246. Naltrexone is used to treat by blocking the high feelings produced by ______. A. amphetamine psychosis B. withdrawal from barbiturates C. alcohol and opioid dependence D. LSD flashbacks Answer: C 247. The major problem with drug treatments involving disulfiram, naltrexone, or methadone is hat ______. A. they cannot be given to patients for long periods of time B. they only work on about half the patients to whom they are given C. they produce tolerance to an even greater degree than some of the substances they are attempting to replace D. patients can choose not to use them as required, rendering them useless Answer: D 248. Many members of ethnic minorities resist traditional treatment approaches to alcoholism because ______. A. these approaches have not been shown to work with members of ethnic minorities B. these approaches do not work as well as "home-grown" methods of treatment C. they are not interested in treatment for something that is only considered a problem in white society D. they feel excluded from full participation in society Answer: D 249. Which of the following has been recommended as a way of improving the success rate of alcohol treatment plans among ethnic minorities? A. Improve the level of technology that is brought to bear during treatment. B. Incorporate social media into the treatment aftercare plan. C. Use counselors who have not been chemically dependent themselves. D. Address all facets of the human being, including racial and cultural identity. Answer: D 250. To Alcoholics Anonymous, alcoholics who have quit drinking are always seen as ______. A. cured B. recovering C. fooling themselves D. in remission Answer: B 251. Alcoholics Anonymous is run by ______. A. physicians B. social workers C. psychotherapists D. laypersons Answer: D 252. In Alcoholics Anonymous, more experienced group members called ______ support newer members during periods of crisis or potential relapse. A. peer mentors B. sponsors C. recovery buddies D. guides . Answer: B 253. Alcoholics Anonymous follows a ______-step approach for treating alcohol abuse. A. 3 B. 6 C. 9 D. 12 Answer: D 254. Which of the following is a component of groups such as Alcoholics Anonymous, Narcotics Anonymous, and Cocaine Anonymous? A. asserting one’s control over his or her drug use B. learning to use alcohol or drugs in moderation C. working in isolation to overcome one’s addiction D. getting in touch with a "higher power" through prayer and meditation Answer: D 255. Al-Anon is designed to ______. A. support people suffering from alcoholism who have failed at the regular Alcoholics Anonymous programs B. provide support to people suffering from alcoholism who are struggling with other substance abuse problems in addition to alcohol abuse C. provide support exclusively for teenaged sufferers of alcoholism D. provide support to spouses and family members of people suffering from alcoholism Answer: D 256. Alateen provides support ______. A. exclusively to teenaged sufferers of alcoholism B. exclusively to teenaged polydrug abusers C. to the children of people suffering from alcoholism D. to the spouses of teenaged sufferers of alcoholism Answer: C 257. Hospitalization would be recommended for which of the following persons with chemical dependence? A. A client with solid medical health coverage. Otherwise the treatment is too costly to be borne by the addict. B. Chemically dependent users with legal charges pending. C. In a case where outpatient treatment would be more costly. D. When the abuser’s behavior is self-destructive or dangerous to others. Answer: D 258. ______ of people treated for alcoholism are treated on an outpatient basis. A. A small minority B. A large minority C. A slight majority D. The great majority Answer: D 259. Most inpatient programs use a ______ day treatment program. A. 7 B. 14 C. 21 D. 28 Answer: D 260. Comparisons of outpatient and inpatient treatment programs for alcoholism have found that ______. A. neither work as well as individuals quitting "cold turkey" on their own B. outpatient treatment is generally more effective than inpatient treatment C. inpatient treatment is generally more effective than outpatient treatment D. both inpatient and outpatient treatment work about equally well in relapse rate Answer: D 261. Residential treatment programs for substance use have ______ numbers of early dropouts and ______ residents relapse upon returning to the outside world. A. low, few B. high, few C. low, many D. high, many Answer: D 262. Psychodynamic approaches to the treatment of substance use focus on ______. A. replacing substance abuse behaviors with alternate behaviors that are more socially acceptable and equally gratifying B. improving the patient's social support system so that it does not encourage drug use C. altering positive outcome expectancies and self-efficacy expectancies associated with drug use D. resolving underlying emotional conflicts which led to drug abuse in the first place Answer: D 263. Natalie goes to a therapist for treatment of her substance use problem. Her therapist spends a lot of time exploring her childhood in an effort to find the underlying conflicts which created her need to use drugs. Her therapist is most likely a ______ therapist. A. behavioral B. cognitive C. psychodynamic D. humanistic Answer: C 264. Behavioral approaches to the treatment of substance use focus on ______. A. modifying abusive and dependent behavior patterns B. improving the patient's social support system so that it does not encourage drug use C. altering positive outcome expectancies and self-efficacy expectancies associated with drug use D. resolving underlying emotional conflicts which led to drug use in the first place Answer: A 265. Terri goes to a therapist for treatment of her substance use problem. Her therapist immediately begins teaching her new skills and self-control strategies, focusing on new ways of behaving rather than on possible underlying mechanisms which may have led her to use drugs. Her therapist is most likely a ______ therapist. A. behavioral B. cognitive C. psychodynamic D. humanistic Answer: A 266. Self-control strategies for substance abuse include all but which one of the following? A. controlling the antecedents B. controlling the behaviors C. controlling the consequences D. controlling the reinforcements Answer: D 267. Which of the following is a technique typically used by behavioral therapists to treat substance abuse? A. hypnosis B. electroconvulsive therapy C. self-actualization exploration D. social skills training Answer: D 268. In the contingency management approach to treatment of opioids and cocaine, the patient ______. A. vomits whenever taking the drug B. uses a substitute drug like methadone C. is awarded money for staying clean D. gradually is weaned off of the substance Answer: C 269. Jennifer goes to a therapist for treatment of her substance use problem. Her therapist teaches her to focus on the antecedent cues which lead to her drug use, the drug use itself, and the consequences of her drug use. Then, the therapist discusses ways she can avoid the cues which tempt her to use drugs, competing responses she can substitute for drug use, and self-rewards she can use to substitute for the rewards she used to get from drug use. Her therapist is using _______. A. self-control training B. aversive conditioning C. covert sensitization D. social skills training Answer: A 270. Stacy goes to a therapist for treatment of her drinking problem. The therapist makes her drink alcohol at the same time she takes a drug that induces nausea and vomiting. Her therapist is using ______. A. negative reinforcement B. aversive conditioning C. covert sensitization D. skills training Answer: B 271. Marta goes to a therapist for treatment of her drinking problem. Her therapist teaches her to be more assertive in dealing with her "drinking buddies" who are always pressuring her to drink until she can't stand up. This technique is called ______. A. self-control training B. aversive conditioning C. covert sensitization D. social skills training Answer: D 272. Rosa goes to a therapist for treatment of her drinking problem. Her therapist makes her sign a written behavioral contract in which she agrees to abstain from drinking and to take Antabuse. Her husband agrees to refrain from making comments about her past drinking and he probability of future lapses. This technique is part of ______. A. self-control training B. aversive conditioning C. covert sensitization D. social skills training Answer: D 273. Sarah goes to her therapist for treatment of her drinking problem. Her therapist teaches her methods to stop the drinking, which work quite effectively. Then, her therapist teaches her a series of techniques and skills designed to help prevent her from drinking again and to help her cope with high-risk situations and temptations she is sure to encounter. This approach is called ______. A. self-control training B. skills training C. relapse prevention training D. the abstinence violation effect Answer: C 274. The relapse prevention model focuses on ______. A. underlying psychological conflicts which create the need to use drugs B. total abstinence from drug use C. identifying high-risk situations and learning effective coping skills D. modification of social support systems Answer: C 275. Most compulsive gamblers seek treatment _____________. A. when they are still successful B. only during a financial or emotional crisis C. only after they have been arrested and are facing still legal consequences D. only if they have no access to family financial resources Answer: B 276. Miguel has been involved in online gambling. Each day he tells himself that he will quit when he has spent $20, but frequently goes over that amount, sometimes by a large sum. This pattern of gambling more than one intends to gamble is characteristic of which DSM-5 disorder? A. gambling addiction disorder B. gambling disorder C. problem gambling disorder D. chronic gambling disorder Answer: B 277. About ______ young Americans aged 14 to 21 engage in problem gambling. A. 40% B. 2% C. 25% D. 5% Answer: B 278. About _________ of the general population will develop a gambling disorder at some point in their lives. A. 1.5% to 3.0% B. 0.4% to 1.0% C. 5% D. 10% Answer: B 279. Compulsive or problem gambling is ________, due in part to the ____________. A. on the rise; increasing spread of legalized forms of gambling B. on the rise; ease of access to gambling through the Internet C. decreasing slightly; increasingly harsher penalties for declaring bankruptcy D. decreasing dramatically; intense gambling addiction awareness education through media and schools Answer: A 280. Which of the following is often true about compulsive gamblers? A. They have high self-esteem. B. They have low self-esteem. C. They come from accepting families. D. They have parents that gamble compulsively. Answer: B 281. Which of the following is a similarity between nonchemical addictions and substance addictions? A. withdrawal symptoms B. high arousal before the addictive behavior is performed but low arousal during the addictive behavior C. low arousal before the addictive behavior is performed and low arousal during the addictive behavior D. a loss of control over the addictive behavior Answer: D 282. Which of the following is true about compulsive gambling? A. It is more likely in individuals with high impulse control. B. It is more likely in individuals with low emotional instability. C. It is more likely in individuals with high frustration tolerance. D. It is more likely in individuals with high levels of self-centeredness. Answer: D 283. Compulsive gamblers show brain deficits in the _______. A. temporal lobes B. hippocampus C. prefrontal cortex D. occipital lopes Answer: C 284. Like many forms of abnormal behavior, evidence points to an important __________ component in compulsive gambling. A. genetic B. learning C. unconscious D. sociocultural Answer: A 285. __________ medication has shown promise in the treatment of compulsive gambling. A. Antianxiety B. Antidepressant C. Antipsychotic D. Ant obsessional Answer: B True-False Questions 286. Tobacco and alcohol cause more deaths through sickness and accidents than all illicit drugs combined. Answer: True 287. Korsakoff’s syndrome leads to irreversible memory loss after years of chronic alcohol abuse. Answer: True 288. The DSM-5 classifies substance-related disorders in terms of two major types: substance-abuse disorders and substance dependence disorders. Answer: False 289. A state of drunkenness or being “high,” brought about by use of a particular drug is called substance intoxication. Answer: True 290. Two of the major types of substance use disorders identified in the DSM-5 are substance intoxication and substance withdrawal. . Answer: False 291. Substance withdrawal is a substance-induced disorder involving a cluster of symptoms that occur when a person abruptly stops using a particular substance following a period of prolonged and heavy use. Answer: True 292. Tolerance is a state of physical habituation to a drug, resulting from frequent use such that higher doses are needed to achieve the same effect. Answer: True 293. Alcohol induced mania is a state of mental confusion characterized by incoherent speech, disorientation, and extreme restlessness. Answer: False 294. The DSM-5 recognizes that regular use of caffeine can lead to a substance withdrawal disorder following the abrupt cessation of caffeine intake after a prolonged period of daily use. Answer: True 295. Drug-related problems are more frequent among ethnic minorities. Answer: False 296. Addiction involves a loss of control over use of a drug despite knowledge of the harmful consequences it causes. Answer: True 297. The three pathways to addiction listed in your text include: prodromal experimentation, active use, and addiction /dependence. Answer: False 298. Drinking among college students tends to be limited to weekends and to be heavier early in the semester when academic demands are relatively light. Answer: False 299. Hispanic American women are much more likely to use alcohol and to develop alcohol use disorders than non-Hispanic White women. Answer: False 300. The prevalence of cirrhosis of the liver is nearly twice as high in African Americans as in non-Hispanic White Americans. Answer: True 301. Native Americans overall have higher rates of alcoholism and suffer from more alcohol-related problems than any other ethnic group. Answer: True 302. The effects of alcohol reflect the interaction of (a) the physiological effects of the substances and (b) our interpretations of those effects. Answer: True 303. A mixture of barbiturates and alcohol is about four times as powerful as either drug taken by itself. Answer: True 304. Opioids are a group of stimulants whose main uses include alleviating lethargy and attentional problems. Answer: False 305. Neurons in the brain have receptor sites into which opioids fit like a lock and key. Answer: True 306. Heroin was developed during a search for a nonaddictive drug that would relieve pain as effectively as morphine. Answer: True 307. Stimulants have been used to treat chronic pain. Answer: False 308. The hallucinations and delusions of amphetamine psychosis mimic the features of paranoid schizophrenia. Answer: True 309. The amphetamines are a class of natural, organic stimulants. . Answer: False 310. Ecstasy, or MDMA, is a designer drug, a chemical knockoff similar in chemical structure to amphetamine. Answer: True 311. Ecstasy can produce adverse psychological effects, including depression, anxiety, insomnia, and even paranoia and psychosis. Answer: True 312. Research has revealed that using ecstasy does not have an enduring adverse effect on memory. Answer: False 313. The original formula for Coca-Cola contained an extract of cocaine. Answer: False 314. Next to marijuana, cocaine is the most widely used illicit drug in the United States. Answer: True 315. Unlike heroin, cocaine does not directly stimulate the brain’s reward or pleasure circuits. Answer: False 316. The World Health Organization estimates that one billion people worldwide smoke and more than three million die each year from smoking-related causes. Answer: True 317. More women die of lung cancer than any other type of cancer, including breast cancer. Answer: True 318. Breast cancer is the leading cause of cancer deaths among U.S. women. Answer: False 319. Habitual use of nicotine does not lead to physiological dependence on the drug. Answer: False 320. Mescaline is derived from the peyote cactus and has been used for centuries by Native Americans in religious ceremonies. Answer: True 321. LSD is a naturally hallucinogenic that is extracted from the Colorado River Toad. Answer: False 322. A deliriant is a drug capable of producing states of spiritual awareness and enlightenment. Answer: False 323. Among Americans aged 12 or older, about 7 in 10 report having used marijuana or hashish at some point in their lives. Answer: False 324. Many drugs of abuse produce pleasurable effects by increasing the availability of the neurotransmitter dopamine. Answer: True 325. Over time, regular use of drugs such as cocaine, alcohol, and heroin may boost the brain’s own production of dopamine. Answer: False 326. People who have a family history of substance use disorders stand a four to eight times greater chance of developing these disorders themselves. Answer: True 327. Monozygotic (MZ) twins share half of their genes, whereas fraternal or dizygotic (DZ) wins have identical genes. Answer: False 328. Cocaine interferes with the process of reuptake by which excess molecules of dopamine are reabsorbed by the transmitting neuron. Answer: True 329. To the learning theorists, drug-related problems are not regarded as symptoms of disease but rather as problem habits. Answer: True 330. According to the tension-reduction theory, the more often one drinks to reduce tension or anxiety, the stronger the habit becomes. Answer: True 331. The conditioning model of craving has not been supported by research because people with alcoholism do not tend to salivate more than others at the sight and smell of alcohol. Answer: False 332. Alcohol lowers self-efficacy expectancies. Answer: False 333. Church attendance is generally connected with abstinence from alcohol. Answer: True 334. In most cases, substance-dependent people really do not want to discontinue the substances hey are abusing. Answer: True 335. Disulfiram prevents users from getting high if they subsequently take heroin. Answer: False 336. Many substance abusers have additional psychological disorders. Answer: True 337. Antidepressant medications have shown some promise in stemming cravings for cocaine in some users shortly after they discontinue the drug. Answer: True 338. Nicotine replacement has not been shown to reduce withdrawal symptoms for smokers trying to quit smoking. Answer: False 339. A widely used treatment for heroin addiction involves the substitution of another addictive drug. Answer: True 340. Alcoholics Anonymous promotes controlled social drinking. Answer: False 341. Alcoholics Anonymous is run by laypeople. Answer: True 342. It has been demonstrated that most people recovering from alcoholism require hospitalization during the early stages of recovery. Answer: False 343. Contingency management (CM) programs provide reinforcements (rewards) contingent on performing desirable behaviors, such as producing drug-negative urine samples. Answer: True 344. All in all, efforts to help people discontinue substance dependence and abuse have been highly successful. Answer: False 345. Gambling is less popular than it has been in previous generations and rates for compulsive gambling have been decreasing slightly. Answer: False 346. One difference between nonchemical addictions and substance addictions is that nonchemical addictions do not have withdrawal symptoms. Answer: False 347. Mood-stabilizing medication has shown promise in the treatment of compulsive gambling. Answer: True Essay Questions 348. Define substance-induced disorders and substance use disorders as defined by The DSM-5. Answer: Substance-Induced Disorders and Substance Use Disorders as Defined by the DSM-5 Substance-Induced Disorders: Substance-induced disorders are mental disorders that are directly attributable to the use of substances, including drugs and alcohol. According to the DSM-5, these disorders can include intoxication, withdrawal, and other substance/medication-induced mental disorders such as psychotic disorder, bipolar disorder, depressive disorder, anxiety disorder, obsessive-compulsive disorder, sleep disorder, sexual dysfunction, and delirium. The key aspect is that these conditions are temporary and are directly caused by substance use. Substance Use Disorders: Substance use disorders, also outlined in the DSM-5, encompass a range of issues related to the continued use of substances despite significant substance-related problems. These disorders are characterized by an array of cognitive, behavioral, and physiological symptoms indicating that the individual continues using the substance despite significant substance-related problems. Diagnosis is based on evidence of impaired control, social impairment, risky use, and pharmacological criteria (tolerance and withdrawal). 349. Distinguish between psychological and physiological dependence, and briefly explain each of the stages of drug dependence. Answer: Psychological and Physiological Dependence, and Stages of Drug Dependence Psychological Dependence: Psychological dependence refers to the emotional and mental processes associated with the development and recovery from a substance use disorder. This type of dependence is characterized by a perceived need to use the substance to relieve negative emotions, anxiety, or other psychological conditions. The individual may experience cravings and compulsive drug-seeking behavior. Physiological Dependence: Physiological dependence involves the physical adaptation of the body to the substance. It is marked by tolerance (needing more of the substance to achieve the same effect) and withdrawal symptoms when the substance is not taken. Withdrawal can include a range of physical symptoms such as shaking, sweating, nausea, and other discomforts. Stages of Drug Dependence: 1. Experimentation: This is the initial stage where the individual tries the substance out of curiosity or social pressure. 2. Regular Use: At this stage, the individual starts using the substance regularly, though it may not be daily. There is still some control over the use. 3. Risky Use: The substance use begins to have negative consequences, but the individual continues to use it despite these issues. 4. Dependence: The individual experiences tolerance and withdrawal symptoms. Substance use becomes a central part of life. 5. Addiction: This is the final stage, where the individual loses control over substance use. It becomes compulsive, and the individual cannot stop despite severe consequences. 350. Identify and explain the five factors that place an individual at risk for developing alcoholism or alcohol-related problems. Answer: Five Factors that Place an Individual at Risk for Developing Alcoholism or Alcohol-Related Problems 1. Genetic Predisposition: A family history of alcoholism can increase the likelihood of developing alcohol-related problems due to inherited genetic traits. 2. Psychological Factors: Mental health disorders such as depression, anxiety, and PTSD can lead to self-medication with alcohol. 3. Social Environment: Peer pressure, cultural norms, and exposure to environments where drinking is prevalent can increase the risk. 4. Early Use: Individuals who begin drinking at an early age are more likely to develop alcohol dependency later in life. 5. Stress and Coping Mechanisms: High levels of stress and poor coping mechanisms can drive individuals to use alcohol as a way to manage stress and negative emotions. 351. Summarize the differences in the use of alcohol and health related factors as they apply to the ethnic background of the user. Answer: Differences in the Use of Alcohol and Health-Related Factors by Ethnic Background Alcohol use and its health-related consequences can vary significantly across different ethnic groups due to cultural, social, and genetic factors: • Caucasians: Tend to have higher rates of alcohol use and binge drinking. They also have a higher prevalence of alcohol use disorders compared to some other ethnic groups. • African Americans: Generally have lower rates of alcohol use but may experience more severe health consequences from drinking, such as higher rates of liver disease. • Hispanics/Latinos: Show varied patterns; Mexican-Americans tend to have higher rates of heavy drinking compared to other Latino groups, and cultural factors can play a significant role in drinking behavior. • Asian Americans: Typically have lower rates of alcohol use. Genetic factors such as the prevalence of the alcohol flush reaction (due to a variant of the ALDH2 gene) can deter drinking. • Native Americans: Experience some of the highest rates of alcohol use disorders and alcohol-related health problems. Cultural and historical factors, including trauma and socioeconomic disadvantages, contribute to these high rates. Understanding these differences is crucial for developing culturally appropriate prevention and treatment programs. 352. Discuss the research on the health benefits of moderate drinking. Answer: Research on the Health Benefits of Moderate Drinking Research on moderate drinking has suggested several potential health benefits, primarily associated with cardiovascular health. Moderate drinking is typically defined as up to one drink per day for women and up to two drinks per day for men. Some of the health benefits identified include: 1. Cardiovascular Health: Moderate alcohol consumption, particularly of red wine, has been associated with a reduced risk of heart disease. Studies suggest that moderate drinking can increase high-density lipoprotein (HDL) cholesterol, which is known as "good" cholesterol, and has anticoagulant properties that may prevent the formation of blood clots. 2. Longevity: Some studies have found a correlation between moderate alcohol consumption and increased life expectancy. This is often linked to the cardiovascular benefits and reduced incidence of certain types of heart disease. 3. Type 2 Diabetes: Moderate drinking has been linked to a lower risk of developing type 2 diabetes. Alcohol can improve insulin sensitivity, which helps regulate blood sugar levels. 4. Social and Psychological Benefits: Moderate alcohol consumption can have social benefits, such as improved social interactions and reduced stress and anxiety in social situations. However, it's important to note that the benefits of moderate drinking must be weighed against the potential risks, including the possibility of developing alcohol dependence and the negative health impacts of alcohol on the liver, brain, and other organs. 353. Describe the two research discoveries from the 1970s that demonstrated that the brain produces chemicals of its own that have opiate-like effects. Answer: Two Research Discoveries from the 1970s on Brain Chemicals with Opiate-Like Effects 1. Endorphins Discovery: In the 1970s, researchers discovered that the brain produces its own chemicals that have similar effects to opiates. These chemicals, called endorphins (short for "endogenous morphines"), act as neurotransmitters and have pain-relieving properties. They bind to opioid receptors in the brain and help reduce pain and stress, producing a feeling of euphoria similar to that caused by opiate drugs. 2. Enkephalins Discovery: Another significant discovery was the identification of enkephalins, another type of endogenous opioid peptide. Enkephalins also bind to opioid receptors and play a crucial role in regulating pain and emotion. These discoveries were pivotal in understanding how the brain manages pain and stress and laid the foundation for further research into pain management and addiction. 354. What is ecstasy? Describe the rise and fall in use patterns and the health risks associated with the use of this drug. Answer: Ecstasy: Rise and Fall in Use Patterns and Health Risks What is Ecstasy? Ecstasy, also known as MDMA (3,4-methylenedioxymethamphetamine), is a psychoactive drug that is chemically similar to both stimulants and hallucinogens. It produces feelings of increased energy, pleasure, emotional warmth, and distorted sensory and time perception. Rise and Fall in Use Patterns: • Rise: Ecstasy became popular in the 1980s and 1990s, particularly within the rave and club culture. Its use was associated with all-night dance parties, music festivals, and social gatherings. • Fall: The use of ecstasy saw a decline in the 2000s due to increased awareness of its potential health risks, legal crackdowns, and the rise of other substances. Despite this decline, periodic resurgences in its popularity have been noted, especially with the emergence of electronic dance music (EDM) culture. Health Risks: • Short-term Risks: Ecstasy use can cause dehydration, hyperthermia (overheating), and electrolyte imbalances, which can be fatal in severe cases. Other immediate effects include increased heart rate, blood pressure, and risk of serotonin syndrome. • Long-term Risks: Chronic use of ecstasy can lead to memory problems, cognitive deficits, anxiety, depression, and potential damage to serotonin-producing neurons in the brain. There is also the risk of addiction and psychological dependence. 355. Discuss the effects of ecstacy. Answer: Effects of Ecstasy Ecstasy affects users both physically and psychologically: Physical Effects: • Increased heart rate and blood pressure • Muscle tension and teeth clenching • Nausea • Blurred vision • Faintness and chills or sweating Psychological Effects: • Elevated mood and a sense of euphoria • Increased sociability and emotional closeness to others • Enhanced sensory perception • Reduced anxiety and inhibitions However, negative psychological effects can include confusion, depression, sleep problems, drug craving, severe anxiety, and paranoia. 356. Describe the effects of cocaine and three methods of cocaine use. Answer: Effects of Cocaine and Methods of Use Effects of Cocaine: Cocaine is a powerful stimulant that affects the central nervous system. Its effects can vary depending on the method of use, dosage, and individual factors but generally include: • Short-term Effects: Increased energy and alertness, euphoria, increased heart rate and blood pressure, decreased appetite, and heightened senses. • Long-term Effects: Chronic use can lead to severe health issues such as cardiovascular problems (heart attack, stroke), respiratory issues, neurological damage, mental health disorders (anxiety, paranoia, hallucinations), and high potential for addiction. Methods of Cocaine Use: 1. Snorting: Cocaine powder is inhaled through the nose, where it is absorbed into the bloodstream through the nasal tissues. This method leads to a rapid onset of effects but can damage nasal tissues and lead to chronic nasal problems. 2. Injecting: Cocaine dissolved in water is injected directly into the bloodstream, providing an intense and immediate high. This method increases the risk of overdose, infectious diseases (HIV, hepatitis) from shared needles, and cardiovascular complications. 3. Smoking: Cocaine can be smoked in its freebase form (known as crack cocaine). Smoking crack provides an immediate, intense high but also poses significant risks, including severe respiratory issues, addiction, and rapid tolerance development. Each method of use comes with its own set of risks and health implications, contributing to the overall danger of cocaine use. 357. Summarize the World Health Organization’s findings on health and the use of tobacco and nicotine. Answer: World Health Organization’s Findings on Health and the Use of Tobacco and Nicotine The World Health Organization (WHO) has conducted extensive research on the health impacts of tobacco and nicotine use. Key findings include: Health Risks: 1. Cancer: Tobacco use is a leading cause of various cancers, including lung, throat, mouth, esophagus, and bladder cancer. Over 70% of global lung cancer deaths are attributed to tobacco smoking. 2. Cardiovascular Disease: Smoking significantly increases the risk of heart disease, stroke, and peripheral vascular disease. It contributes to the buildup of plaque in arteries, leading to atherosclerosis. 3. Respiratory Disease: Chronic obstructive pulmonary disease (COPD), chronic bronchitis, and emphysema are strongly linked to smoking. It damages the airways and alveoli in the lungs. 4. Secondhand Smoke: Non-smokers exposed to secondhand smoke are at risk for many of the same diseases as smokers, including heart disease, respiratory illnesses, and cancer. Children exposed to secondhand smoke are at risk for sudden infant death syndrome (SIDS), respiratory infections, and asthma. 5. Nicotine Addiction: Nicotine is highly addictive, leading to dependency and continued tobacco use despite known health risks. It can also impact brain development in adolescents. Global Impact: 1. Mortality: Tobacco use is one of the largest public health threats, killing more than 8 million people annually, including over 1 million non-smokers exposed to secondhand smoke. 2. Economic Burden: The healthcare costs and lost productivity due to tobacco-related illnesses result in significant economic burdens on societies worldwide. 3. Tobacco Control Measures: The WHO advocates for strong tobacco control measures such as taxation, advertising bans, smoke-free environments, and public education campaigns to reduce tobacco use. 358. Describe flashbacks in the context of LSD use. How do psychological factors impact the experience of flashbacks? Answer: Flashbacks in the Context of LSD Use Flashbacks: Flashbacks, also known as Hallucinogen Persisting Perception Disorder (HPPD), refer to the re-experiencing of visual or perceptual disturbances that mimic the effects of LSD (lysergic acid diethylamide) long after the drug has been used. These experiences can occur spontaneously and without warning, sometimes years after the initial use of the drug. Psychological Factors Impacting Flashbacks: 1. Mental Health: Individuals with pre-existing mental health conditions, such as anxiety or depression, may be more susceptible to experiencing flashbacks. Psychological stress can also trigger flashbacks. 2. Set and Setting: The environment and mindset during the initial LSD experience can influence the likelihood of flashbacks. A negative or traumatic trip may result in more frequent or distressing flashbacks. 3. Frequency of Use: Regular or high-dose use of LSD increases the risk of flashbacks. The brain's adaptation to repeated exposure to the drug can lead to persistent perceptual changes. 4. Subsequent Substance Use: The use of other psychoactive substances can trigger or exacerbate flashbacks. Alcohol, cannabis, and other hallucinogens are particularly associated with re-triggering LSD-like experiences. 359. What was the initial use of PCP? Why was its use discontinued in medical settings and what are the effects of using this drug? Answer: Initial Use of PCP and Reasons for Discontinuation in Medical Settings Initial Use of PCP: Phencyclidine (PCP) was initially developed in the 1950s as an intravenous anesthetic for medical use. It was valued for its potent analgesic (pain-relieving) and anesthetic properties without causing respiratory depression, a common side effect of other anesthetics. Discontinuation in Medical Settings: The use of PCP in medical settings was discontinued primarily due to its severe and unpredictable side effects. Patients often experienced hallucinations, delirium, and severe agitation during and after surgery. These adverse reactions were deemed too dangerous and unpredictable for clinical use, leading to its removal from the market for human use. Effects of Using PCP: 1. Physical Effects: Numbness, slurred speech, loss of coordination, and a sense of invulnerability. High doses can lead to a decrease in blood pressure, heart rate, and respiratory function. 2. Psychological Effects: Hallucinations, severe agitation, paranoia, and delusions. Users may experience violent behavior, mood swings, and an altered sense of reality. 3. Long-term Effects: Chronic use can lead to memory loss, cognitive impairments, depression, and persistent psychosis. Users may also experience long-term anxiety and social withdrawal. 4. Overdose Risks: Overdose can result in seizures, coma, and potentially death due to respiratory failure. 360. What is the role of neurotransmitters in terms of understanding addictive processes? Answer: Role of Neurotransmitters in Understanding Addictive Processes Neurotransmitters play a crucial role in understanding the mechanisms underlying addiction. Addiction is a complex condition characterized by compulsive drug seeking and use despite harmful consequences. Several key neurotransmitters and their pathways are involved in the development and maintenance of addictive behaviors: 1. Dopamine: • Reward Pathway: The mesolimbic dopamine system, which includes the ventral tegmental area (VTA) and nucleus accumbens, is central to the brain's reward pathway. Drugs of abuse typically increase dopamine levels in this pathway, producing feelings of euphoria and reinforcing drug-taking behavior. • Reinforcement: Elevated dopamine levels reinforce the association between the drug and pleasurable experiences, promoting repeated use. 2. Serotonin: • Mood Regulation: Serotonin affects mood, emotion, and sleep. Drugs such as MDMA (ecstasy) increase serotonin release, contributing to mood elevation and feelings of emotional closeness. • Impulsivity and Control: Altered serotonin levels can impact impulse control and decision-making, influencing the likelihood of substance use. 3. GABA (Gamma-Aminobutyric Acid): • Inhibition: GABA is the primary inhibitory neurotransmitter in the brain. Drugs like alcohol and benzodiazepines enhance GABA activity, leading to sedative and anxiolytic (anxiety-reducing) effects. • Withdrawal: Chronic use can downregulate GABA receptors, leading to tolerance and severe withdrawal symptoms when the drug is discontinued. 4. Glutamate: • Excitation: Glutamate is the primary excitatory neurotransmitter. It plays a role in learning and memory processes that underlie the formation of drug-associated cues and cravings. • Neuroadaptation: Chronic drug use can alter glutamate signaling, contributing to neuroadaptations that promote continued drug use and relapse. 5. Endorphins and Enkephalins: • Pain and Pleasure: These endogenous opioids modulate pain and are involved in the reward system. Opioid drugs (e.g., heroin, morphine) mimic these neurotransmitters, leading to pain relief and intense pleasure. • Dependence: Repeated opioid use can suppress natural endorphin production, resulting in physical dependence and withdrawal symptoms. Understanding the roles of these neurotransmitters helps in developing treatments for addiction, such as medications that target specific neurotransmitter systems (e.g., methadone for opioid addiction, naltrexone for alcohol dependence) and behavioral therapies that address the psychological aspects of addiction. 361. Summarize the research on addictions and addiction focusing on twin studies, the role of genetic vulnerabilities, and the impact of environment on these vulnerabilities. Answer: Research on Addictions: Twin Studies, Genetic Vulnerabilities, and Environmental Impact Twin Studies: Twin studies have been instrumental in understanding the genetic basis of addiction. By comparing the concordance rates of substance use disorders between monozygotic (identical) twins and dizygotic (fraternal) twins, researchers can estimate the heritability of addiction. Findings consistently show higher concordance rates for addiction in identical twins compared to fraternal twins, suggesting a significant genetic component. For example, studies have shown that genetic factors account for approximately 50-60% of the risk for alcohol dependence. Genetic Vulnerabilities: Genetic vulnerabilities refer to inherited traits that increase the risk of developing addiction. Research has identified several genes and genetic variants associated with addiction. For instance: • Dopamine Receptor Genes (DRD2): Variants in the DRD2 gene are linked to an increased risk of addiction, particularly involving substances that affect the dopamine system, such as alcohol, cocaine, and opioids. • Opioid Receptor Genes (OPRM1): Variants in the OPRM1 gene influence the body's response to opioids and can affect the risk of opioid dependence. • Alcohol Metabolism Genes (ADH and ALDH): Variations in genes involved in alcohol metabolism (e.g., ADH1B and ALDH2) can influence alcohol use and dependence, with some variants providing a protective effect by causing unpleasant reactions to alcohol. Environmental Impact: While genetics play a crucial role in addiction, environmental factors also significantly influence the development and progression of substance use disorders. These factors can interact with genetic vulnerabilities to either exacerbate or mitigate the risk of addiction. Key environmental influences include: • Family Environment: Exposure to substance use within the family, parenting styles, and family history of addiction can impact an individual's risk. • Peer Influence: Association with peers who use substances can increase the likelihood of experimentation and continued use. • Socioeconomic Status: Lower socioeconomic status and associated stressors (e.g., unemployment, lack of access to healthcare) can contribute to higher rates of substance use. • Trauma and Stress: Experiences of trauma, abuse, and chronic stress are linked to higher rates of substance use disorders. • Availability of Substances: The ease of access to addictive substances can significantly affect the risk of addiction. 362. Discuss how cocaine impacts the brain. Focus on the role of neurotransmitters and action at the synapse level. Answer: Cocaine is a powerful stimulant that significantly affects the brain's neurotransmitter systems, particularly dopamine, norepinephrine, and serotonin. Role of Neurotransmitters: • Dopamine: Cocaine primarily affects the dopamine system by blocking the dopamine transporter (DAT), which is responsible for the reuptake of dopamine from the synaptic cleft back into the presynaptic neuron. By inhibiting this reuptake, cocaine increases the concentration of dopamine in the synaptic cleft, leading to prolonged stimulation of postsynaptic receptors. This results in intense feelings of euphoria and increased energy. • Norepinephrine: Cocaine also blocks the reuptake of norepinephrine, which enhances alertness, arousal, and the fight-or-flight response. Increased norepinephrine levels contribute to the stimulant effects of cocaine, such as elevated heart rate and blood pressure. • Serotonin: Similarly, cocaine inhibits the reuptake of serotonin, affecting mood regulation, emotional stability, and overall sense of well-being. Action at the Synapse Level: At the synapse level, cocaine's inhibition of reuptake transporters for dopamine, norepinephrine, and serotonin leads to an accumulation of these neurotransmitters in the synaptic cleft. This results in: • Enhanced Neurotransmission: Prolonged and intensified activation of postsynaptic receptors, leading to the stimulating and euphoric effects of the drug. • Neuroadaptation: With repeated use, the brain undergoes neuroadaptive changes, such as downregulation of dopamine receptors, which can lead to tolerance (requiring more of the drug to achieve the same effect) and dependence. • Craving and Addiction: The overstimulation of the reward pathway reinforces drug-taking behavior and contributes to the development of cravings and addiction. The brain becomes reliant on cocaine to maintain normal levels of neurotransmitter activity. 363. Discuss biological and behavioral approaches to explain cravings for substances. Answer: Biological Approaches: 1. Neurotransmitter Imbalance: Cravings are often linked to imbalances in neurotransmitter systems. For example, deficiencies in dopamine levels, particularly in the reward pathway, can lead to intense cravings as the brain seeks to restore dopamine balance through substance use. 2. Neuroplasticity: Repeated substance use can cause long-lasting changes in brain structure and function, particularly in areas involved in reward, motivation, and memory. These changes can create a heightened sensitivity to drug-related cues and triggers, leading to cravings. 3. Genetic Factors: Genetic predispositions can influence how the brain responds to substances and the likelihood of developing cravings. Specific genetic variants can affect neurotransmitter receptors, transporters, and enzymes involved in drug metabolism, altering the risk of addiction and the intensity of cravings. Behavioral Approaches: 1. Conditioning: Cravings can be understood through classical and operant conditioning. Drug use often becomes associated with specific cues (people, places, emotions) that can trigger cravings through learned associations. For instance, if a person habitually uses a substance in a particular environment, being in that environment can trigger cravings. 2. Cognitive-Behavioral Factors: Thoughts, beliefs, and expectations about substance use can influence cravings. For example, beliefs about the ability of a substance to relieve stress or enhance social interactions can drive cravings. 3. Stress and Coping Mechanisms: Stressful situations can trigger cravings as individuals may turn to substance use as a coping mechanism. Poor coping skills and high levels of stress increase the likelihood of craving and relapse. 364. Discuss the effectiveness and controversies associated with methadone maintenance programs Answer: Effectiveness: Methadone maintenance programs (MMPs) are used to treat opioid addiction by providing a long-acting opioid agonist, methadone, which helps reduce withdrawal symptoms and cravings without producing the euphoria associated with heroin or other opioids. Research indicates that MMPs are effective in several ways: 1. Reduction in Opioid Use: Methadone helps stabilize individuals by reducing illicit opioid use and the associated risks of overdose and infection (e.g., HIV, hepatitis). 2. Improved Health Outcomes: Participants in MMPs typically show improved physical and mental health, as well as a reduction in risky behaviors like needle sharing. 3. Social and Economic Benefits: MMPs are associated with increased employment, improved social functioning, and reduced criminal activity. They also reduce the societal costs associated with untreated opioid addiction. 4. Retention in Treatment: Methadone treatment is associated with higher retention rates in treatment programs compared to non-medication-based approaches. Controversies: 1. Dependency on Methadone: Critics argue that MMPs simply replace one addiction with another, as methadone itself is an opioid and can lead to physical dependence. 2. Diversion and Misuse: There are concerns about the potential for methadone diversion, where the medication is sold or misused, contributing to illegal drug markets. 3. Stigma: Methadone treatment carries a stigma, both within the medical community and society at large, which can deter individuals from seeking help and can impact the quality of care received. 4. Long-term Treatment: Some argue that MMPs can lead to prolonged or indefinite methadone use, raising questions about the goal of achieving complete abstinence from all opioids. 5. Access and Regulation: There are barriers to accessing MMPs, including regulatory restrictions, limited availability, and cost, which can prevent individuals from receiving necessary treatment. Despite these controversies, the evidence supports the overall effectiveness of methadone maintenance programs in reducing the harms associated with opioid addiction and improving quality of life for individuals struggling with this chronic condition. 365. Summarize research findings on the effectiveness of residential approaches to treating substance use disorders. Answer: Research Findings on the Effectiveness of Residential Approaches to Treating Substance Use Disorders Residential treatment programs, also known as inpatient rehabilitation, provide an intensive, structured environment for individuals with substance use disorders. These programs typically involve a stay of 30 days to several months and offer comprehensive care, including medical detoxification, individual and group therapy, and skills training. Research findings on their effectiveness include: Overall Effectiveness: 1. Reduction in Substance Use: Studies have shown that residential treatment programs are effective in reducing substance use among participants. The structured environment and constant support help individuals abstain from substances and begin recovery. 2. Improvement in Psychological and Physical Health: Participants often experience improvements in mental health, including reduced symptoms of depression and anxiety, as well as physical health due to medical care and detoxification. 3. Skill Development: Residential programs focus on developing coping skills, life skills, and relapse prevention strategies, which are crucial for maintaining long-term sobriety. 4. Long-Term Outcomes: While residential treatment can be effective in the short term, long-term success often depends on continued support and aftercare. Follow-up studies indicate that individuals who engage in aftercare programs, such as outpatient therapy or support groups, have better long-term outcomes. Factors Influencing Effectiveness: 1. Duration of Stay: Longer stays in residential treatment are generally associated with better outcomes. Programs of 90 days or more have been found to be more effective than shorter programs. 2. Comprehensive Care: Programs that offer a range of services, including medical, psychological, and social support, tend to be more effective. Addressing co-occurring mental health disorders and providing holistic care improve outcomes. 3. Individualized Treatment Plans: Tailoring treatment to the specific needs of the individual, including personalized therapy and targeted interventions, enhances the effectiveness of residential programs. 366. How effective have nonprofessional support groups like AA been in helping clients remain chemical-free? What makes analysis of AA outcomes so difficult? Answer: Effectiveness of Nonprofessional Support Groups like AA and Challenges in Analysis Effectiveness of AA: Alcoholics Anonymous (AA) is a nonprofessional support group based on a 12-step program designed to help individuals achieve and maintain sobriety. Research findings on its effectiveness include: 1. Support and Community: AA provides a supportive community and peer support, which are crucial for individuals seeking to remain chemical-free. The sense of belonging and shared experience can enhance motivation and accountability. 2. Abstinence Rates: Studies have shown that participation in AA is associated with higher rates of abstinence and longer periods of sobriety. Regular attendance at meetings correlates with better outcomes. 3. Accessibility: AA is widely accessible and free, making it an important resource for individuals without access to formal treatment programs. Challenges in Analysis: 1. Anonymity and Self-Reporting: The anonymous nature of AA makes it difficult to conduct systematic research and gather reliable data. Outcomes are often based on self-reports, which can be biased or inaccurate. 2. Self-Selection Bias: Individuals who choose to attend AA may be more motivated or have different characteristics than those who do not, complicating the comparison of outcomes. 3. Variability in Participation: The level of engagement and participation in AA can vary widely among members, influencing outcomes. Some may attend meetings regularly and actively participate, while others may attend sporadically. 4. Lack of Control Groups: Many studies on AA lack control groups, making it challenging to attribute outcomes directly to AA participation as opposed to other factors or concurrent treatments. 367. Discuss the need for, and methods of, relapse-prevention training. Answer: Need for Relapse-Prevention Training: Relapse prevention is a crucial component of treatment for substance use disorders. Despite initial success in treatment, many individuals experience relapse, often due to triggers, stress, or underlying psychological issues. Relapse-prevention training aims to equip individuals with the skills and strategies needed to maintain long-term sobriety and manage potential triggers effectively. Methods of Relapse-Prevention Training: 1. Identifying Triggers and High-Risk Situations: Helping individuals identify personal triggers (e.g., stress, social situations, emotional distress) and high-risk situations that could lead to relapse. This involves self-reflection and awareness of factors that may compromise sobriety. 2. Cognitive-Behavioral Techniques: Teaching cognitive-behavioral strategies to manage cravings and negative thought patterns. Techniques such as cognitive restructuring, stress management, and problem-solving skills are used to change maladaptive behaviors and thought processes. 3. Coping Skills Training: Developing healthy coping mechanisms to deal with stress, anxiety, and other emotions that may trigger substance use. This includes relaxation techniques, mindfulness, and assertiveness training. 4. Lifestyle Modifications: Encouraging lifestyle changes that support sobriety, such as regular exercise, healthy eating, and engaging in fulfilling activities. Building a balanced and healthy lifestyle reduces the reliance on substances for coping. 5. Social Support and Peer Networks: Emphasizing the importance of social support networks, including participation in support groups (e.g., AA, NA) and building strong, supportive relationships. Peer support can provide motivation, accountability, and encouragement. 6. Relapse Management Plans: Creating a detailed relapse management plan that outlines steps to take in case of a relapse, including whom to contact, strategies to use, and how to re-engage in treatment. This proactive approach helps individuals quickly address a relapse and return to recovery. Research indicates that comprehensive relapse-prevention training, when integrated into substance use disorder treatment, significantly reduces the likelihood of relapse and supports long-term recovery. 368. Explain the controversy related to treatment for alcoholism with controlled drinking. Answer: Controversy Related to Treatment for Alcoholism with Controlled Drinking Overview: The concept of treating alcoholism with controlled drinking (CD) rather than complete abstinence has sparked significant controversy within the field of addiction treatment. Controlled drinking aims to teach individuals with alcohol use disorders (AUDs) to moderate their alcohol intake rather than abstain entirely. Arguments in Favor of Controlled Drinking: 1. Realistic Goals: Some proponents argue that complete abstinence may be an unrealistic goal for certain individuals, particularly those with less severe alcohol problems. Controlled drinking offers a more attainable and flexible approach. 2. Harm Reduction: Controlled drinking can be seen as a harm reduction strategy, aiming to minimize the negative consequences of drinking without requiring total abstinence. This approach can be particularly useful for individuals who are not ready or willing to quit drinking entirely. 3. Personal Choice: Advocates of CD emphasize the importance of respecting personal choice and autonomy in treatment. Offering an alternative to abstinence may engage individuals who might otherwise avoid seeking help. 4. Research Support: Some studies have shown that controlled drinking interventions can be effective for certain individuals, leading to reduced alcohol consumption and fewer alcohol-related problems. Arguments Against Controlled Drinking: 1. Risk of Relapse: Critics argue that controlled drinking can be risky for individuals with severe AUDs, as it may lead to a relapse into uncontrolled drinking. The temptation and potential for loss of control may be too great. 2. Lack of Evidence: While some studies support controlled drinking, many addiction specialists believe that the evidence is not robust enough to endorse it as a primary treatment for alcoholism, particularly for those with a history of severe dependence. 3. Mixed Messages: Offering controlled drinking as an option may send mixed messages about the seriousness of alcoholism and the importance of complete abstinence. It could potentially undermine the efforts of those who are striving for total sobriety. 4. Long-Term Effectiveness: Concerns exist about the long-term effectiveness and sustainability of controlled drinking. There is a fear that initial success may not translate into lasting change, and individuals may eventually revert to problematic drinking patterns. Conclusion: The controversy over controlled drinking reflects broader debates within the field of addiction treatment regarding the most effective and appropriate approaches for different individuals. While controlled drinking may offer a viable option for some, it remains a contentious issue, particularly for those with severe alcohol dependence. The choice between controlled drinking and abstinence should be based on individual assessments, taking into account the severity of the disorder, personal preferences, and the potential risks and benefits. 369. Discuss the similarities in experience and personality between chemically-dependent individuals and those with a gambling disorder. Answer: Similarities in Experience and Personality Between Chemically-Dependent Individuals and Those with a Gambling Disorder Overview: Chemically-dependent individuals (those with substance use disorders) and individuals with a gambling disorder share several similarities in their experiences and personality traits. Both conditions are characterized by compulsive behaviors and significant negative consequences, despite attempts to control or stop the behavior. Similarities in Experience: 1. Cravings and Urges: Both groups experience strong cravings or urges to engage in their respective behaviors—substance use or gambling. These cravings can be overwhelming and difficult to resist. 2. Loss of Control: Individuals with either disorder often report a loss of control over their behavior. They may intend to limit their substance use or gambling but find themselves unable to do so. 3. Tolerance and Withdrawal: Just as chemically-dependent individuals develop tolerance (needing more of the substance to achieve the same effect) and experience withdrawal symptoms, those with a gambling disorder may also feel increased tolerance (needing to gamble more to achieve the same excitement) and withdrawal-like symptoms (restlessness, irritability) when unable to gamble. 4. Negative Consequences: Both groups face significant negative consequences, including financial problems, relationship issues, legal troubles, and health problems, yet continue the behavior despite these consequences. 5. Preoccupation: A preoccupation with the behavior is common. Individuals may spend a significant amount of time thinking about, planning, or engaging in substance use or gambling, often to the detriment of other activities and responsibilities. Similarities in Personality Traits: 1. Impulsivity: High levels of impulsivity are commonly seen in both chemically-dependent individuals and those with a gambling disorder. Impulsivity can lead to spontaneous decisions to use substances or gamble without considering the consequences. 2. Sensation-Seeking: Both groups may exhibit high sensation-seeking behavior, which involves seeking out novel and intense experiences. This trait can drive the pursuit of the highs associated with substance use or gambling. 3. Risk-Taking: A propensity for risk-taking is another shared trait. Individuals may engage in dangerous or reckless behaviors in pursuit of their addiction, whether it's driving under the influence or betting large sums of money. 4. Emotion Regulation Difficulties: Difficulty managing emotions is common. Many individuals use substances or gamble as a way to cope with negative emotions such as stress, anxiety, or depression. 5. Compulsivity: Both groups exhibit compulsive behavior patterns, characterized by repetitive and persistent actions despite negative outcomes. This compulsion to continue the behavior is a hallmark of both disorders. Conclusion: The similarities between chemically-dependent individuals and those with a gambling disorder highlight the common underlying mechanisms of addiction, regardless of the specific behavior. These similarities suggest that similar therapeutic approaches, such as cognitive-behavioral therapy (CBT), motivational interviewing, and relapse prevention strategies, may be effective for both groups. Understanding these shared traits and experiences can help in developing more comprehensive and effective treatment plans for individuals struggling with either disorder. Test Bank for Abnormal Psychology in a Changing World Jeffrey S. Nevid, Spencer A. Rathus, Beverly Greene 9780205965014, 9780135821688, 9780134458311, 9780205961719, 9780130052162

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