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A Comprehensive Approach to Address Substance Use in America

1. Substances can be divided into only two major categories: alcohol and illicit drugs.

A. True B. False

2. Which of the following statements regarding binge drinking is most accurate?

A. Binge drinking for women is drinking 5 or more standard alcoholic drinks on the same occasion on at least 1 day in the past 30 days. B. Binge drinking for men is drinking 4 or more standard alcoholic drinks on the same occasion on at least 1 day in the past 30 days. C. Binge drinking for women is drinking 4 or more standard alcoholic drinks on the same occasion on at least 1 day in the past 30 days. D. None of the above

3. A 48 year-old male patient presents to the emergency department with a history of alcohol abuse. The patient may be suffering from which of the following long-term alcohol effects?

A. Liver disease B. Hypertension C. Pancreatic disease D. All of the above

4. Patients with a history of substance misuse are at a higher risk for contracting HIV/AIDS.

A. True B. False

5. Which of the following may be considered a risk factor for substance misuse?

A. Low levels of school involvement B. High levels of school involvement C. High levels of family conflict D. Both A and C

6. Which of the following may be considered DSM-5 criteria for diagnosing a substance use disorder?

A. Giving up important activities because of substance use B. Decreasing tolerance to substances C. Spending a small amount of time to get, use, or recover from substance use D. Both A and B

7. Marijuana is the most commonly used illicit drug in the United States.

A. True B. False

8. Which of the following statements is most accurate?

A. Well-supported scientific evidence shows that addiction to alcohol or drugs is not a chronic brain disease that has the potential for recurrence and recovery B. Well-supported scientific evidence shows that disruptions in three areas of the brain are significant in the onset, development, and maintenance of substance use disorders: the basal ganglia, the extended amygdala, and the prefrontal cortex C. Well-supported scientific evidence shows that adolescence is not a critical at-risk period for substance use and addiction D. None of the above

9. Clinical studies show more than 60 percent of people treated for a substance use disorder experience relapse within the first year after they are discharged from treatment.

A. True B. False

10. Which of the following statements is most accurate?

A. The basal ganglia control the rewarding or pleasurable effects of substance use and are also responsible for the formation of habitual substance taking B. The extended amygdala is involved in executive function C. The prefrontal cortex is involved in stress and the feelings of unease, anxiety, and irritability that typically accompany substance withdrawal D. None of the above

11. The preoccupation stage of addiction is the stage at which one seeks substances again after a period of abstinence.

A. True B. False

12. Which of the following statements is most accurate?

A. The basal ganglia is associated with the binge stage of the addiction cycle B. The prefrontal cortex is associated with the withdrawal stage of the addiction cycle C. The extended amygdala is associated with the anticipation stage of the addiction cycle D. All of the above

13. The positively reinforcing effects of substances tend to increase with repeated use.

A. True B. False

14. As substance abuse progresses, which of the following occur?

A. Use becomes an ingrained behavior B. Impulsivity shifts to compulsivity C. The primary drivers of repeated substance use shift from positive reinforcement to negative reinforcement D. All of the above

15. Many studies have shown that the neurons that release dopamine are activated, either directly or indirectly, by all addictive substances, but mainly by stimulants such as cocaine, amphetamines, and nicotine.

A. True B. False

16. Which of the following statements is most accurate?

A. Incentive salience can persist even after the rewarding effects of the substance have diminished B. The prefrontal cortex is associated with incentive salience C. The extended amygdala is associated with incentive salience D. None of the above

17. Which part of the brain is believed to be involved in habit formation?

A. Dorsal striatum B. Prefrontal cortex C. Extended amygdala D. None of the above

18. When used over the long term, all substances of abuse cause dysfunction in the brain's dopamine reward system.

A. True B. False

19. Which of the following occurs in the withdrawal stage of the addiction cycle?

A. Stress neurotransmitters are activated in the extended amygdala B. Stress neurotransmitters are inactivated in the extended amygdala C. Stress neurotransmitters are activated in the prefrontal cortex D. Stress neurotransmitters are inactivated in the prefrontal cortex

20. Which of the following statements is most accurate?

A. The "Go system" disengages habit-response systems in the dorsal striatum B. The "Go system" engages habit-response systems in the dorsal striatum C. The "Stop system" engages habit-response systems in the dorsal striatum D. None of the above

21. The preoccupation stage of the addiction cycle is characterized by a disruption of executive function caused by a compromised prefrontal cortex.

A. False B. True

22. Addiction to stimulants, such as cocaine, typically follows a pattern that emphasizes the binge stage of the addiction cycle.

A. True B. False

23. Marijuana can lead to which of the following?

A. Increased dopamine in the prefrontal cortex B. Decreased dopamine in the prefrontal cortex C. Increased dopamine in the basal ganglia D. Decreased dopamine in the basal ganglia

24. Which of the following statements is most accurate?

A. All adolescents who experiment with alcohol, cigarettes, or other substances go on to develop a substance use disorder. B. Research shows that one-third of individuals who have experienced PTSD have also experienced alcohol dependence at some point in their lives. C. Genetic factors are not a risk factor for substance addiction. D. None of the above

25. Clinical reports suggest that women who use cocaine, opioids, or alcohol progress from initial use to a disorder at a faster rate than men.

A. True B. False

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