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Chapter 11: Substance-Related Disorders and Impulse-Control Disorders

MULTIPLE CHOICE

1. Joan consumes alcohol alone in her residence room when she has trouble sleeping. What level of
involvement with alcohol would best apply to Joan?
a. substance use
b. substance abuse
c. substance dependence
d. intoxication
ANS: A PTS: 1 DIF: MOD REF: 394
OBJ: 2 BLM: Higher Order

2. Candace rarely drinks alcohol, but she became very intoxicated at the office party. She began to drive
herself home but on the way, she was arrested for driving under the influence. Jason has had his
driving licence suspended three times over the past two years for driving while intoxicated, yet he
never drinks on the job. Which of the following levels of involvement with alcohol would best apply
to Candace and Jason?
a. Candace, abuse; Jason, use
b. Candace, use; Jason, use
c. Candace, use; Jason, abuse
d. Candace, abuse; Jason, abuse
ANS: C PTS: 1 DIF: LOW REF: 394
OBJ: 2 BLM: Higher Order

3. Lisa has been using "crack" for about two months now. Although she knows it is destroying her job
performance and she has been reprimanded for missing work, she refuses to give it up. She says she
can quit whenever she wants to and just uses "crack" because she enjoys it. She tells others who
question her drug use to mind their own business and leave her alone. What is Lisas level of
involvement with the drug?
a. dependence
b. use
c. abuse
d. misuse
ANS: C PTS: 1 DIF: LOW REF: 394
OBJ: 2 BLM: Higher Order

4. The diagnosis of substance intoxication would depend on all of the following EXCEPT which one?
a. physiological dependence on the drug
b. the specific drug that is used
c. the drug users individual biological reaction
d. how much of a drug is used or ingested
ANS: A PTS: 1 DIF: MOD REF: 394
OBJ: 2 BLM: Remember

Copyright 2012 Nelson Education Ltd.


5. Mark has been using "crack" for two years. His whole life is now oriented around trying to get more
"crack" to feed his habit. He has even sells drugs to get "crack" money. Although he has tried
repeatedly to give it up, the "crash" is so intense and his cravings for the "rush" her are so strong he
just can't quit. What is Marks level of involvement with the drug?
a. use
b. dependence
c. abuse
d. misuse
ANS: B PTS: 1 DIF: LOW REF: 395
OBJ: 2 BLM: Higher Order

6. According to the American Psychiatric Association, what does the term dependence refer to?
a. physiological dependence on a drug
b. drug-seeking behaviours such as repeated use and the desperate need to ingest more of the
drug
c. a combination of the physiological as well as behavioural and psychological responses to
drugs
d. repeated use and reliance on street drugs
ANS: C PTS: 1 DIF: MOD REF: 395
OBJ: 2 BLM: Remember

7. Shannon 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. What is the term
for this need for higher dosages?
a. dependence
b. potentiation
c. addiction
d. tolerance
ANS: D PTS: 1 DIF: LOW REF: 395
OBJ: 2 BLM: Higher Order

8. Jan has used crack 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 stop
herself from taking it. Which of the following best describes Jans reliance on crack?
a. biological abuse
b. psychological dependence
c. physiological dependence
d. physiological abusive
ANS: B PTS: 1 DIF: LOW REF: 396
OBJ: 2 BLM: Higher Order

9. When a person is physiologically dependent on a drug, what will he or she most likely experience?
a. an increased likelihood that use will resume after a period of abstinence
b. both tolerance and withdrawal
c. withdrawal symptoms if the drug is withdrawn
d. tolerance to the effects of the drug
ANS: B PTS: 1 DIF: MOD REF: 396
OBJ: 2 BLM: Higher Order

Copyright 2012 Nelson Education Ltd.


10. Carol has been addicted to narcotics for many years. Recently, she has been trying to quit and has not
used any drugs for the last week. As part of her withdrawal from narcotics, Carol will experience all of
the following EXCEPT which one?
a. fever and chills
b. nausea, vomiting, and diarrhea
c. aches and pains
d. increase in blood pressure
ANS: D PTS: 1 DIF: MOD REF: 395-396
OBJ: 2 BLM: Higher Order

11. The condition called delirium tremens, also known as the DTs, involves hallucinations and body
tremors during withdrawal from which of the following?
a. alcohol
b. marijuana
c. cocaine
d. heroin
ANS: A PTS: 1 DIF: LOW REF: 395
OBJ: 2 BLM: Remember

12. George decided to abruptly quit using alcohol. He is now experiencing sweating, mental confusion,
incoherent speech, disorientation, terrifying hallucinations, and extreme restlessness. What are
Georges symptoms typical of?
a. alcohol poisoning
b. hypnagogic shock
c. delirium tremens
d. drug withdrawal
ANS: C PTS: 1 DIF: LOW REF: 395
OBJ: 2 BLM: Higher Order

13. A perspective on substance dependence that involves drug-seeking behaviours includes all of the
following EXCEPT which one?
a. resuming drug use after a period of abstinence
b. physical symptoms when the drug is no longer used
c. repeated use of the drug
d. a desperate need to ingest more of the drug
ANS: B PTS: 1 DIF: MOD REF: 396
OBJ: 2 BLM: Remember

14. What is the danger of using a definition of dependence that uses drug-seeking behaviours as a measure
of dependence?
a. It may exclude alcohol, which is freely available in our society.
b. It may include activities such as sex, work, or even eating chocolate.
c. It makes it seem as though addicted individuals actively choose to be addicted.
d. It may exclude instances where the drug in question is prescribed by a doctor.
ANS: B PTS: 1 DIF: HIGH REF: 395
OBJ: 2 BLM: Remember

Copyright 2012 Nelson Education Ltd.


15. Experts in the field of substance abuse were asked about the relative addictiveness of various drugs.
What was at the top of the list as most addictive?
a. heroin
b. crack cocaine
c. nicotine
d. methamphetamine
ANS: C PTS: 1 DIF: LOW REF: 398
OBJ: 1-2 BLM: Remember

16. A 46-year-old man has terminal cancer and has been receiving fairly high doses of morphine, for pain
relief, around the clock for several months. What level of substance involvement would best apply to
this individual?
a. abuse
b. dependence
c. use
d. tolerance
ANS: B PTS: 1 DIF: MOD REF: 398
OBJ: 1-2 BLM: Higher Order

17. Why did early editions of the DSM classify alcoholism and drug abuse as sociopathic personality
disorders?
a. They were considered to be signs of mental illness.
b. They were considered to be morally deficient behaviours.
c. They were considered to be criminal behaviours.
d. They were considered to be symptoms of psychosis.
ANS: B PTS: 1 DIF: MOD REF: 398
OBJ: 1-2 BLM: Remember

18. In an epidemiological study of six countries, including Canada, alcohol disorders were found to be
highly comorbid with which of the following?
a. schizophrenia
b. mood and anxiety disorders
c. a sociopathic personality disturbance
d. abuse of marijuana
ANS: B PTS: 1 DIF: MOD REF: 398
OBJ: 1-2 BLM: Remember

19. Nick has been an alcoholic for many years. He has also experienced major depression and manic
episodes. Approximately what percentage of alcoholics also have an additional psychiatric disorder?
a. 10 percent
b. 25 percent
c. 50 percent
d. 99 percent
ANS: C PTS: 1 DIF: MOD REF: 398
OBJ: 1-2 BLM: Remember

Copyright 2012 Nelson Education Ltd.


20. Ellery and colleagues (2005) showed that ingestion of alcohol led to increased risk-taking among
regular gamblers when they were using a video lottery terminal, relative to gamblers ingesting a
non-alcoholic control beverage. What does this finding suggest?
a. People addicted to alcohol may also be prone to engage other risk taking behaviours.
b. Gamblers addicted to alcohol may be more likely to engage in aggressive behaviours when
they are drinking.
c. Risk-taking tendencies may contribute to alcohol addiction.
d. Alcohol may contribute to the high co-occurrence of alcohol and gambling disorders.
ANS: D PTS: 1 DIF: MOD REF: 399
OBJ: 1-2 BLM: Higher Order

21. What are alcohol and the drugs Seconal, Halcion, and Valium classified as?
a. intoxicants
b. stimulants
c. depressants
d. narcotics
ANS: C PTS: 1 DIF: MOD REF: 400
OBJ: 1-2 BLM: Remember

22. Because they decrease central nervous system activity and help us relax, all of the following
substances are classified as depressants EXCEPT which one?
a. Seconal
b. cigarettes
c. Valium
d. alcohol
ANS: B PTS: 1 DIF: MOD REF: 400
OBJ: 1-2 BLM: Remember

23. What does the criteria of abstinence in a harm reduction approach to substance abuse?
a. Abstinence is assumed to be the natural result of improved cognitive and behavioural
coping skills after therapy.
b. Abstinence can be the final goal but it does not have to be.
c. Abstinence is an unrealistic goal for a person with a history of dependence problems.
d. Abstinence is a key requirement for the user.
ANS: B PTS: 3 DIF: MOD REF: 427
OBJ: 3 BLM: Higher Order

24. Which of the following explains the apparent stimulation, feeling of well-being, and outgoing
behaviour that are the initial effects of alcohol ingestion?
a. stimulation of the autonomic nervous system
b. activation of the inhibitory centres in the brain
c. depression of the inhibitory centres in the brain
d. depression of the autonomic nervous system
ANS: C PTS: 1 DIF: HIGH REF: 401
OBJ: 2 BLM: Remember

Copyright 2012 Nelson Education Ltd.


25. Although most psychoactive substances interact with specific substances in the brain cells, the effects
of some substances are much more complex because several different neurotransmitter systems are
affected. What substance affects several neurotransmitter systems?
a. alcohol
b. marijuana
c. opiates
d. tranquilizers
ANS: A PTS: 1 DIF: HIGH REF: 401
OBJ: 2 BLM: Remember

26. All of the following describe the specific effect of alcohol on a particular neurotransmitter system
EXCEPT which one?
a. dopamineslurred speech
b. glutamatealcoholic blackouts
c. serotoninalcoholic cravings
d. GABAanti-anxiety effect
ANS: A PTS: 1 DIF: HIGH REF: 401
OBJ: 2 BLM: Remember

27. All of the following are symptoms of withdrawal from alcohol EXCEPT which one?
a. delirium tremens
b. hallucinations
c. hypersomnia
d. nausea and/or vomiting
ANS: C PTS: 1 DIF: LOW REF: 401
OBJ: 2 BLM: Remember

28. In some individuals, chronic alcohol use causes physical damage to the body. Whether this occurs
depends on all of the following factors EXCEPT which one?
a. type of alcohol consumed
b. how frequently and how long drinking binges occur, and how much time elapses between
binges
c. genetic vulnerability
d. blood alcohol levels during drinking periods
ANS: A PTS: 1 DIF: HIGH REF: 401
OBJ: 2 BLM: Remember

29. Consequences of long-term excessive drinking include all of the following except which one?
a. infertility
b. liver disease and/or pancreatitis
c. brain damage
d. cardiovascular disorders
ANS: A PTS: 1 DIF: LOW REF: 401
OBJ: 2 BLM: Remember

Copyright 2012 Nelson Education Ltd.


30. All of the following occur in persons who are alcohol-dependent for even short periods of time
EXCEPT which one?
a. hallucinations
b. memory loss
c. dementia
d. blackouts and/or seizures
ANS: C PTS: 1 DIF: MOD REF: 401
OBJ: 2 BLM: Remember

31. Which of the following is the CORRECT pairing of an organic brain syndrome associated with
long-term alcohol abuse and its symptoms and causes?
a. dementialoss of intellectual abilities caused by a deficiency of the vitamin called
thiamine
b. Wernickes diseaseloss of intellectual abilities caused by the toxic effects of alcohol on
the brain
c. dementiaconfusion, loss of muscle coordination and unintelligible speech caused by the
toxic effects of alcohol on the brain
d. Wernickes diseaseconfusion, loss of muscle coordination, and unintelligible speech
caused by a deficiency of the vitamin called thiamine
ANS: D PTS: 1 DIF: HIGH REF: 402
OBJ: 2 BLM: Higher Order

32. Fetal alcohol syndrome (FAS) is a combination of problems that can occur in a child whose mother
drank alcohol while pregnant. Symptoms of FAS include all of the following except which one?
a. learning difficulties
b. distorted facial features
c. cognitive deficits and behaviour problems
d. excessive fetal growth
ANS: D PTS: 1 DIF: MOD REF: 402
OBJ: 2 BLM: Remember

33. According to a 19981999 Canadian survey, approximately what percentage of adult men and women
were classified as heavy drinkers?
a. 4 percent of men; 1 percent of women
b. 12 percent of men; 3 percent of women
c. 16 percent of men; 4 percent of women
d. 20 percent of men; 5 percent of women
ANS: C PTS: 1 DIF: MOD REF: 402
OBJ: 2 BLM: Remember

Copyright 2012 Nelson Education Ltd.


34. What are the noted research differences between how Canadian college and university students use
alcohol compared to American students?
a. More American female students drink alcohol than Canadian female students, but male
students in both countries drink at about the same rate.
b. More American than Canadian students drink alcohol, but more Canadian students are
binge drinkers.
c. More Canadian than American students drink alcohol, but more American students are
binge drinkers.
d. More Canadian female students drink alcohol than American female students, but male
students in both countries drink at about the same rate.
ANS: C PTS: 1 DIF: HIGH REF: 402
OBJ: 2 BLM: Higher Order

35. Approximately what percentage of Canadians who consume alcohol are classified as a problem
drinker?
a. 3 percent
b. 9 percent
c. 14 percent
d. 18 percent
ANS: B PTS: 1 DIF: MOD REF: 402
OBJ: 2 BLM: Remember

36. According to researchers, approximately what percentage of Canadians are alcohol-dependent in any
given year?
a. 3 percent
b. 10 percent
c. 15 percent
d. 18 percent
ANS: A PTS: 1 DIF: MOD REF: 403
OBJ: 2 BLM: Remember

37. What did DeWit and colleagues (2000) find to be predictive of later alcohol disorders?
a. being in the presence of adults who drink a lot
b. aggressive behaviour in early adolescence
c. drinking at an early age (from ages 1114)
d. extreme shyness and social anxiety in childhood
ANS: C PTS: 1 DIF: MOD REF: 404
OBJ: 2 BLM: Remember

38. What did DeWit and colleagues (2000) find regarding their study of 6000 lifetime drinkers who drank
at an early age (ages 1114)?
a. Drinking at an early age resulted in more severe withdrawal symptoms than drinking at
later ages.
b. Drinking at an early age seemed to lead to more responsible drinking habits at later ages.
c. Drinking at an early age caused more frequent blackouts than drinking at later ages.
d. Drinking at an early age was predictive of later alcohol use disorders.
ANS: D PTS: 1 DIF: MOD REF: 404
OBJ: 2 BLM: Remember

Copyright 2012 Nelson Education Ltd.


39. Which of the following best describes the connection between drinking and alcoholism? ?
a. A progressive pattern leading to alcoholism is inevitable for those who drink alcohol.
b. Preteen and young teenage drinking is unrelated to later abuse.
c. The factors that determine a drinkers susceptibility to alcoholism are not yet known.
d. Drinking alcohol and aggressive behaviour are negatively correlated.
ANS: C PTS: 1 DIF: HIGH REF: 404
OBJ: 2 BLM: Higher Order

40. Alcohol use and aggression are positively correlated, and the factors that determine aggressive
behaviour involve all of the following EXCEPT which one?
a. the persons previous history of violence
b. the persons IQ (measured intelligence)
c. quantity and timing of alcohol consumed
d. the persons expectations about drinking
ANS: B PTS: 1 DIF: MOD REF: 404-405
OBJ: 2 BLM: Remember

41. You have just heard about a situation in which someone who was drunk vandalized a building and
assaulted a security guard. You are aware that although alcohol does not cause aggressive behaviour, it
can increase the likelihood of engaging in violent behaviour. For whom is this most likely so?
a. people who have Wernickes disease, caused by long-term chronic alcohol abuse
b. people who have fetal alcohol syndrome
c. people who have poor executive functions, such as planning and organizing abilities
d. people who possess a combination of low IQ and poor impulse control
ANS: C PTS: 1 DIF: HIGH REF: 405
OBJ: 2 BLM: Higher Order

42. What does the term anxiolytic mean?


a. anti-seizure
b. anxiety-reducing
c. calming
d. sleep-inducing
ANS: B PTS: 1 DIF: MOD REF: 405
OBJ: 2 BLM: Remember

43. What does the term sedative mean?


a. anti-seizure
b. anxiety-reducing
c. calming
d. sleep-inducing
ANS: C PTS: 1 DIF: MOD REF: 405
OBJ: 2 BLM: Remember

44. What does the term hypnotic mean?


a. sleep-inducing
b. calming
c. anxiety-reducing
d. anti-seizure
ANS: A PTS: 1 DIF: MOD REF: 405
OBJ: 2 BLM: Remember

Copyright 2012 Nelson Education Ltd.


45. All of the following are classified as barbiturates except which one?
a. Amytal
b. Nembutal
c. Rohypnol
d. Seconal
ANS: C PTS: 1 DIF: MOD REF: 405
OBJ: 2 BLM: Remember

46. All of the following are classified as benzodiazepines except which one?
a. Halcion
b. Seconal
c. Valium
d. Xanax
ANS: B PTS: 1 DIF: LOW REF: 405
OBJ: 2 BLM: Remember

47. Billions of doses of benzodiazepines are consumed by North Americans every year. Why is this
problematic?
a. Their use is positively correlated with violent behaviour.
b. It has long been known that they are not appropriate for reducing tension and anxiety from
everyday stresses and strains.
c. They are more dangerous than barbiturates.
d. They are largely ineffective at relieving symptoms of anxiety.
ANS: B PTS: 1 DIF: HIGH REF: 405
OBJ: 2 BLM: Remember

48. At low doses, barbiturates relax the muscles and can produce feelings of well-being. However, large
doses can have results similar to which of the following?
a. heavy drinking
b. opiates
c. stimulants
d. hallucinogens
ANS: A PTS: 1 DIF: MOD REF: 405
OBJ: 2 BLM: Remember

49. Why was the use of Royhpnol popular among adolescents in the 1990s?
a. It has the same effect as alcohol without the telltale odour.
b. It is a sexual stimulant.
c. It can be taken in fairly high doses without any withdrawal symptoms.
d. It produces a longer and more intense high than marijuana.
ANS: A PTS: 1 DIF: LOW REF: 406
OBJ: 2 BLM: Remember

Copyright 2012 Nelson Education Ltd.


50. Sedative, hypnotic, and anxiolytic drugs affect the brain by acting on which of the following
neurotransmitter systems?
a. serotonin
b. GABA
c. dopamine
d. serotonin and norepinephrine
ANS: B PTS: 1 DIF: MOD REF: 406
OBJ: 2 BLM: Remember

51. Jack has been diagnosed as having an amphetamine use disorder? What is the outcome of his
amphetamines use?
a. Amphetamines cause an increase in appetite and a decrease in fatigue.
b. Amphetamine overdose can cause hallucinations, panic, agitation, and paranoid delusions.
c. Amphetamines decrease the availability of dopamine and norepinephrine in the nervous
system.
d. Amphetamines cause a period of depression and fatigue (called crashing), which is
followed by feelings of elation and euphoria.
ANS: B PTS: 1 DIF: MOD REF: 406
OBJ: 2 BLM: Higher Order

52. What were amphetamines originally used to treat?


a. neurasthenia
b. irregular heart rhythms
c. hysteria
d. asthma and as a nasal decongestant
ANS: D PTS: 1 DIF: MOD REF: 407
OBJ: 2 BLM: Remember

53. All of the following statements explain why ice is a particularly dangerous drug except which one?
a. At extremely high doses, the diaphragm muscles can relax so much as to cause death by
suffocation.
b. It causes marked aggressive tendencies.
c. It stays in the system longer than cocaine.
d. It has an extremely high risk of physiological dependence.
ANS: A PTS: 1 DIF: MOD REF: 407
OBJ: 2 BLM: Remember

54. Amphetamines stimulate the central nervous system by enhancing the activity of which of the
following?
a. norepinephrine and dopamine
b. dopamine and GABA
c. serotonin and dopamine
d. GABA
ANS: A PTS: 1 DIF: MOD REF: 407
OBJ: 2 BLM: Remember

Copyright 2012 Nelson Education Ltd.


55. Stimulation of which of the following neurotransmitters in the pleasure pathway probably causes the
high associated with cocaine use?
a. adrenaline
b. serotonin and dopamine
c. dopamine
d. endorphin
ANS: C PTS: 1 DIF: MOD REF: 407
OBJ: 2 BLM: Remember

56. In their controlled study of the effects of cocaine exposure on the developing fetus, what kind of
deficits did Potter and colleagues (2000) find in the cocaine-exposed infants?
a. They found subtle deficits in cardiac regulatory processes.
b. They found subtle deficits in reflexive responding.
c. They found subtle deficits in visual information processing.
d. They found subtle deficits in auditory information processing.
ANS: D PTS: 1 DIF: MOD REF: 408
OBJ: 2 BLM: Remember

57. Your shy and introverted friend tells you that she has discovered a wonder drug that produces feelings
of euphoria and it is not addictive. When you realize that she is talking about cocaine, which of the
following might you tell her?
a. Shes right, but when she takes the drug she will want to be reclusive and non-social.
b. Shes right but if she continues to use she will exhibit extreme symptoms of depression
which are common to two-thirds or more of cocaine abusers. In the early 20th century,
cocaine was an ingredient in Pepsi-Cola.
c. Shes right, but if she continues to use it, she will gradually develop an inability to resist
taking more over time.
d. Shes right, but unlike other recreational drugs, the mellowing and calming effect she
achieves will not last over repeated use.
ANS: C PTS: 1 DIF: MOD REF: 408
OBJ: 2 BLM: Higher Order

58. From a physiological perspective, a nicotine addict smokes cigarettes frequently throughout the day in
order to prevent withdrawal symptoms, which include all of the following except which one?
a. difficulty concentrating
b. weight loss
c. irritability
d. depression
ANS: B PTS: 1 DIF: MOD REF: 409
OBJ: 2 BLM: Remember

Copyright 2012 Nelson Education Ltd.


59. Barrett and colleagues (2006) found that administering nicotine (through tobacco smoke) leads most
smokers to increase their alcohol consumption. According to the researchers, which of the following
reasons may explain the cause?
a. Using both substances simultaneously may maximize the effects of both smoking and
alcohol on the dopamine reward system.
b. Smoking becomes a conditioned stimulus for the alcohol and increases cravings for
alcohol.
c. Alcohol maximizes the pleasurable effects of smoking on the dopamine reward system.
d. Nicotine may make drinking alcohol more rewarding in terms of its effect on the
dopamine reward system.
ANS: D PTS: 1 DIF: HIGH REF: 410
OBJ: 2 BLM: Remember

60. The most common of the psychoactive substances is used by 90 percent of North Americans.
What is it?
a. nicotine
b. caffeine
c. alcohol
d. marijuana
ANS: B PTS: 1 DIF: LOW REF: 410
OBJ: 2 BLM: Remember

61. All of the following analgesic substances are classified as opiates except which one?
a. morphine
b. cocaine
c. heroin
d. codeine
ANS: B PTS: 1 DIF: LOW REF: 411
OBJ: 2 BLM: Remember

62. Why are both morphine and codeine considered analgesics?


a. They both have a sedative effect.
b. They both relieve pain and produce euphoria.
c. They both cause hallucinations and dissociative experiences.
d. They both activate the central nervous system.
ANS: B PTS: 1 DIF: MOD REF: 411
OBJ: 2 BLM: Remember

63. What is the primary use for legally available narcotic medications, such as morphine and codeine?
a. as antagonists
b. as antidotes
c. as antibiotics
d. as analgesics
ANS: D PTS: 1 DIF: MOD REF: 411
OBJ: 2 BLM: Remember

Copyright 2012 Nelson Education Ltd.


64. Why is opioid withdrawal considered to be life-threatening?
a. Early treatment for withdrawal symptoms was not as effective as it is today.
b. Users in the early 20th century had access to cheaper and purer forms of the drug than are
available today.
c. Users often ingest other substances to reduce withdrawal symptoms and this may produce
a lethal interaction.
d. Opiate users tend to be secretive, precluding researchers from gaining accurate
information about the withdrawal syndrome.
ANS: B PTS: 1 DIF: HIGH REF: 412
OBJ: 2 BLM: Higher Order

65. A newer prescription drug for pain is oxycodone. Which of the following describes why it has been
prominently in the news?
a. because of its potential for the treatment for cancer
b. because of its potential for the treatment of AIDS
c. because of its potential for the treatment of withdrawal symptoms of heroin
d. because of its potential for abuse and lethal overdose
ANS: D PTS: 1 DIF: MOD REF: 412
OBJ: 2 BLM: Remember

66. According to the results of a 24-year follow up study of more than 500 opioid addicts approximately
28% of them had died. What was mean age of death?
a. 35 years
b. 45years
c. 40 years
d. 50 years
ANS: B PTS: 1 DIF: HIGH REF: 412
OBJ: 2 BLM: Remember

67. Where are the natural opioids enkephalins and endorphins found?
a. in DNA
b. in the adrenal glands
c. in the pituitary gland
d. in the brain
ANS: D PTS: 1 DIF: LOW REF: 412
OBJ: 2 BLM: Remember

68. Which of the following substances distort sensory experiences, feelings, and perceptions?
a. benzos
b. opiates
c. roofies
d. hallucinogens
ANS: D PTS: 1 DIF: LOW REF: 412
OBJ: 2 BLM: Remember

Copyright 2012 Nelson Education Ltd.


69. What can marijuana use and abuse lead to?
a. Psychological dependence even with occasional use.
b. Rapid development of tolerance.
c. Physiological addiction to tobacco smoke.
d. Paranoia and hallucinations.
ANS: D PTS: 1 DIF: MOD REF: 413
OBJ: 2 BLM: Remember

70. Which of the following best describes the reverse tolerance phenomenon reported by some regular
users of marijuana?
a. wanting to use the drug less often after repeated use
b. experiencing more pleasure from the same amount of the drug after repeated use
c. experiencing less pleasure from smaller amounts of the drug after repeated use
d. experiencing more pleasure from greater amounts of the drug after repeated use
ANS: B PTS: 1 DIF: MOD REF: 413
OBJ: 2 BLM: Higher Order

71. The hallucinogenic drug LSD is produced synthetically in laboratories. However, a naturally occurring
derivative has caused outbreaks of illness throughout history. Which of the following is it?
a. lysergic acid amide
b. ergot
c. psilocybin
d. mescaline
ANS: B PTS: 1 DIF: MOD REF: 414
OBJ: 2 BLM: Remember

72. In the 1950s, Dr. Humphrey Osmond experimented with the hallucinogenic drug LSD as a treatment
for which of the following?
a. sleep disorders
b. pain
c. anxiety disorders
d. alcoholism
ANS: D PTS: 1 DIF: MOD REF: 414
OBJ: 2 BLM: Remember

73. What do inhalants cause?


a. Symptoms of withdrawal that can last up to two or more weeks.
b. Use of inhalants can cause users to be antisocial and aggressive.
c. Symptoms that include heighten auditory and visual perception.
d. Damage bone marrow, the kidneys, the liver, and the brain.
ANS: D PTS: 1 DIF: MOD REF: 415
OBJ: 1-2 BLM: Remember

74. Jason uses mescaline repeatedly over several days. Which of the following is most likely?
a. He will overdose and may die.
b. The drug will completely lose its effectiveness.
c. He will experience severe withdrawal symptoms when he stops.
d. He will experience at least one bad trip.
ANS: B PTS: 1 DIF: HIGH REF: 415
OBJ: 1-2 BLM: Higher Order

Copyright 2012 Nelson Education Ltd.


75. How does the use of the testosterone-derived, anabolic-androgenic steroids differ from the use of other
illicit drugs?
a. There is no desirable high with steroid use.
b. Steroids can be taken orally or by injection.
c. Twice as many young males abuse steroids for body size and performance as those who
abuse drugs that produce a high.
d. The high produced from steroid use is more intense than that experienced with other
drugs.
ANS: A PTS: 1 DIF: MOD REF: 416
OBJ: 2-3 BLM: Remember

76. Karrie uses an illicit designer drug that is a dissociative anesthetic. It produces in her a sense of
detachment along with a reduced awareness of pain. What drug is it?
a. K or Special K
b. Ecstasy (MDMA)
c. Eve
d. Nexus
ANS: A PTS: 1 DIF: LOW REF: 416
OBJ: 2-3 BLM: Higher Order

77. What physiological reaction appears to prevent some persons from becoming alcohol dependent?
a. ADA response
b. skin-flushing response
c. red cell syndrome
d. meta-alcohol syndrome
ANS: B PTS: 1 DIF: MOD REF: 417
OBJ: 2-3 BLM: Remember

78. What facts does research data indicated regarding the connection between substance abuse in general
and how it is affected by our genes?
a. No one gene causes substance abuse or dependence.
b. It plays little or no part in substance abuse in females.
c. Genes are probably a small contributor compared to environmental factors that it may not
be worth studying.
d. Researchers have not yet identified the specific gene responsible.
ANS: A PTS: 1 DIF: MOD REF: 417
OBJ: 2-3 BLM: Remember

79. What might be the common factor among abused psychoactive drugs?
a. their identical effect on neurotransmitters at the synapse
b. the suppression of the nervous system
c. the similar way in which they are metabolized in the body
d. their ability to activate the pleasure pathways of the brain
ANS: D PTS: 1 DIF: MOD REF: 417
OBJ: 2-3 BLM: Higher Order

Copyright 2012 Nelson Education Ltd.


80. In the 1950s, James Olds used electrical stimulation on the brains of rats. What did he discover?
a. that rats lost memory of previously learned skills
b. that rats have completely different neurotransmitter systems from humans
c. the aggressive centre of the brain
d. the pleasure centre of the brain
ANS: D PTS: 1 DIF: MOD REF: 417
OBJ: 2-3 BLM: Remember

81. The pleasure pathways, or internal reward centres, in the human brain are primarily made up of
which of the following?
a. both dopamine-sensitive and serotonin-sensitive neurons
b. serotonin-sensitive neurons
c. dopamine-sensitive neurons
d. GABA-sensitive neurons
ANS: C PTS: 1 DIF: HIGH REF: 417
OBJ: 2-3 BLM: Remember

82. Which of the following drugs act directly on the dopamine system?
a. cocaine and alcohol
b. LSD and alcohol
c. inhalants and benzodiazepines
d. amphetamines and cocaine
ANS: D PTS: 1 DIF: MOD REF: 417
OBJ: 2-3 BLM: Remember

83. How do both amphetamines and cocaine produce their desired effects?
a. by indirectly stimulating the internal reward centre or pleasure pathway of the brain
b. by directly stimulating the internal reward centre or pleasure pathway of the brain
c. by enhancing the activity of GABA in the septal-hippocampal system
d. by increasing beta-endorphin release
ANS: B PTS: 1 DIF: HIGH REF: 417
OBJ: 2-3 BLM: Higher Order

84. Yesterday, you asked your friend John for a couple of aspirin tablets. John informs you that, in
behavioural terms, aspirin is which of the following?
a. a positive reinforcer
b. a neutral reinforcer
c. a negative reinforcer
d. a variable reinforcer
ANS: C PTS: 1 DIF: MOD REF: 418
OBJ: 2-3 BLM: Higher Order

85. In behavioural terms, when is a drug considered a negative reinforcer?


a. when it punishes the user with aversive withdrawal symptoms
b. when it stops a person from feeling bad
c. when it makes a person feel good
d. when it has a high risk of physiological dependency
ANS: B PTS: 1 DIF: MOD REF: 418
OBJ: 2-3 BLM: Higher Order

Copyright 2012 Nelson Education Ltd.


86. In trying to understand why some individuals become addicted to drugs and others do not, it is
important to consider the negative reinforcement that is associated with the anxiolytic effect. What is
the anxiolytic effect?
a. a drugs ability to metabolize slowly, extending its effects
b. a drugs ability to reduce anxiety
c. a drugs ability to relieve pain
d. a drugs ability to produce a high
ANS: B PTS: 1 DIF: HIGH REF: 418
OBJ: 2-3 BLM: Higher Order

87. Why do some drugs produce an anxiolytic (anxiety-relieving) effect?


a. They act directly on the dopamine system.
b. They increase the activity of GABA in the septal-hippocampal region.
c. They stimulate the pleasure pathways of the brain.
d. They negatively reinforce drug-taking behaviour.
ANS: B PTS: 1 DIF: HIGH REF: 418
OBJ: 2-3 BLM: Higher Order

88. What does the term sensitization mean?


a. an increased high when taking the drug
b. an increased dopamine release when taking the drug
c. a decreased dopamine release when taking the drug
d. a decreased high when taking the drug
ANS: B PTS: 1 DIF: MOD REF: 417
OBJ: 2-3 BLM: Remember

89. In trying to understand why some people continue to use drugs until they become dependent on them
and others are able to stop before this happens, what is important to consider?
a. how sensitive a person is to both the negative effects of alcohol when it is first ingested
and to the negative effects of alcohol after a few hours
b. how sensitive a person is to the negative effects of alcohol when it is first ingested and to
the positive effects a few hours later
c. how sensitive a person is to the positive effects of alcohol when it is first ingested and to
the positive effects a few hours later
d. how sensitive a person is to the positive effects of alcohol when it is first ingested and to
the negative effects after a few hours
ANS: D PTS: 1 DIF: HIGH REF: 417
OBJ: 2-3 BLM: Higher Order

90. What did Pihl and colleagues (1992) discover about individuals at high familial genetic risk for
alcoholism?
a. They may be more sensitive to the positive effects of alcohol when it is first ingested.
b. They may be less sensitive to the positive effects of alcohol when it is first ingested.
c. They may be more sensitive to the negative effects of alcohol after a few hours.
d. They may be more sensitive to the positive effects of alcohol and less sensitive to the
negative effects of alcohol after a few hours.
ANS: A PTS: 1 DIF: HIGH REF: 418
OBJ: 2-3 BLM: Remember

Copyright 2012 Nelson Education Ltd.


91. What did laboratory research involving drug addiction in animals demonstrate about the positive
reinforcing effect of drugs?
a. It occurs regardless of biological influences.
b. It occurs with fewer social and cultural influences than humans.
c. It occurs independently of social and cultural influences.
d. It occurs with as much social influence as with humans.
ANS: C PTS: 1 DIF: HIGH REF: 418
OBJ: 2-3 BLM: Remember

92. Many individuals use drugs as negative reinforcement, in their lives. This phenomenon is called all of
the following EXCEPT which one?
a. negative affect
b. self-medication
c. tension reduction
d. controlled dosing
ANS: D PTS: 1 DIF: MOD REF: 418
OBJ: 2-3 BLM: Remember

93. Which of the following theories uses both positive reinforcement and negative reinforcement to
explain why the crash that follows the initial euphoria of drug use is not a deterrent to further drug
use?
a. amotivational theory
b. substance-related self-schema theory
c. opponent-process theory
d. expectancy theory
ANS: C PTS: 1 DIF: MOD REF: 419
OBJ: 3 BLM: Remember

94. How is the opponent-process explanation of drug addiction best described?


a. An increase in negative feelings will be followed by further negative feelings and this
mechanism is both strengthened with use and weakened by disuse.
b. An increase in positive feelings will be followed by an increase in negative feelings and
this mechanism is strengthened with disuse.
c. An increase in positive feelings will be followed by an increase in negative feelings and
this mechanism is strengthened with use.
d. An increase in negative feelings will be followed by an increase in positive feelings and
this mechanism is weakened by use.
ANS: C PTS: 1 DIF: HIGH REF: 419
OBJ: 3 BLM: Higher Order

Copyright 2012 Nelson Education Ltd.


95. Which of the following explains the cognitive phenomenon called alcohol myopia?
a. An individual continues to drink and denies that there are any negative consequences
associated with alcohol.
b. An individual properly evaluates the risks associated with continued abuse of alcohol and
decides to enter a treatment program.
c. An individual finally sees that drinking alcohol has only negative consequences and stops
drinking.
d. An individual continues to drink even when he or she knows that excessive drinking has
severe negative consequences.
ANS: D PTS: 1 DIF: HIGH REF: 420
OBJ: 3 BLM: Higher Order

96. A 2003 study by Galambos and colleagues examined the influence of parenting behaviours and of
peers on childrens adjustment in early adolescence. What did the results of this study suggest?
a. Positive peer-counselling can overcome negative peer influences on alcohol and drug use
in adolescents.
b. Parenting can exert an important influence on adolescents use of alcohol and drugs,
despite negative peer influences.
c. If negative peer influences are strong enough, parenting style is unrelated to alcohol and
drug use.
d. Parenting can exert an important influence on adolescents use of alcohol and drugs
provided that positive peer influences are in place.
ANS: B PTS: 1 DIF: HIGH REF: 421
OBJ: 3 BLM: Higher Order

97. The integrative approach to substance abuse reflects the concept of equifinality. It is best described by
which of the following?
a. Neurobiological factors determine whether substance abuse will develop.
b. A genetic factor alone is the cause of substance abuse.
c. For any particular individual, substance abuse may arise from multiple and different
causes.
d. Psychological factors are the primary determinants of whether or not a person becomes a
drug addict.
ANS: C PTS: 1 DIF: MOD REF: 422
OBJ: 3 BLM: Higher Order

98. Which of the following is an example of agonist types of treatment for substance abuse?
a. the use of methadone to treat heroin addiction
b. moral condemnation of the behaviours as sins
c. encouraging the user to focus on the pain and suffering his or her substance use inflicts on
themselves and others
d. the use of naltrexone to treat heroin addiction
ANS: A PTS: 1 DIF: HIGH REF: 423
OBJ: 3 BLM: Higher Order

Copyright 2012 Nelson Education Ltd.


99. Heroin and methadone are cross-tolerant. What does this mean?
a. They act on the same neurotransmitter receptors and, thus, a person addicted to one drug
may become addicted to the other.
b. They each produce the same level of high in users.
c. They each produce a significantly different type and level of high in users.
d. They do not act on the same neurotransmitter receptors; however, the level of tolerance
developed will automatically cause a generalization to the other drug.
ANS: A PTS: 1 DIF: HIGH REF: 423
OBJ: 3 BLM: Higher Order

100. The drug opiate-antagonist naltrexone is a treatment for substance abuse. How does it work?
a. by substituting a chemically similar drug for the addictive drug
b. by producing a cross-tolerance effect in a drug user
c. by producing only a temporary euphoric effect if opiates continue to be used
d. by both counteracting the effects of opiates and producing withdrawal symptoms
ANS: D PTS: 1 DIF: MOD REF: 424
OBJ: 1-2 BLM: Higher Order

101. An alcoholic who is highly motivated to stop drinking and who understands the possible consequences
of treatment may be prescribed Antabuse. This medication is an example of which of the following
types of treatment for alcoholism?
a. abstinent
b. antagonist
c. agonist
d. aversive
ANS: D PTS: 1 DIF: LOW REF: 424
OBJ: 1-2 BLM: Higher Order

102. Which of the following accurately describes Alcoholics Anonymous?


a. AA was developed during the 1960s when self-help treatments approaches were
increasing.
b. Leaders from AA advocate controlled drinking so former alcoholics can become social
drinkers.
c. AA is an effective for some people, which involves a 10-step treatment approach to
recovery.
d. AA members must acknowledge their addiction to alcohol and its destructive power over
them
ANS: D PTS: 1 DIF: MOD REF: 425
OBJ: 1-2 BLM: Higher Order

Copyright 2012 Nelson Education Ltd.


103. According to Sobell and Sobell (1978), which of the following best describes the difference between
the abstinence approaches compared to the controlled drinking approach when to treating alcoholism?
a. Very few abusers are capable of using alcohol in a controlled manner, whereas the
abstinence approach has a very high rate of long-term effectiveness.
b. Controlled drinking may be a viable alternative to abstinence but it isnt a cure.
c. While some abusers may be able to limit their drinking to normative levels, the abstinence
approach is still the most effective treatment for all abusers.
d. Controlled drinking is far more effective than the abstinence approach in the long term
because it provides at least some relief from cravings.
ANS: B PTS: 1 DIF: HIGH REF: 427
OBJ: 3 BLM: Higher Order

104. It seems that a valuable part of therapy for substance use may be contingency management. In it, what
do clinician and client do together?
a. They develop a skills-training program to resist social, media, and peer pressure to use
drugs.
b. They identify and correct aspects of the clients life that might contribute to substance use
or interfere with efforts to abstain.
c. They focus on the learned aspects of dependencethat is, the failure of cognitive and
behavioural coping skills.
d. They select specific behaviours for change and reinforcers that will reward success.
ANS: D PTS: 1 DIF: MOD REF: 427
OBJ: 3 BLM: Higher Order

ESSAY

1. Compare and contrast the levels of involvement in substance-related disorders: use, intoxication,
abuse, and dependence. Define the meaning of the word addiction.

ANS:
Student responses will vary.

PTS: 1 REF: 394-395 OBJ: 1-2 BLM: Remember

2. Define psychoactive substance and give examples of the different categories of psychoactive drugs.
Discuss whether these drugs are psychologically or physiologically addictive.

ANS:
Student responses will vary.

PTS: 1 REF: 399-400 OBJ: 1 BLM: Remember

3. Describe the psychological and behavioural effects of alcohol. Discuss both the short-term and
long-term consequences of alcohol abuse.

ANS:
Student responses will vary.

PTS: 1 REF: 400-402 OBJ: 1-2 BLM: Remember

Copyright 2012 Nelson Education Ltd.


4. Discuss the current research and theories regarding the progression of alcohol use disorders. How do
current ideas contrast with Jellineks model?

ANS:
Student responses will vary.

PTS: 1 REF: 403-405 OBJ: 2 BLM: Remember

5. Compare and contrast the depressant drugs, including benzodiazepines, barbiturates, and anxiolytics.
Discuss medical uses for these substances and the potential for abuse and/or addiction.

ANS:
Student responses will vary.

PTS: 1 REF: 405-405 OBJ: 2 BLM: Remember

6. Compare and contrast the stimulant drugs. Discuss the history of cocaine as well as its atypical type of
addictive process.

ANS:
Student responses will vary.

PTS: 1 REF: 406-411 OBJ: 2 BLM: Remember

7. Discuss the problems of both steroid and inhalant abuse, noting psychological and physical effects.
How do steroid and inhalant abuses differ from abuse of other substances?

ANS:
Student responses will vary.

PTS: 1 REF: 415-416 OBJ: 2-3 BLM: Remember

8. Discuss current research on the genetic/biological, social, and cultural factors related to alcoholism.
Which factors appear most strongly related to the development and progression of the disorder?

ANS:
Student responses will vary.

PTS: 1 REF: 416-422 OBJ: 1-3 BLM: Higher Order|Remember

9. Explain the basic assumptions and tenets of the Alcoholics Anonymous model of treatment for
alcoholism versus the controlled drinking approach. Referring to recent research into long-term relapse
prevention, what conclusions can be drawn about both approaches?

ANS:
Student responses will vary.

PTS: 1 REF: 425-426 OBJ: 1-3 BLM: Remember

Copyright 2012 Nelson Education Ltd.


10. Explain the basic assumptions and examples of the harm reduction approach to drug abuse. Discuss
fully the controversy surrounding this approach, explaining the positions of both its proponents and
critics.

ANS:
Student responses will vary.

PTS: 1 REF: 428-429 OBJ: 1-3 BLM: Remember

Copyright 2012 Nelson Education Ltd.