Student I.D. #;________________________ Lecturer: Dr.

Sandra McDermott

JAMAICA THEOLOGICAL SEMINARY

“That I may know Him……that I might make Him known”

DEPARTMENT OF HUMANITIES

FINAL EXAMINATION
SUBSTANCE ABUSE AND HUMAN BEHAVIOUR

DATE: THURSDAY, DECEMBER 15, 2011

DURATION: 9:00 A.M. – 12 NOON (3 hours)

GENERAL INSTRUCTIONS:

1. THIS PAPER COMPRISES FOUR (4) SECTIONS - A, B & C & D

2. STUDENTS ARE REQUIRED TO ANSWER ALL SECTIONS

3. ALL ANSWERS MUST BE DONE ON YOUR ANSWER BOOKLET

4. THIS PAPER HAS A TOTAL VALUE OF 100 POINTS

5. THERE IS ONE BONUS QUESTION THAT IS WORTH FIVE (5) points

NOTE CAREFULLY: ANSWER A NEW QUESTION ON A SEPARATE SHEET

NUMBER YOUR ANSWERS ACCURATELY AND CLEARLY ON THE ANSWER SHEETS .

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 SECTION A
Multiple Choice Questions
Circle the correct response. (30 points)

1. A woman went to see her physician due to her inability to sleep for several months after the
death of her spouse. The physician will likely prescribe which of the following classification of
drugs to treat the woman’s disorder?

a. An Axiolytic (Anxiety) drug

b. Central Nervous System Depressant
c. An Hypnotic ( Sedating) Drug
d. Admit the woman to hospital to administer an anaesthetic

2. A man decides to seek professional help due to the habitual abuse of Barbiturates. You are
concerned because the client has begun to complain of heart palpitations. He had a recent seizure
due to consuming large drug doses in order to deal with his physiological cravings. Which of the
following side effects would you be concerned about:

a. Death from respiratory depression

b. Drug toxicity in the human body
c. Withdrawal effects
d. All of the above

3. The stage initial stage where the liver cells increase the production of fat resulting in an enlarged
liver from excessive amount of Alcohol. The Alcohol produces a direct toxic effect and which is
known by which of the following?

a. Drug Cirrhosis
b. Hepatoxic Effect
c. Fetal Alcohol Syndrome
d. Wernicke-Korsakoff’s syndrome.

Questions 4-6 will assess Types of Alcoholics in Chapter 8-Drugs and Society

4. This type of Alcoholic is a person who has primarily a psychological dependence on Alcohol to
bolster an inability to cope with life. The person needs alcohol and becomes irritable when the
alcohol is not available. This type of alcoholic is known as which of the following:-

a. Compulsive user
b. Alpha Alcoholism
c. Beta Alcoholism
d. An Addicted person
5. This other type of alcoholic is the most severe form of alcoholism and the person suffers from
psychological and emotional problems. The alcoholism progresses from psychological
dependence to physical dependence.

a. Gamma Alcoholism
b. Zeta Alcoholism:
c. Alpha Alcoholism
d. Substance Tolerance Alcoholism.

6. Known as a maintenance drinker, this kind of alcoholic will lose control over drinking and cannot
abstain even for a day or two. The person is sometimes “tipsy but not drunk and is known by
which of the following alcoholism type:-

a. Alcohol Dependence Syndrome

b. Delta Alcoholism
c. Alpha Alcoholism
d. Epsilon Alcoholism

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7. A 16 year old teenager was referred to you for suspicion of substance abuse by a Guidance
Counsellor. During your session with him, it was observed that he appeared uncoordinated. He
had red and watery eyes, slurred speech, nausea, complaining of a headache, and there was a
rash around the corners of his mouth. The teenager also had a nosebleed. Which of the following
drug categories would you suspect that the teenager was abusing:

a. Cocaine
b. Inhalants
c. Opiods
d. Marijuana

8. The Marijuana plant is known as the Hemp plant which has cultivated for thousands of years.
Which of the following is the scientific name for this universal drug:-

a. Marinol
b. Jamaican Ganja
c. Cannabis Sativis
d. Sinsemilla Hashish

9. The biological process through which Yeast converts Sugar to Alcohol is known by which of the
following chemical process:-.

a. Fermentation
b. Methyl-alcohol
c. Distillation
d. Alcohol de-hydrogenise

10. According to the class presentation on Anabolic Steroids which of the following is the most
accurate description of the term “Anabolic Steroid”

a. Performing Enhancing Drug

b. Testosterone Enhancer Drug
c. Dose response Drug
d. None of the Above

11. Drugs that serve as a path that usually precedes the use of illicit drugs such as Marijuana and
Cigarettes into the drug using world are known as which of the following?
a. Designer drugs
b. Gateway drugs
c. Blood brain Pathway
d. Alerted Perception drugs

12. A Body builder collapsed and died on his way to the hospital. Which of the following would an
autopsy report from a Pathologist conclude regarding the use of Anabolic Steroids:-

a. Cardiovascular problems
b. Liver problems
c. Increase Blood Pressure
d. All of the Above

13. This type of drug classification normally increase alertness, excitation and euphoria in a
substance user and is known as:

a. Stimulants
b. Opiods
c. Nicotine
d. Marijuana

Questions 14-15 will ask questions about the use of Cocaine and the Impact on the individual.

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14. Cocaine interferes with the Brain’s normal handling of ____________, which is a chemical
neurotransmitter involved in the feelings of pleasure.

a. Serotonin
b. Dopamine
c. GABA
d. Acetylcholine

15. A 20 year old young man was evaluated by a drug counsellor for substance abuse. The client
complains of dizziness, headache, insomnia and depression from a recent drug binge. What is the
likely of cause of the young man’s substance abuse problems?

a. Cocaine Crash
b. Alcohol Euphoria
c. Barbiturates Abuse
d. Low Drug Dependence

16. A pregnant woman drug alcohol in her third trimester of pregnancy. She was also known to
smoke marijuana and drink a couple of red Stripe Beer in order to deal with her problems. What will
be the consequences of damage to her unborn child:-

a. Fetal Alcohol Syndrome

b. Marijuana A-motivational Syndrome
c. Alcohol De-hydrogenise
d. Hepatoxic Effect

17. Which of the following is an accurate description of the effect of Barbiturates on the Central
Nervous System?

a. Cognitive Inhibitors
b. Depression of Memory function
c. Impairment in motor skills and judgement
d. All of the Above

18. Which of the following Psychoactive Drugs is NOT considered to be an Over the Counter Drug
classification:-

a. Ibuprophen
b. Mescaline
c. Tylenol
d. Paracetamol

19. A young woman went to the Emergency room of a local Kingston Hospital. The Emergency Room
Physician who attended to her noted that she was complaining of Restlessness, Seizures, Vomiting,
Dizziness and Confusion. The woman’s medical symptoms are likely to be caused by which of the
following:-

a. Analgesic Medication Overdose

b. Cocaine Intoxication
c. Alcohol Dependence
d. Marijuana Abuse
20. The term “Analgesics” are Drugs or Substances and which represent which of the following drug
classification:-

a. CNS Stimulants
b. CNS Depressants
c. Over the Counter Drugs
d. Hallucinogens

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21. According to the Substance Abuse and Human Behaviour class notes on Abnormal Behaviour
which of the following factors does abnormal behaviour take into account?
a. Statistical Infrequency
b. Personal Distress
c. Violation of Social Norms
d. All of the above

Questions 22-25 deals with the effects of drug and substance use on the Central Nervous System
and the Human Body.
22. This drug type (Cocaine) tends to cause permanent damage to which of the following human
body structure when the drug has been sniffed or inhaled for a prolonged period of abuse.

a. The Liver
b. The Lungs
c. The Central Nervous System
d. The Stomach and Small intestine

23. This type of drug (Alcohol) has a major psychoactive effect which is rapidly distributed to every
tissue in the body. A high concentration of the drug is likely to be found in which of the following
structures:-

a. The Central Nervous System

b. The Spleen
c. The Lungs
d. All of the Above

24. This performance enhancing type of drug is determined by the adverse effects when the route of
administration, the specific drug taken, the frequency of drug is use are likely to affect which of the
following:-

a. The Reproductive System

b. The Digestive System
c. The Cardiovascular System
d. All of the Above

25. This type of sedative has played a historical role in the therapeutic effects as a sleeping aid.
(Barbiturates) However, prolonged overuse can affect which of the following human body structures:-

a. The Central Nervous System

b. The Respiratory System
c. The Reproductive System
d. The Cardiovascular System

26 A man decided to stop abusing Heroin, a form of Opiods. He comes to you as a substance abuse
counsellor for recommendations to stop using the drug. As a substance counsellor with knowledge of
opiod /or heroin withdrawal, what symptoms would you cautioned him to expect:-

a. Flu like symptoms

b. Insomnia and irritability
c. Elevated blood pressure
d. All of the above

27. Morphine is an Opiod Agonist, produces euphoria and other pleasurable feelings primarily
by___________________ activity in the “reward centre”.

a. Dopamine Agonist
b. Glutamate Antagonist
c. Dopamine Antagonist
d. Glutamate Agonist

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28. Richard C experiments with Barbiturates. He starts with a low dose and overtime he has to
take larger and larger doses in order to experience the desired effect. Richard C is experiencing:-

a. Tolerance
b. Dependence
c. Withdrawal
d. Addiction

29. The Text Drugs and Society, Chapter 14, P. 372, discussed more than 421 different chemicals in
the Cannabis or Marijuana Plant. One of the primary chemicals identified in the Text is which of the
following:-

a. L Dopa
b. Serotonin
c. Tetra-hydro-cannabinol (THC)
d. Acetylcholine
30. Like many Hallucinogens, LSD is a potent drug of abuse. In the area of distribution, LSD will be
concentrated in which of the following brain structures:-

a. The Blood brain Barrier

b. The Hypothalamus
c. The Limbic System
d. All of the above

SECTION B
True or False
In the space provided, mark “T” (true) or “F” (false). (10 points)

1. ___ All major Stimulants decrease alertness, and excitation and euphoria of the Central
Nervous System.

2. ___ E.M. Jellinick (1890-1963) published the Monograph, the Disease Concept of
Alcoholism.

3. ___ Ethanol is a consumable type of alcohol that is the psychoactive ingredient in alcohol
beverages.

4. ___ CNS depressants produced a qualitatively high and then a dis-inhibitory effect on the
human brain.

5. ___ Stimulants (e.g. Ritalin) are used to treat Attention Deficit Hyperactivity Disorder.

6. ___ Alcohol Dependence is classified as a psychiatric disorder in the Diagnostic statistical

Manual of Mental Disorders (Fourth Edition)

7. ___ Freebasing is a method of reducing impurities in Morphine and preparing the drug for
smoking.

8. ___ The habitual use of a drug or substance which causes changes in personality, apathy
and lack interest is defined as A-motivational Syndrome.

9. ___ Anabolic Steroids tend to act on the Limbic System of the Central Nervous System.

10. ___ The origin of the word “Tobacco” comes from a two-pronged tube used by the natives
of Central America.

11 ___ The translation of the Greek term Narkoticos can be translated “benumbing or
deafening”.

12. ___ The physiological effects of Methadone are the same as Morphine and Heroin
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 substance.

13. ___ The Benzodiazepines (Valium like drugs) are much safer than the Barbiturates.

14. ___ Cocaine administration increasing the effects of the Sympathetic Nervous System and
alters cardiovascular activity.

15. ___ Steroids are a family of drugs which increase the speed of body tissue growth and to
stimulate the male sex hormone on the user.

16. ___ Alcoholism temporarily relieves anxiety and stress because of its Central Nervous
System (CNS) depressant.

17. ___ Nicotine increases the neurotransmitter GABA in the reward or pleasure
centers of the brain.

18. ___ Delirium Tremens is a form of extreme alcohol syndrome when an individual
hallucinate and has a rapid heartbeat with a high fever.

19. ___ Analgesics (pain relievers) are a form of stimulants effective in the treatment of
diarrhoea.

20. ___ The stimulant Amphetamines can treat narcolepsy when taken at higher dosage.

SECTION C
Choose any Two of the following Essay Questions worth 40 points. There is also one
bonus question that is worth five (5) points

EITHER

Question 1

Discuss how the abuse of Substances and or Drugs affects human behaviour in relation to Age,
Gender, and the Environment. Please discuss at least two drugs and provide case examples. (20
Points)

OR

Question 2

Choose ONE CLASSIFICATION OF A DRUG OR SUBSTANCE that was the focus of the class
presentations and write an essay on the following: - You are reminded that an essay is more than a
few lines or two paragraphs. REMEMBER THE MAXIM IT IS BETTER TO WRITE TOO MUCH THAN TO
WRITE TWO LITTLE.

a. The definition and the properties or compound of the drug or substance classification

b. The Diagnostic Criteria effect of the drug or substance classification.

c. The effect on the central nervous system, addictive behaviours.

d. The Ethical and legal implications in the Jamaican context, and TREATMENT intervention
approaches available in the Jamaican context (cite examples from your out of class experiences).
(20 Points)

OR
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Question 3

Critically discuss the Substance Abuse Counsellor’s role in the Assessment and Diagnosis in the
understanding of substance and/or drugs. (20 Points)

OR
Question 4

Discuss the characteristics of the Substance abuse counsellor or professional and at least TWO types
of treatment interventions for substance and/or drug dependence and abuse. (20 Points)

OR

Discuss the role of Neurotransmitters in the activity of Drug Abuse or Substance Dependence.
Please write the essay with the following guide in mind. Provide Case examples. (20 Points).

a. The Antagonist and Agonist Action

b. Nerve Cell Structure and Synapse Conduction

c. Exhibitory and Inhibitory Action

d. Dopamine Effect on the Central Nervous System.

SECTION D
SUBSTANCE ABUSE CASE STUDY

INSTRUCTIONS:

This paper consists of ONE SECTION and has a total value of 20 points.

This section is mandatory. Please answer all questions related to the case. Each question should

be answered separately in 1 - 3 paragraphs.

Question 1

Read the case below and answer the questions that follow.

_________________________________________________________________

Suzanne S.

The client Suzanne S has come by the free “drop-in” counseling clinic where you work as a substance
abuse counselor to get some information and advice. Ms S is a 22-year-old single woman who has
been living with her boyfriend Jack in Kingston’s lower East side for the last four years. Ms. S and her
boyfriend has been abusing alcohol and heroin
addicts for as many years.
When Suzanne was 10 years old, her father, whom she says was a very heavy drinker, left her mom
and the kids and never came back. At 14 she started drinking and smoking marijuana. At age 16, she
had dropped out of high school and at 18 years old, she moved in with Jack where her boyfriend had
introduced her to heroin.

Ms. S reports using about a 1/2 gram of heroin per day just to be able to function and feel
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comfortable. In order to pay for the heroin and pay the rent on their apartment, Jack doesn’t work
instead; she works as a prostitute in the New Kinston area at night. She usually drinks four or five
beers each night before going out to work as a prostitute. If she can’t score enough heroin, she will
try to score either some Valiumor
Klonopin, a prescription drug to “tide me over until I can get some ‘horse’”. She says she has tried
cocaine but, “I really didn’t care for the high all that much.”
Suzanne tells you that the alcohol and heroin help to calm her nerves and get her through the night.
She and Jack are not having sex all that much. When they do make love he never wears a condom. He
says that’s what makes him different from her “john’s” “Which is true because I won’t work without a
condom.”

Lately she has noticed that her breasts have become swollen and tender. She also hasn’t had her
period in the last 12 weeks. She is pretty sure she is pregnant and knows it’s her boy friend’s baby.
However she not sure she can stop using dope or work to have the baby even though Jack wants her
to keep it. She really confused at what she should do and is her asking for you to help her make some
decisions. Her friend who works with her at night told her not to stop using dope if she’s pregnant
“Because it’s worse for the baby than to keep using.” “I just don’t know what I should do?”

CASE QUESTIONS

1. Discuss the effects of the drugs listed in the case study on the Central Nervous System (CNS)?
2. What in Suzanne’s environment might lead you to believe that environmental factors may
also play a role in her drug behaviour?
3. Of the drugs she is abusing, which one(s) pose more of a danger to withdraw?
from? Why?
4. What dangers do you see as you read this case? What are the dangers for Suzanne?
and for her unborn child?
5. What treatment options would you offer Suzanne and why?
6. What referrals would you give to her and in what order? Is her girlfriend correct?
in her advice for Suzanne not to stop her heroin use if she is pregnant?

BONUS QUESTION
(5 points)

Why do people abuse drugs? Explain how you would assess and treat someone who is addicted to
drugs or substances.

***** END OF EXAMINATION*****