Substances
ASAM Critera
The big six
Core Competencies
DSM V & Case Studies
100

 When assessing the impact of alcohol use on a person's body, mind, and spirit, which of the following would be considered a spiritual consequence?

A elevated liver enzymes, B difficulty concentrating, C feelings of hopelessness and loss of purpose, D increased blook pressure 

Spiritual consequences often involve a loss of meaning, purpose, hope, connection, or alignment with personal values. The other options describe physical or cognitive effects of alcohol use.

100

A client with severe alcohol use disorder presents with a history of withdrawal seizures, unstable medical conditions, and current intoxication. What is the most appropriate initial placement?

A early intervention, B outpatient, C medically managed inpatient, D recovery residence 

Significant withdrawal risk and unstable medical conditions require the highest level of medical monitoring and management.

100

A client presents for treatment and reports daily alcohol use. They have tremors, sweating, elevated blood pressure, and a history of withdrawal seizures. Which ASAM dimension is the primary concern?

A 2, biomedical, B 3 Emotional, behavioral, or cognitive conditions, C acute intoxication and withdrawal D. 6 Recovery environment 

C

D-1 evaluates the risk associated with intoxication and withdrawal. A history of seizures indicates significant withdrawal risk 

100

The time when you gather demographic, consent forms, and complete admission paperwork 

A Intake, B Assessment, C Consultation, D Crisis Intervention 

Intake involves administrative and initial procedures necessary for admission to the agency 

100

A client meets five DSM-5 criteria for Alcohol Use Disorder. How would the severity be classified?

A Mild, B Moderate, C Severe, D in remission 

  • Mild = 2–3 criteria
  • Moderate = 4–5 criteria
  • Severe = 6 or more criteria
200

Which of the following best illustrates the impact of opioid use on the body?

A Decreased energy, B respiration depression, emotional numbness, C improved physical health due to less pain, D reduced stress 

Opioid use can affect the body through respiratory depression and physical dependence, the mind through emotional blunting and cognitive impairment, and the spirit through disconnection from values, relationships, and purpose.

200

A client is medically stable and highly motivated for treatment but has experienced multiple relapses while living in an environment where substances are readily available. Which factor most strongly supports placement in a residential level of care?

A Intoxication, B biomedical, C recovery environment, D lack of DX 

C

An unsafe or unsupportive recovery environment (Dimension 6) may indicate the need for a more structured residential setting.

200

client acknowledges that substance use is causing problems but states, "I know I should quit, but I'm not ready to make any changes yet." Which ASAM dimension is most relevant?

A 3 emotional behavioral cognitive, B 4 readiness to change, c 5 relapse, continued use, or problem potential D 6 recovery environment 

B

D-4 assess motivation, engagement, and willingness to participate in treatment and make behavioral changes

200

An Addiction counselor seeks guidance from an MD regarding a clients co-occuring symptoms and medication concerns 

A Client education, B consultation, C Counseling, D Supervision 

B

Consultation involves communicating with professionals and experts to improve client care and treatment outcomes 

200

Which statement best describes tolerance?

A Experiencing physical symptoms when substance use stops, B using despite relationship problems, C.  needing increased amounts to achieve the desired effect, D withdrawal 

Tolerance occurs when an individual requires more of the substance to achieve the same effect or experiences diminished effects from the same amount.

300

Heavy, long-term cannabis use may affect which of the following areas of functioning?

A Physical Health only, B mental health only, C spiritual health only, D motivational health 

D

While the effects vary among individuals, chronic cannabis use can influence physical health, cognitive functioning, emotional well-being, but, participation in activities that provide meaning and fulfillment is the most common impact for most 

300

A client has mild withdrawal risk, stable housing, strong family support, and can maintain employment while attending treatment several days per week. Which ASAM level of care?

A Clinically managed residential, B medically mangaed intensitive, C IOP, D Medically monitored inpatient 

The client has sufficient stability and support to participate in intensive outpatient treatment while remaining in the community.

300

client recently completed residential treatment but has relapsed three times within the past year when exposed to stress and social situations involving substance use. Which ASAM dimension is most impacted?

A 1, Acute intoxication, B 2 biomedical etc, C 5 relapse potential, D Recovery environment 

D-5 assesses the likelihood of continued use, relapse, or continued problems related to use 

300
Counselor documents the client's attendance, progress toward goals, interventions, and recommends continued care


A Assessment, B counseling, C Reports and Record keeping, D relapse prevention plan / discharge summary 

Reports and record keeping involve maintaining accurate, timely, and legally compliant documentation regarding client services, progress, and treatment outcomes

300

Which of the following is NOT one of the DSM-5 criteria for Substance Use Disorder?

A craving, B Withdrawal, C emotional wellbeing, D hazardous use

Although emotional well-being is tied through several of the criteria, it is not associated alone as one of the 11. 

400

An addiction counselor is conducting a holistic assessment. The client states, "I don't know who I am anymore, and I've lost touch with everything that used to matter to me." Which area should the counselor explore further?

A spiritual well-being, B withdrawal potential, C empoloyment history, D medication compliance 

Many individuals with substance use disorders experience a loss of purpose, connection, identity, or meaning, which may be explored as part of a holistic assessment.

400

A client in residential treatment continues to experience strong cravings, poor coping skills, and repeated urges to leave treatment. They have not yet met treatment goals. According to ASAM principles, the counselor should:

A discharge the client immediately, B. Continue the current LOC, C. Move the client to OP, D refer client to 12 step groups 

B

ASAM continued-stay criteria support maintaining the current level of care when the client continues to demonstrate clinical needs that require that level of service.

400

When determining which dimensions are positive for a client in counseling, according to ASAM, the most appropriate approach to determining LOC is to:

A based soley on the client's DX, B. Lease restrictive level of care regardless of risk, C. Consider all 6 dimensions, D. Place all clients that have relapse potential into a program. 

C

Level of care decisions are based on a multidimensional assessment across all 6

400

Counselor leads a group discussion on the effects of alcohol on the brain, the disease model of addiction, and relapse warning signs. 

A Counseling, B Consultation, C client education, D Assessment 

C

Client education involves providing information about substance use disorders, recovery, treatment options, and related topics to increase client knowledge and support recovery 

400

Case study one   


A. Important activities given up, B. Tolerance, C. Continued use despite persistent social or interpersonal problems, D. Withdrawal

C

Continued use despite recurrent social or interpersonal problems caused or worsened by substance use is a DSM-5 criterion.

500

A client reports using benzodiazepines and alcohol together to cope with anxiety. Why is this combination especially concerning?

A Both substances increase energy levels, B. Both are stimulants. C. Both depress the CNS and increase the risk of respiratory depression and an OD, D There are no significant risks associated with combining the two 

C

Alcohol and benzodiazepines are central nervous system depressants. Combining them can significantly increase sedation, respiratory depression, and overdose risk.

500

Case study 3

A Level 4.0 medically managed intensive inpatient, B Level 3.5 Residential treatment, C Level 2.5 Partial Hospitalization, D level 1.0 OP

D

Low severity across all six ASAM dimensions generally supports placement in outpatient services.

500

According to the ASAM Criteria, which principle is MOST important when determining an appropriate level of care?

A the client's age, B the substance used, C the clients multipldimensional assessment across all 6, D the counselor's preference 

C

ASAM placement decisions are based on a comprehensive evaluation of all six dimensions, ensuring that treatment intensity matches the unique risks, needs, and strengths of the client 

500

Counselor coordinates housing services, medical appointments, transportation assistance, and communication among treatment providers for a client. Which core function is MOST clearly demonstrated?

A Referral, B Case Management, C Consultation, D Orientation 

B


Case management focuses on Coordinating services and resources to help clients address needs that support recovery and overall all functioning

500

Case study 2

A. Social impairment, B. Craving, C. Withdrawal, D. Hazardous use

Craving is defined as a strong desire or urge to use a substance and is one of the 11 DSM-5 criteria.

M
e
n
u