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Thinking about taking the Substance Abuse DSST exam? Great choice! Whether it’s something you’re already familiar with or a new subject you’re excited to learn, read on for everything you need to know.

This exam includes 100 multiple choice questions (free mini practice test below). By taking this exam, you’ll be awarded credit equivalent to a freshman single semester course. You’ll first need to learn basic terminologies and theories about substance abuse. After that, you’ll delve into deeper and more exciting stuff, like the types of addictive substances, their harmful effects, and treatment options.

Substance Abuse
Study Guide

substance abuse dsst

Below is a breakdown of the various content areas that will be included in the exam. Each of these areas will have a different weighting.

  • (12%) Overview of Substance Abuse and Dependence

    While this introductory section might sound theoretical and boring, it’s actually pretty interesting. You’ll get to learn and understand:
    • Substance use vs. abuse, how substance dependency starts, and the differences between psychological vs. physical addiction. Interesting fact: it’s possible to be psychologically dependent on chocolate and tacos!
    • Fundamental theories that explain Substance Abuse and dependency (SAD): how genetics, environmental, psychological and biopsychosocial factors make some people more likely to be dependent on substances.
    • Fascinating insights into SAD demographics- how SAD is more common in certain age groups, genders, and socio-economic groups.
    • SAD is linked to other social problems- more DUIs, higher crime rates, family problems, etc.
    • Testing and diagnosis of SAD

  • (6%) Classification of Drugs

    A shorter section where you’ll need to know how drugs are categorized according to:
    • Their potential for physical and/or psychological dependence
    • Safety
    • Potential use in medical applications.
    You’ll also learn about The Drug Enforcement Administration schedule (DEA) and how it classifies drugs.

  • (9%) Pharmacological and Neurophysiological Principles

    Here you’ll need to understand how an average, healthy person’s nervous system works- a few things to memorize here. Once you know this, you’ll learn about the effects drugs have on the body, health, and nervous system functioning. Drugs mainly cause spikes or inhibit the operation of neurotransmitters in the brain. E.g., cocaine stimulates the neurotransmitter, dopamine, in the brain, increasing reward-seeking behavior.
    In this section, you’ll also be tested on your understanding of drug interactions. Consuming certain combinations of drugs can be lethal and even lead to death.

  • (14%) Alcohol

    A more extended, yet in-depth and fascinating section where you’ll learn about:
    • The categories and history of alcohol- how consuming it became a recreational activity.
    • How alcohol affects short-term and long-term brain functioning
    • How it makes the brain fuzzy, leading to slurred speech and difficulty standing upright or walking
    • Why pregnant women shouldn’t consume alcohol- it leads to fetal alcohol syndrome in their babies, which is damaging and incurable.
    • How gender and body weight affect blood alcohol levels.
    • How the body builds tolerance to alcohol
    • Withdrawal effects- anxiety, low mood, nausea, insomnia and even hallucinations might occur when heavy drinkers lower or stop alcohol consumption
    • How alcohol dependency negatively affects people’s lives- their work, relationships and family lives.
    • Strategies to prevent alcohol abuse and addiction.
    • Various methods to treat alcohol dependency- psychotherapy, support groups (think AA) and medication.

  • (6%) Anti-Anxiety Drugs, Sedatives, and Hypnotics

    • The history of these drugs
    • Short-term and long-term usage effects on physiology and behavior- These include sleepiness, poor memory and concentration, stomach upset, increased risk of death, liver damage and brain functioning problems.
    • The categories and classification of these drugs.
    • These drugs are tolerance forming, and it’s easy to become physically dependent on them. The withdrawal effects can be quite rough – insomnia, suicidal thoughts, depression, aggressive impulses, etc. The amounts of deaths related to overdosing on anti-anxiety pills (particularly benzodiazepines) have skyrocketed recently.
    • Treating dependency through a combination of behavioral and pharmacological methods.

  • (10%) Tobacco and Nicotine

    • The history of smoking tobacco.
    • Short-term and long-term usage effects- Nicotine is a mild stimulant that increases dopamine levels, making it easily addictive. It harms the lungs, heart, kidney and reproductive systems. As you probably already know, lung cancer can be a devastating result of long-term smoking.
    • Nicotine is highly tolerance forming, and its withdrawal effects are often unbearable- ask any smoker who’s tried to quit. Overdosing on nicotine can cause vomiting, stomach ache, tremors, dizziness and even seizures.
    • Behavioral and pharmacological methods to treat tobacco and nicotine abuse and dependency- nicotine gum and patches, cognitive behavioral therapy (CBT) and counseling are recommended.

  • (6%) Psychomotor

    • Types- Particularly caffeine and xanthine (found in chocolate and tea too)
    • Effects include psychomotor activation, stimulated dopamine functioning and dependency.
    • Withdrawal effects are usually more emotionally or mentally distressful rather than physically distressful. Caffeine overdose can be very harmful, leading to arrhythmia and even death in some cases.
    • Treatment- Here, behavioral treatments- CBT, counseling and support groups- are most effective.

  • (7%) Opioids

    • History- Opioids are one of the most commonly abused drugs (Vicodin is a notorious example).
    • Types, including heroin and morphine which work similarly to endorphins (endogenous opioids)
    • Effects- they work as painkillers, dulling pain and relaxing the nervous system. The bad side- paranoia, drowsiness and oxygen starvation.
    • Opioids are tolerance forming, causing withdrawal symptoms like anxiety, depression and muscle cramping. Overdose can be fatal, leading to decreased breathing and even death.
    • Treatment- pain management, alternative medication, and psychotherapy.

  • (10%) Cannabinoids

    • All things weed (and endogenous cannabinoids)
    • Effects- euphoria, hunger, calmness, poor concentration and memory. Long-term usage effects are more harmful- lower intelligence, paranoia, anxiety, and psychosis.
    • Can be tolerance forming when excessively consumed. Withdrawal effects include irritability, anxiety, and insomnia. Withdrawal effects aren’t as severe or long-lasting compared to withdrawal from other substances. Overdose is dangerous though- poor coordination, slow reaction time (this can lead to accidents and death), hallucinations and seizures.
    • Pharmacological treatments to overcome dependence- these minimize side effects that cause relapse.
    • Psychotherapy based treatment- CBT, counseling, etc.

  • (16%) Other Drugs of Abuse

    • Hallucinogens- types, history, short and long-term effects, withdrawal, tolerance, and overdose.
    • Inhalants- types, history, short and long-term effects, withdrawal, tolerance, overdose, and dependency treatment.
    • Antipsychotic Drugs- types, history, side effects (like adverse reactions and toxicity)
    • Anabolic steroids
    • Over-the-counter substances
    • Synthetic substances
    • Party drugs

  • (4%) Antidepressants and Mood Stabalizers

    These are also among the most common prescription drugs that cause dependency.
    • Types- SSRIs, SNRIs, MAOIs, Tricyclic
    • Side-effects- insomnia, nausea, weight gain, low sex drive, etc.
    • Toxicity and adverse reactions when combined with certain substances
    • Antidepressants are tolerance forming, causing withdrawal symptoms like insomnia, anxiety, worsened depression, etc.
    • The link between antidepressants and suicidal thoughts/ attempts- Many research studies show an alarming link between antidepressants and suicide ideation or attempts.

Substance Abuse
Practice Quiz

Do you feel confident to give the practice test a try? The format of the test will be nice and familiar for most as it will be multiple-choice with only one correct answer. When you write your answer make sure to tap (or hover over) the question to give you the answer and an explanation.

All test questions are in a multiple-choice format, with one correct answer and three incorrect options. The following are samples of the types of questions that may appear on the exam.

Please do keep in mind that we can’t guarantee the accuracy of this quiz, so we do recommend you also run through a full-length practice exam.  We’ll recommend some good options in the resources section at the bottom of this page.

Question 1: Alcohol dependency can be treated by..

a) Psychotherapy
b) Aversion therapy
c) Pharmacological methods
d) All of the above

Answer: d. All of the above
Alcohol dependency can be treated by a combination of psychological and pharmacological approaches. Psychological treatments such as counseling, cognitive behavioral therapy and support groups (like Alcoholics Anonymous) can reduce depression, anxiety and unhelpful habits which often underlie alcohol abuse. Pharmacological methods and aversion therapy through drugs such as Antabuse, induce vomiting when consumed with alcohol, therefore, helping reduce alcohol consumption and dependency.

Question 2: Which of these substances is most likely to cause aggressive behavior?

a) Cannabinoids
b) Amphetamines
c) Nicotine
d) LSD

Answer: b. Amphetamines
Amphetamines are the drugs most commonly associated with aggression and violent behavior. Amphetamine users- especially long-term ones- can develop an amphetamine-induced psychosis, resulting in paranoia, delusions, hallucinations, and impulsiveness. During an amphetamine-induced psychosis, an individual might experience hallucinations of being threatened with thoughts like “someone is out there to get me.” False perceptions of threats and dangers can lead users to engage in aggressive behavior or violence to “fight” threats or “defend themselves” from perceived (non-existent) dangers.

Question 3: Which of these statements is true about physical and psychological substance dependence?

a) You can be physically dependent only on certain substances, but you can be psychologically dependent on any substance
b) You can be psychologically dependent only on certain substances, but you can be physically dependent on any substance
c) Psychological dependence results from changes in the brain or brain functioning; whereas physical dependence does not.
d) It’s possible to cure psychological dependence, but not physical dependence.

Answer: a. You can be physically dependent only on certain substances, but you can be psychologically dependent on any substance.
Physical dependence can only occur with tolerance forming substances (e.g., alcohol, benzodiazepines and nicotine). Conversely, psychological dependence can happen with any substance, regardless of whether it’s tolerance forming (e.g., sugar, chocolate or junk food). After prolonged use of tolerance forming substances, the body and brain become dependent on them for functioning. Psychological dependence, on the other hand, is characterized by mental and/or emotional dependence on a substance, not physical dependence.

Question 4: An example of a hallucinogen is…

a) Marijuana
b) Cocaine
c) Nicotine
d) Lysergic acid diethylamide (LSD)

Answer: d. Lysergic acid diethylamide (LSD).
A hallucinogen is a drug or substance that causes hallucinations. Hallucinogens are divided into three categories: psychedelics, dissociatives, and deliriants. LSD is the most commonly consumed hallucinogenic drug. Its effects include visual hallucinations, paranoia, flashbacks, and impaired time and depth perception. Some other hallucinogens are PCP, Magic Mushrooms, DMT and Ketamine.

Question 5: Substance abuse and dependency is more common in ________ and ________.

a) Females; individuals with a genetic history of substance abuse
b) Males; individuals from developed countries
c) Females; individuals from developed countries
d) Males; individuals with a genetic history of substance abuse

Answer: d. Males; individuals with a genetic history of substance abuse.
Males are more likely to abuse substances compared to females because they have easier access to drugs through their peer groups, are more likely to use alcohol and drugs to cope with negative emotions, and engage in riskier behavior compared to females. Additionally, individuals with a genetic history of substance abuse are more likely to be dependent on substances. Half the risk-factor arises from an individual’s genetics. If an individual’s parents or relatives had a history of alcohol or substance abuse, he or she is more vulnerable to substance abuse and dependency.

Question 6: An effect of chronic cannabinoid abuse is _________.

a) Decline in cognitive functioning
b) Heightened energy levels and euphoria
c) Impaired coordination and poor balance
d) Dehydration

Answer: a. Decline in cognitive functioning
Chronic or long-term cannabinoid use has been found to result in a decline in intelligence levels (lower IQ), poor academic performance, declined short-term memory and impaired ability to learn and grasp new or complex concepts. Some studies indicate that prolonged cannabis use causes brain areas associated with memory and information processing to reduce in size.

Question 7: Nicotine dependency can be treated by…

a) Cognitive behavioral therapy (CBT)
b) Nicotine gum or patches
c) Hypnotherapy
d) All of the above

Answer: d. All of the above
Nicotine dependency can be treated with both, psychological and pharmacological treatments. Cognitive behavioural therapy and hypnotherapy can modify unhealthy thought patterns and beliefs, replacing them with new, healthier ones. Psychotherapy based treatments also promote alternative, healthier ways to deal with stress- like meditation or exercise. Nicotine gum or patches can help individuals quit smoking by minimizing unpleasant nicotine withdrawal symptoms.

Question 8: An opioid is a…

a) Stimulant
b) Type of alcohol
c) Substance found in cigarettes
d) Painkiller

Answer: d. Painkiller
Opioids are drugs that alter nervous system functioning to relieve pain. Some opioids that are legal are medically prescribed in the form of painkillers (e.g., codeine, Vicodin, and oxycodone). Other opiates such as heroin are illegal since they are tolerance forming and can lead to physical dependency. The effects of opioids include difficulty breathing, brain damage from oxygen starvation, liver damage and a weakened immune system.

Question 9: Dopamine is a/an…

a) Type of cell in the body
b) Hormone
c) Neurotransmitter
d) Illegal substance

Answer: c. Neurotransmitter
Neurotransmitters are chemicals produced by nerve cells that serve as messengers, transmitting nerve impulses from one cell to another cell, a tissue or an organ. Dopamine is a neurotransmitter that relays messages between the brain and different nerve cells in the body. Dopamine plays a big part in reward-seeking behavior. Many dependency forming substances increase brain dopamine levels.

Question 10: __________ and __________ are determinants of blood alcohol levels.

a) Socioeconomic status; gender
b) Gender; body weight
c) Age; level of education
d) Gender; level of education

Answer: b. Gender; body weight
Generally, if a man and a woman drink the same amount of alcohol, the woman is more likely to have higher blood alcohol levels and be more affected by it. From an assigned-at-birth gender perspective, assigned male individuals have higher body water content levels (61% vs. 52%) and more Alcohol Dehydrogenase levels to break down alcohol before reaching the bloodstream. Lighter individuals are more likely to have higher blood alcohol levels and be more affected by alcohol compared to heavier individuals because individuals that weigh more have larger total water volumes in their body. This dilutes the alcohol, resulting in lower blood alcohol levels.

More DSST Study Resources

Are you at the beginning of your study process, or just looking for a couple more practice questions to finish prepping for your exam? In either case, you can find some of my favorite resources below. Some of the links below are affiliate (Amazon for instance), which means they’ll pay us a few bucks for every purchase through the link. Feel free to use those links if you want to support the site, but you can also just Google the title or pick the book up at your local library.

Official DSST Practice Test: Ok, so the DSST website isn’t the most inviting, but it will give you the best approximation of the real exam experience. Also, the official practice test is quite affordable (currently just $5 per practice exam).

Mometrix – DSST Substance Abuse: Textbooks are great as far as they go, but I’d generally recommend you opt for this exam guide instead. It tends to cut through the confusion and help you accelerate your learning process.

InstantCert Academy: Another website with a very dated design, but as ancient as it looks, this is actually an incredibly valuable resource. Basically, you get a massive set of flashcards that you can use to learn Substance Abuse and to really solidify that knowledge so you’re ready for the exam.

Plenty of other resources exist – just do a quick internet search – but these are a fantastic start, and probably all you really need. I’ve personally done some exams with just InstantCert and the official practice test.

Congrats on starting your DSST study journey! Study hard, earn credit, and most of all remember to have fun.