CARN-AP study guide
CARN-AP · Work through your exam, one topic at a time.
The Certified Addictions Registered Nurse – Advanced Practice (CARN-AP) is a specialty credential for nurses prepared at the graduate level - typically nurse practitioners, clinical nurse specialists, and other advanced practice nurses - who assess, diagnose, and treat substance use disorders and co-occurring mental health conditions. It signals that the holder can practice independently or within an interprofessional team across withdrawal management, pharmacotherapy for substance use disorders, integrated psychotherapy, and long-term recovery support. The CARN-AP study guide has 6 sections and about 2,096 words.
01Assessment, Screening, and Diagnosis of Substance Use and Co-occurring Disorders
DSM-5-TR defines substance use disorder across 11 criteria in four clusters: impaired control (larger amounts or longer use, unsuccessful cutting down, time spent, craving), social impairment (role failure, interpersonal problems, activities given up), risky use (hazardous situations, continued use despite physical or psychological harm), and pharmacological (tolerance, withdrawal). Two or more criteria within 12 months establish the diagnosis; severity is graded mild (2-3), moderate (4-5), or severe (6 or more).
387 words, about 2 min02Psychopharmacology and Medication Management
Three FDA-approved medications treat opioid use disorder: methadone (full agonist, dispensed through federally regulated opioid treatment programs), buprenorphine (partial agonist with a ceiling effect on respiratory depression), and naltrexone (antagonist). Buprenorphine induction requires a COWS score of roughly 8-12 and adequate abstinence from short-acting opioids (typically 12-24 hours) to prevent precipitated withdrawal.
346 words, about 2 min03Psychotherapeutic, Behavioral, and Counseling Interventions
Motivational interviewing (OARS: open questions, affirmations, reflections, summaries) is directive and goal-oriented; the clinician evokes change talk and explores sustain talk rather than arguing. Prochaska stages (precontemplation through maintenance) guide intervention selection but are not linear, and relapse is expected.
344 words, about 2 min04Care Coordination, Referral, and Collaborative/Interprofessional Practice
Care coordination in addictions depends on warm handoffs (in-person or live telephone transfer), closed-loop referrals in which the receiving team confirms engagement, and discharge planning that begins at admission. Integrated models include the collaborative care model, integrated dual diagnosis treatment with assertive outreach, and case management or ACT for high-acuity patients.
356 words, about 2 min05Health Promotion, Disease Prevention, and Recovery Support
Harm reduction meets people where they are: naloxone distribution with overdose education, syringe services programs, fentanyl and xylazine test strips, and never-use-alone guidance reduce death and infection without requiring abstinence. Infectious disease prevention includes hepatitis B vaccination, hepatitis C and HIV testing with linkage to curative treatment, PrEP for HIV, and STI screening.
323 words, about 2 min06Ethics, Legal, Regulatory, and Professional Practice Issues
Confidentiality is the backbone of addiction practice: 42 CFR Part 2 for SUD records, HIPAA for general health information, and parallel state statutes, with the most stringent standard governing. Valid informed consent covers diagnosis, treatment options and alternatives, risks and benefits, and the right to refuse.
340 words, about 2 min