Substance Use, Abuse, and Prevention
This domain tests drug classifications, effects, addiction, prevention, and legal and ethical responsibilities. Questions often ask you to select the best prevention or intervention response.
Core rules and concepts
- Depressants slow the central nervous system: alcohol, benzodiazepines, barbiturates. Stimulants increase it: cocaine, amphetamines, nicotine, caffeine. Opioids bind opioid receptors: heroin, fentanyl, prescription painkillers. Hallucinogens alter perception: LSD, psilocybin.
- Alcohol: blood alcohol concentration depends on weight, sex, time, food, and drink strength. Binge drinking is 4 or more drinks for women or 5 or more for men in about 2 hours. Fetal alcohol spectrum disorders are preventable by avoiding alcohol in pregnancy.
- Nicotine is highly addictive; vaping is not harmless. EVALI has been linked to vitamin E acetate in THC products.
- Opioid overdose signs include slowed breathing, pinpoint pupils, and unresponsiveness; naloxone reverses opioid overdose.
- Prevention levels: primary (before use), secondary (early intervention), tertiary (treatment and recovery). Use SBIRT: screening, brief intervention, referral to treatment.
- Legal and ethical: follow mandatory reporting and school policy; do not enable use; know confidentiality limits.
Worked example: A student is caught with a vaping device. The best response is to follow school policy, provide education on nicotine addiction, screen with SBIRT, refer for cessation support, and avoid shaming. Reasoning: punishment alone does not change behavior; a health-focused approach addresses addiction and school safety together.
Traps that cost marks: equating any use with dependence; assuming all drugs cause physical withdrawal; forgetting alcohol is a depressant; misclassifying nicotine as a depressant; ignoring mandatory reporting; assuming naloxone treats all overdoses.