Free CASAC Exam Flashcards

A pharmacological adaptation in which the body requires increasing amounts of a substance to achieve the same effect. It develops through receptor down-regulation and is a predictor of physical dependence, but tolerance alone is not the same as addiction.

Physical dependence produces measurable withdrawal symptoms when the substance is stopped. Psychological dependence is the emotional or cognitive drive to use for reward, craving relief, or coping. A client can have one without the other, and treatment must address both.

A characteristic cluster of physiological and psychological symptoms that appears when a substance is reduced or stopped after sustained use. The presentation is substance-specific (alcohol, opioids, stimulants differ) and severity guides whether medical detoxification is required.

Reduced responsiveness to one substance because of tolerance developed to a chemically related substance. Clinically relevant when switching opioids or sedatives: the new drug may be less effective or require dose adjustment to avoid undertreatment or overdose.

An agonist binds and activates a receptor, mimicking the effects of the substance (e.g., methadone at opioid receptors). An antagonist blocks a receptor without activating it, preventing the substance from exerting its effect (e.g., naltrexone). The distinction drives medication-assisted treatment choices.

Severe alcohol withdrawal can progress to delirium tremens, characterized by autonomic hyperactivity, confusion, hallucinations, and risk of seizure. Symptoms typically peak 24-72 hours after the last drink. This is a medical emergency requiring supervised detoxification, not outpatient counseling alone.

The classic overdose presentation combines pinpoint pupils, respiratory depression, and decreased level of consciousness. Recognizing it promptly is essential because opioid antagonists can reverse it if administered before hypoxic injury occurs.

Naloxone is a short-acting opioid antagonist that displaces opioids from mu-receptors, rapidly restoring respiration. Its effect is temporary, so a person revived with naloxone still needs medical evaluation because respiratory depression can return once the antagonist wears off.

The simultaneous presence of a substance use disorder and an independent mental health disorder in the same client. Comorbidity is common, complicates treatment, and requires integrated care rather than treating each condition in isolation.

Sequential treatment addresses one disorder first and the other later, which can leave the untreated condition destabilizing progress. Integrated treatment addresses both disorders concurrently in the same setting by a coordinated team, and is the evidence-based standard for co-occurring disorders.

The clinical observation that some clients use substances to relieve symptoms of an underlying mental health condition. It explains part of the overlap between SUD and psychiatric disorders but is not the only pathway; intoxication and withdrawal can also cause or worsen psychiatric symptoms.

A substance-induced disorder is caused by intoxication or withdrawal and typically resolves with sustained abstinence. An independent disorder persists regardless of substance use. Distinguishing them requires observing the client during a period of abstinence and shapes the treatment plan.

Depression and alcohol use disorder, anxiety and benzodiazepine use, PTSD and opioid use, and bipolar disorder and stimulant use are frequent overlaps. Each pairing carries elevated relapse and suicide risk, so safety planning must account for both conditions.

DSM-5-TR defines severity by the count of met criteria: mild is 2-3 criteria, moderate is 4-5, and severe is 6 or more out of 11. The count drives diagnosis and informs intensity of recommended care.

The 11 criteria span impaired control, social impairment, risky use, and pharmacological indicators (tolerance and withdrawal). Meeting 2 or more within a 12-month period establishes a diagnosis. Withdrawal and tolerance alone are not sufficient without the behavioral criteria.

A structured evaluation covering biological (substance history, medical, family), psychological (mental health, trauma, coping), and social (relationships, employment, legal, housing) domains. It provides the clinical foundation for diagnosis, treatment planning, and level-of-care placement.

ASAM criteria evaluate intoxication and withdrawal, biomedical conditions, emotional and behavioral complications, readiness to change, relapse potential, and recovery environment. Together they determine the appropriate intensity and level of care.

The process of distinguishing a substance use disorder from other conditions that produce similar symptoms, such as psychiatric illness, medical illness, or medication effects. It requires a substance-free observation period and corroborating records when available.

Laboratory testing of biological samples to detect recent substance use. It is an objective adjunct to self-report, can confirm or contradict the clinical interview, and supports treatment matching, but a single result is not diagnostic of a substance use disorder.

Information obtained from sources other than the client, such as family, prior providers, or records, used to verify or supplement self-report. It must be gathered only with the client's written consent under 42 CFR Part 2 and can reveal discrepancies the client does not report.

A brief four-question screen for alcohol problems: Cut down, Annoyed, Guilty, Eye-opener. Two or more positive responses suggest a likely alcohol use disorder and indicate that a fuller assessment is warranted. It is a screen, not a diagnostic instrument.

A 10-item screening tool developed by the WHO to detect hazardous and harmful alcohol use. A score of 8 or more in men (7 or more in women, or lower in some guidance) indicates risky drinking. It covers consumption, dependence symptoms, and alcohol-related harm.

A screening instrument for non-alcohol substance use problems. The DAST-10 short form asks about drug-related consequences and dependence signs; a higher score indicates greater involvement with drugs and signals the need for a comprehensive assessment.

Screening, Brief Intervention, and Referral to Treatment is a public health approach that identifies risky substance use in general settings, delivers a short motivational conversation, and refers those with likely disorders to specialty care. The brief intervention is typically a few minutes, not full treatment.

CBT teaches that thoughts, feelings, and behaviors are interconnected, so changing distorted thoughts and maladaptive behaviors reduces substance use. Clients learn to identify triggers, challenge cognitive distortions, and rehearse coping skills. It is one of the most evidence-based modalities for SUD.

The model describes readiness as a progression through precontemplation, contemplation, preparation, action, and maintenance, with relapse as a possible return rather than failure. The counselor matches interventions to the client's current stage rather than pushing action on a precontemplative client.

A structured, manualized approach that introduces clients to the principles and fellowship of 12-step programs such as AA or NA. The counselor works on acceptance, surrender, and active involvement in a mutual-help community. It is distinct from simply telling a client to attend meetings.

A cognitive-behavioral approach that teaches clients to anticipate high-risk situations and develop coping responses before a lapse occurs. It distinguishes a lapse (a single use) from a relapse (return to problematic patterns) and treats lapses as learning opportunities, not failures.

A set of strategies that reduce the negative consequences of substance use without requiring immediate abstinence. Examples include syringe services, naloxone distribution, and managed alcohol programs. It meets clients where they are and can be a pathway to engagement rather than an alternative to recovery.

Early group stages involve members testing trust and the leader, often with hesitation and conflict. The counselor's task is to establish safety, norms, and cohesion. Skipping this work leads to superficial participation and higher dropout; productive working-stage change depends on it.

Open-ended questions, Affirmations, Reflective listening, and Summaries are the four core counseling skills of motivational interviewing. They reduce defensiveness and elicit the client's own motivation for change rather than the counselor arguing for it.

Change talk is client speech favoring movement toward change (desire, ability, reasons, need, commitment). Sustain talk favors the status quo. The counselor deliberately elicits and strengthens change talk while softening sustain talk, because the balance predicts behavioral outcomes.

Instead of confronting or arguing with a client's resistance, the counselor reframes or reflects it, shifting the dynamic without opposition. This avoids power struggles and preserves the therapeutic alliance, which is essential for engagement.

Helping the client perceive a gap between their current behavior and their own goals or values. The discrepancy is drawn from the client's own words, not imposed by the counselor, and it creates internal motivation for change.

Goals that are Specific, Measurable, Achievable, Relevant, and Time-bound. They turn vague intentions into observable behavioral targets, allow progress to be tracked, and are revised collaboratively as treatment advances.

ASAM defines a continuum from 0.5 (early intervention) through 1 (outpatient), 2 (intensive outpatient or partial hospitalization), 3 (residential), to 4 (medically managed inpatient). Each level specifies intensity of service and is matched to the client's assessed needs across the six dimensions.

A written document stating the client's measurable goals, objectives, interventions, and target dates, developed collaboratively with the client. It is strengths-based, reviewed and updated regularly, and must reflect the assessed needs rather than a one-size program template.

The principle that clients move through differing intensities of service as their needs change, for example from detoxification to residential to outpatient to aftercare. Matching the client to the right level at the right time reduces relapse and dropout.

Lower-intensity support following formal treatment, including recovery support groups, peer services, and check-ins. It sustains gains made during active treatment and addresses the chronic, relapsing nature of substance use disorders.

The federal confidentiality rule governing substance use disorder treatment records. It is stricter than HIPAA: a separate, specific written consent is required before disclosing SUD treatment information, even to other providers, with limited exceptions for medical emergency and certain audits.

HIPAA sets a general national privacy standard for protected health information. 42 CFR Part 2 overlays additional, more restrictive protections for SUD records. When both apply, Part 2 governs, so a general HIPAA authorization is not sufficient to release Part 2 records.

The ethical and legal obligation to protect a foreseeable victim when a client poses a serious threat of harm. The counselor may need to warn the intended victim and notify authorities, breaking confidentiality only to the extent necessary to prevent the harm.

The process of ensuring a client understands the nature, risks, benefits, limits, and alternatives of treatment before agreeing to participate. Consent must be voluntary and ongoing, documented in writing, and revisited when the treatment approach changes.

Situations in which a counselor has another role with the client outside the professional one, such as friend, employer, or family member. These relationships risk exploiting the client and impairing clinical judgment, so they must be avoided or managed and documented when unavoidable.

The legal requirement to report suspected child abuse or neglect, and in some states elder or vulnerable adult abuse, to authorities. It overrides confidentiality and applies when the counselor has reasonable cause to suspect abuse, not only when it is confirmed.

The California case establishing that a therapist owes a duty to protect a foreseeable victim of a client's serious threat. It is the basis of duty-to-warn obligations nationwide and demonstrates that confidentiality has defined limits when identifiable third parties are at risk.

Screening, intake, orientation, assessment, treatment planning, counseling, case management, crisis intervention, client education, referral, reports and record keeping, and consultation. These functions define the counselor's scope of practice and frame the content of the IC&RC ADC exam.

A CASAC provides counseling, assessment, and case management for substance use disorders but cannot prescribe medication, diagnose independent medical conditions, or practice outside addiction counseling. Recognizing this boundary triggers referrals to qualified medical or psychiatric professionals.

In addition to 42 CFR Part 2, New York rules protect SUD treatment information and require written consent for most disclosures. The counselor must inform clients of these protections at intake, obtain specific consent before any release, and never confirm or deny a client's presence in treatment without consent.

The CASAC credential renews every three years and requires at least 60 continuing education clock hours, including 6 hours of OASAS-approved ethics training and professional boundaries training at each cycle. The renewal application is due at least 75 days before expiration, and training records must be retained for six years.