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How many criteria does the DSM-5-TR list for a Substance Use Disorder diagnosis?

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2026 Statistics

Key Facts: C-CATODSW Exam

No exam

Application-based credential

NASW

$200-350

Application Fee Range

NASW 2026

2 + 2 yrs

Post-MSW clinical + SUD counseling

NASW

11 criteria

DSM-5-TR SUD Symptoms

APA DSM-5-TR

Mild 2-3 / Mod 4-5 / Sev 6+

DSM-5-TR SUD Severity

APA DSM-5-TR

5-15%

Untreated DTs Mortality

NIAAA

C-CATODSW is an application-based NASW clinical specialty credential (no written exam). Requires MSW + current LCSW (or equivalent state clinical license) + 2 years post-MSW clinical practice + 2 years supervised SUD counseling + current NASW membership + supervisor reference. Application fee ranges $200-350 plus NASW dues. Renewed every 2 years with continuing education in addiction practice. Our 100 free practice questions map to DSM-5-TR SUD criteria, MI/CBT/CM/MAT, co-occurring disorders, ASAM levels of care, pharmacology, recovery models, harm reduction, and 42 CFR Part 2 confidentiality.

Sample C-CATODSW Practice Questions

Try these sample questions to test your C-CATODSW exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1How many criteria does the DSM-5-TR list for a Substance Use Disorder diagnosis?

A.11

B.9

C.7

D.13

Explanation: The DSM-5-TR Substance Use Disorder diagnosis combines the former DSM-IV abuse and dependence categories into a single disorder defined by 11 criteria, grouped into 4 clusters: impaired control (1-4), social impairment (5-7), risky use (8-9), and pharmacological (10 tolerance, 11 withdrawal).

2Per DSM-5-TR, how many SUD criteria must a client meet to be diagnosed with a Moderate Substance Use Disorder?

A.4 to 5

B.2 to 3

C.6 or more

D.Exactly 5

Explanation: DSM-5-TR severity for any SUD is determined by symptom count within a 12-month period: Mild = 2 to 3 criteria, Moderate = 4 to 5 criteria, Severe = 6 or more criteria. A diagnosis requires at least 2 criteria.

3Which DSM-5-TR specifier applies to a client who has met no SUD criteria (other than craving) for at least 3 months but less than 12 months?

A.In early remission

B.In sustained remission

C.In a controlled environment

D.On maintenance therapy

Explanation: DSM-5-TR specifies 'in early remission' when none of the SUD criteria (with the exception of craving) have been met for at least 3 months but less than 12 months. 'In sustained remission' applies after 12 months or longer with no criteria met (except craving).

4Which DSM-5-TR criterion was REMOVED from the substance use disorder diagnosis when DSM-5 replaced DSM-IV abuse and dependence?

A.Recurrent legal problems related to substance use

B.Tolerance

C.Withdrawal

D.Craving

Explanation: When DSM-5 consolidated abuse and dependence into a single SUD diagnosis, the 'recurrent substance-related legal problems' criterion was removed because it functioned poorly across cultures and jurisdictions. Craving was added as a new criterion.

5A client meets 7 of the 11 DSM-5-TR criteria for opioid use disorder over the past year. What is the appropriate severity specifier?

A.Severe

B.Moderate

C.Mild

D.In partial remission

Explanation: Severe SUD is assigned when 6 or more criteria are met within a 12-month period. With 7 criteria, the client meets the threshold for Severe Opioid Use Disorder.

6Which of the following is grouped under the 'pharmacological' cluster of DSM-5-TR SUD criteria?

A.Tolerance and withdrawal

B.Craving and unsuccessful efforts to cut down

C.Continued use despite social problems and giving up activities

D.Hazardous use and continued use despite physical or psychological problems

Explanation: The DSM-5-TR groups SUD criteria into 4 clusters: impaired control (1-4: larger amounts/longer than intended, unsuccessful efforts to cut down, time spent obtaining/using/recovering, craving), social impairment (5-7), risky use (8-9), and pharmacological (10 tolerance, 11 withdrawal). Tolerance and withdrawal are the pharmacological criteria.

7Per DSM-5-TR, the diagnosis of tolerance and/or withdrawal in a client receiving an opioid prescription as directed under medical supervision should be:

A.Not counted toward an SUD diagnosis when the medication is taken as prescribed

B.Always counted as 2 SUD criteria

C.Used to immediately diagnose Severe Opioid Use Disorder

D.Reported to the prescriber as evidence of misuse

Explanation: DSM-5-TR explicitly states that tolerance and withdrawal occurring during appropriate medically supervised treatment with prescribed opioids (or benzodiazepines, stimulants, etc.) are NOT counted toward a SUD diagnosis. Physiologic dependence on a medication taken as prescribed is expected and is not pathological by itself.

8Which substance use disorder was newly added in DSM-5 that did NOT appear as a distinct disorder in DSM-IV?

A.Cannabis Withdrawal

B.Alcohol Use Disorder

C.Opioid Use Disorder

D.Cocaine Use Disorder

Explanation: Cannabis Withdrawal was added in DSM-5 as a recognized syndrome (irritability, anxiety, sleep disturbance, decreased appetite, restlessness, depressed mood, physical symptoms) that was NOT included in DSM-IV. The other SUDs existed in DSM-IV under abuse/dependence categories.

9The CIWA-Ar is a clinical assessment tool used to monitor what?

A.Severity of alcohol withdrawal symptoms

B.Severity of opioid withdrawal symptoms

C.Stages of change readiness

D.Severity of stimulant withdrawal symptoms

Explanation: The Clinical Institute Withdrawal Assessment for Alcohol, Revised (CIWA-Ar) scores 10 alcohol withdrawal signs and symptoms (e.g., nausea, tremor, anxiety, agitation, sweats, hallucinations, headache, orientation) to guide benzodiazepine taper dosing. Scores under 10 are mild, 10-18 moderate, and 19+ severe.

10The COWS (Clinical Opiate Withdrawal Scale) is most commonly used to:

A.Time the start of buprenorphine induction

B.Predict alcohol withdrawal seizures

C.Stage cannabis use disorder

D.Score severity of nicotine withdrawal

Explanation: The COWS scores 11 opioid withdrawal signs (resting pulse, sweating, restlessness, pupil size, bone/joint aches, runny nose/tearing, GI upset, tremor, yawning, anxiety, gooseflesh) to determine when withdrawal is sufficient (typically COWS 8-12) to safely begin buprenorphine without precipitated withdrawal.

About the C-CATODSW Exam

The NASW Certified Clinical Alcohol, Tobacco & Other Drugs Social Worker (C-CATODSW) is an advanced clinical specialty credential for MSW-level licensed clinical social workers practicing in substance use disorder treatment. There is NO written exam — NASW awards the credential after application review verifying a CSWE-accredited MSW, current LCSW (or equivalent state clinical license), 2 years post-MSW clinical practice, 2 years supervised SUD counseling experience, current NASW membership, adherence to the NASW Code of Ethics and Standards for Social Work Practice with Clients with Substance Use Disorders (2013), and supervisor/peer references. Our 100 free practice questions cover DSM-5-TR SUD diagnosis, evidence-based treatments (MI, CBT, contingency management, MAT), co-occurring disorders (IDDT), pharmacology, ASAM placement criteria, recovery models, harm reduction, 42 CFR Part 2, and special populations to support competency review and the biennial CE renewal cycle.

Assessment

No written exam — NASW specialty credentials are application-based. The C-CATODSW is awarded via application review, MSW-level licensure (LCSW or equivalent), 2 years post-MSW clinical practice, 2 years supervised SUD counseling experience, NASW membership, attestation to the NASW Code of Ethics, and supervisor/peer references. These practice questions cover the DSM-5-TR SUD criteria, evidence-based SUD treatments (MI, CBT, CM, MAT), co-occurring disorders, pharmacology, recovery models, special populations, harm reduction, and 42 CFR Part 2 confidentiality for renewal CE self-study.

Time Limit

Application-based credential

Passing Score

Application + supervisor reference

Exam Fee

$200-350 + NASW membership (National Association of Social Workers (NASW))

C-CATODSW Exam Content Outline

25%

Evidence-Based SUD Treatments

MI (OARS, DARN-CAT, stages of change), CBT (urge surfing, relapse prevention), Contingency Management, CRA/A-CRA/CRAFT, MAT for alcohol/opioids/tobacco

20%

SUD Assessment and DSM-5-TR Diagnosis

11 DSM-5-TR SUD criteria (impaired control, social impairment, risky use, pharmacological), severity (Mild 2-3, Moderate 4-5, Severe 6+), remission specifiers, ASAM 6 dimensions and Levels of Care 0.5-4

15%

Co-Occurring Disorders (Dual Diagnosis)

Integrated treatment for SMI + SUD (IDDT, NIDA/SAMHSA), screening, sequencing, integrated vs parallel vs sequential models

15%

Pharmacology of Substances of Abuse

Alcohol, opioids (fentanyl, carfentanyl, xylazine), stimulants, cannabis, hallucinogens, benzodiazepines; withdrawal syndromes (CIWA, COWS, DTs); naloxone reversal

10%

Recovery Models

12-Step (AA/NA/CA/Al-Anon), SMART Recovery 4-Point Program, Refuge Recovery (Buddhist), MAT-supportive recovery communities

Special Populations

Adolescents (neuroplasticity, A-CRA), older adults (polypharmacy, alcohol), LGBTQ+ (minority stress), pregnant women (MAT preferred, NAS, Finnegan scoring)

Harm Reduction and Public Health

Naloxone distribution, fentanyl test strips, syringe service programs (SSPs), supervised consumption sites (OnPoint NYC)

Ethics and Confidentiality (42 CFR Part 2 and NASW Standards)

42 CFR Part 2 vs HIPAA, 2024 alignment final rule (effective Feb 2026), specific consent requirements, NASW SU Standards (2013), NASW Code of Ethics

How to Pass the C-CATODSW Exam

What You Need to Know

Passing score: Application + supervisor reference
Assessment: No written exam — NASW specialty credentials are application-based. The C-CATODSW is awarded via application review, MSW-level licensure (LCSW or equivalent), 2 years post-MSW clinical practice, 2 years supervised SUD counseling experience, NASW membership, attestation to the NASW Code of Ethics, and supervisor/peer references. These practice questions cover the DSM-5-TR SUD criteria, evidence-based SUD treatments (MI, CBT, CM, MAT), co-occurring disorders, pharmacology, recovery models, special populations, harm reduction, and 42 CFR Part 2 confidentiality for renewal CE self-study.
Time limit: Application-based credential
Exam fee: $200-350 + NASW membership

Keys to Passing

Complete 500+ practice questions
Score 80%+ consistently before scheduling
Focus on highest-weighted sections
Use our AI tutor for tough concepts

C-CATODSW Study Tips from Top Performers

1Memorize the 11 DSM-5-TR SUD criteria grouped into the 4 clusters (impaired control, social impairment, risky use, pharmacological) and the severity thresholds (Mild 2-3, Moderate 4-5, Severe 6+)

2Know which withdrawals are life-threatening (alcohol, benzodiazepines) and the standard scoring tools (CIWA-Ar for alcohol, COWS for opioids)

3Memorize MI fundamentals — OARS, the 4 processes (engaging, focusing, evoking, planning), DARN-CAT change talk, and the Prochaska/DiClemente Stages of Change

4Know the FDA-approved MAT options by substance: alcohol (naltrexone, acamprosate, disulfiram), opioids (methadone, buprenorphine, naltrexone/Vivitrol), tobacco (NRT, bupropion, varenicline); cannabis has no approved MAT

5Understand 42 CFR Part 2 vs HIPAA differences and the 2024 alignment final rule's 2-year transition (effective Feb 2026) — specific consent for disclosure of SUD records remains stricter than general PHI

Frequently Asked Questions

Is the C-CATODSW a written exam?

No. The C-CATODSW is an application-based NASW clinical specialty credential. You do NOT sit for a standardized written exam. NASW awards the credential after reviewing your MSW transcript, current LCSW (or equivalent state clinical license), 2 years of post-MSW clinical practice, 2 years of supervised SUD counseling experience, current NASW membership, attestation to the NASW Code of Ethics, and supervisor/peer references. These practice questions are for competency review and CE self-study, not a pass/fail qualifying exam.

Who is eligible for the NASW C-CATODSW credential?

Eligibility requires: (1) a Master's in Social Work (MSW) from a CSWE-accredited program, (2) a current LCSW or equivalent state clinical-level social work license, (3) at least 2 years of post-MSW clinical social work practice, (4) at least 2 years of supervised substance use disorder counseling experience, (5) current NASW membership, (6) adherence to the NASW Code of Ethics and the NASW Standards for Social Work Practice with Clients with Substance Use Disorders (2013), and (7) supervisor/peer reference(s) verifying your SUD clinical experience.

How much does the C-CATODSW application cost?

The C-CATODSW application fee is approximately $200-350 (NASW member rate; non-members pay more), plus current NASW membership dues. Exact fees are listed on the NASW credential page and are updated periodically. Renewal occurs every 2 years and requires continuing education hours in addiction practice plus a renewal fee.

What are the DSM-5-TR criteria for a substance use disorder?

The DSM-5-TR combines DSM-IV abuse and dependence into a single Substance Use Disorder diagnosis with 11 criteria grouped into 4 clusters: impaired control (criteria 1-4), social impairment (5-7), risky use (8-9), and pharmacological (10 tolerance, 11 withdrawal). Severity is determined by symptom count: Mild = 2-3, Moderate = 4-5, Severe = 6 or more. Specifiers include 'in early remission' (3 to under 12 months), 'in sustained remission' (12+ months), 'in a controlled environment,' and 'on maintenance therapy.'

Which withdrawal syndromes are life-threatening?

Alcohol and benzodiazepine withdrawal are life-threatening. Severe alcohol withdrawal can progress to delirium tremens (DTs) with 5-15% mortality if untreated and requires CIWA-Ar monitoring and benzodiazepine taper. Benzodiazepine withdrawal can produce seizures and requires a slow taper, often with cross-tapering to a long-acting agent. Opioid withdrawal (assessed with COWS) is extremely uncomfortable but generally not life-threatening; it is typically managed with buprenorphine or methadone. Stimulant and cannabis withdrawal are not life-threatening.

How does 42 CFR Part 2 differ from HIPAA for SUD records?

42 CFR Part 2 provides stricter confidentiality protections than HIPAA for substance use disorder treatment records held by federally assisted programs. Key differences include: each disclosure requires specific written consent (form, purpose, amount/kind, and time limits), redisclosure is prohibited without further consent, and the protections cover even the fact of treatment. The 2024 HIPAA-Part 2 alignment final rule (effective February 2026, with a 2-year transition) brings Part 2 closer to HIPAA's permitted uses for treatment, payment, and operations while still preserving heightened protections for SUD records.