CERTIFIED SUBSTANCE ABUSE
COUNSELOR (CSAC) EXAM QUESTION
AND CORRECT ANSWERS (VERIFIED
ANSWERS) PLUS RATIONALES 2026 Q&A
INSTANT DOWNLOAD PDF
1. The primary goal of substance abuse counseling is to
A. Eliminate all client problems
B. Punish substance use behavior
C. Provide medication only
D. Support recovery and reduce harm
Correct Answer: D
Rationale: Substance abuse counseling focuses on supporting recovery, reducing
harm, and improving overall functioning rather than punishment or problem
elimination.
2. Which substance is classified as a central nervous system depressant?
A. Cocaine
B. Methamphetamine
C. Alcohol
D. Nicotine
Correct Answer: C
Rationale: Alcohol slows brain activity and is classified as a central nervous
system depressant.
3. Tolerance refers to
A. Withdrawal symptoms
, B. Needing more of a substance to achieve the same effect
C. Psychological craving only
D. Loss of control
Correct Answer: B
Rationale: Tolerance develops when increasing amounts of a substance are
required to achieve the same effect.
4. Which stage of change involves recognizing a problem but not yet taking
action?
A. Precontemplation
B. Contemplation
C. Action
D. Maintenance
Correct Answer: B
Rationale: In contemplation, individuals acknowledge a problem but are
ambivalent about change.
5. A co-occurring disorder refers to
A. Multiple substance addictions
B. A substance use disorder with a mental health disorder
C. Chronic relapse
D. Acute intoxication
Correct Answer: B
Rationale: Co-occurring disorders involve both substance use and mental health
conditions.
6. Which neurotransmitter is most associated with reward pathways?
A. Serotonin
B. GABA
C. Dopamine
D. Acetylcholine
, Correct Answer: C
Rationale: Dopamine plays a central role in reward and reinforcement
mechanisms.
7. Confidentiality in substance abuse counseling is primarily governed by
A. HIPAA only
B. State laws only
C. 42 CFR Part 2
D. Criminal law
Correct Answer: C
Rationale: 42 CFR Part 2 provides strict confidentiality protections for substance
use treatment records.
8. Which drug is commonly used in medication-assisted treatment (MAT) for
opioid use disorder?
A. Disulfiram
B. Methadone
C. Acamprosate
D. Naloxone
Correct Answer: B
Rationale: Methadone reduces cravings and withdrawal symptoms in opioid
dependence.
9. Withdrawal from which substance can be life-threatening if untreated?
A. Cannabis
B. Cocaine
C. Alcohol
D. Hallucinogens
Correct Answer: C
Rationale: Alcohol withdrawal can cause seizures and delirium tremens, which
can be fatal.
10.The primary focus of harm reduction is to
A. Require abstinence
COUNSELOR (CSAC) EXAM QUESTION
AND CORRECT ANSWERS (VERIFIED
ANSWERS) PLUS RATIONALES 2026 Q&A
INSTANT DOWNLOAD PDF
1. The primary goal of substance abuse counseling is to
A. Eliminate all client problems
B. Punish substance use behavior
C. Provide medication only
D. Support recovery and reduce harm
Correct Answer: D
Rationale: Substance abuse counseling focuses on supporting recovery, reducing
harm, and improving overall functioning rather than punishment or problem
elimination.
2. Which substance is classified as a central nervous system depressant?
A. Cocaine
B. Methamphetamine
C. Alcohol
D. Nicotine
Correct Answer: C
Rationale: Alcohol slows brain activity and is classified as a central nervous
system depressant.
3. Tolerance refers to
A. Withdrawal symptoms
, B. Needing more of a substance to achieve the same effect
C. Psychological craving only
D. Loss of control
Correct Answer: B
Rationale: Tolerance develops when increasing amounts of a substance are
required to achieve the same effect.
4. Which stage of change involves recognizing a problem but not yet taking
action?
A. Precontemplation
B. Contemplation
C. Action
D. Maintenance
Correct Answer: B
Rationale: In contemplation, individuals acknowledge a problem but are
ambivalent about change.
5. A co-occurring disorder refers to
A. Multiple substance addictions
B. A substance use disorder with a mental health disorder
C. Chronic relapse
D. Acute intoxication
Correct Answer: B
Rationale: Co-occurring disorders involve both substance use and mental health
conditions.
6. Which neurotransmitter is most associated with reward pathways?
A. Serotonin
B. GABA
C. Dopamine
D. Acetylcholine
, Correct Answer: C
Rationale: Dopamine plays a central role in reward and reinforcement
mechanisms.
7. Confidentiality in substance abuse counseling is primarily governed by
A. HIPAA only
B. State laws only
C. 42 CFR Part 2
D. Criminal law
Correct Answer: C
Rationale: 42 CFR Part 2 provides strict confidentiality protections for substance
use treatment records.
8. Which drug is commonly used in medication-assisted treatment (MAT) for
opioid use disorder?
A. Disulfiram
B. Methadone
C. Acamprosate
D. Naloxone
Correct Answer: B
Rationale: Methadone reduces cravings and withdrawal symptoms in opioid
dependence.
9. Withdrawal from which substance can be life-threatening if untreated?
A. Cannabis
B. Cocaine
C. Alcohol
D. Hallucinogens
Correct Answer: C
Rationale: Alcohol withdrawal can cause seizures and delirium tremens, which
can be fatal.
10.The primary focus of harm reduction is to
A. Require abstinence
