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- 50-page printable PDF
- 186 terms with examples
- 70 practice questions, answers explained
- 2-page cram sheet and study plans
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DSST® Study Guide
Printable PDF · 50 pages
DSST Substance Abuse Study Guide
Everything the DSST Substance Abuse exam tests, in one PDF you can print. Built from Prometric's official outline, heaviest topics first.
- 186 key terms, each with an example
- 70 practice questions with every answer explained
- A 2-page cram sheet for the night before
- 2-, 4- and 8-week study plans built from the exam weights
Last updated 2026 · exam details checked against Prometric's published exam information in 2026
Look inside the guide
Real pages from the 50-page PDF.
What you get for $5
One chapter for each official content area, in the order the exam weighs them.
- 📘50pages, printable
- 🧭14chapters, heaviest first
- 🔑186terms with examples
- ✍️70practice questions, answers explained
- ⚠️42exam traps to avoid
- 📄2page cram sheet
Try 10 free Substance Abuse questions
In the style of the real exam, one from each of the ten heaviest areas. About 10 minutes, with every answer explained and a score by area.
10 questions
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Question 1 · Overview of Substance Abuse and Dependence
A woman takes prescribed opioid pain pills for several weeks after surgery. When she stops, she has sweating and muscle aches for a few days, but no craving and no wish to keep taking the drug. Which description fits best?
Show the answer
Answer: C. Physical dependence without addiction. Her body adapted to the drug, so stopping caused withdrawal. She shows no compulsive use, craving or harm, so this is physical dependence without addiction.
The trap: Severe substance use disorder is tempting because withdrawal occurred, but a disorder requires a problematic pattern of use, which she lacks.
Her body adapted to the drug, so stopping caused withdrawal. She shows no compulsive use, craving or harm, so this is physical dependence without addiction.
The trap: Severe substance use disorder is tempting because withdrawal occurred, but a disorder requires a problematic pattern of use, which she lacks.
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Question 2 · Alcohol
A woman and a man of equal weight each drink the same amount of beer in the same period. Her blood alcohol concentration is higher. Which factor best explains this?
Show the answer
Answer: D. She has less body water available to dilute the alcohol. Women generally have less total body water and lower stomach alcohol dehydrogenase, so more alcohol reaches the blood.
The trap: Slower absorption is wrong because slower absorption would lower the peak BAC, not raise it.
Women generally have less total body water and lower stomach alcohol dehydrogenase, so more alcohol reaches the blood.
The trap: Slower absorption is wrong because slower absorption would lower the peak BAC, not raise it.
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Question 3 · Tobacco and Nicotine
Smoke from a cigarette contains a gas that attaches to hemoglobin and leaves the blood carrying less oxygen. Which substance is it?
Show the answer
Answer: A. Carbon monoxide. Carbon monoxide binds hemoglobin much more tightly than oxygen does, reducing oxygen delivery to tissues.
The trap: Tar is tempting because it is a harmful part of smoke, but it deposits in the airways and contains carcinogens; it does not bind hemoglobin.
Carbon monoxide binds hemoglobin much more tightly than oxygen does, reducing oxygen delivery to tissues.
The trap: Tar is tempting because it is a harmful part of smoke, but it deposits in the airways and contains carcinogens; it does not bind hemoglobin.
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Question 4 · Opioids
A man is found unresponsive with very slow breathing and pinpoint pupils. A bystander has access to one emergency medication. Which should be given?
Show the answer
Answer: B. Naloxone. Naloxone is an opioid antagonist that rapidly reverses opioid overdose and restores breathing.
The trap: Flumazenil is tempting because it also reverses an overdose, but it reverses benzodiazepines, not opioids.
Naloxone is an opioid antagonist that rapidly reverses opioid overdose and restores breathing.
The trap: Flumazenil is tempting because it also reverses an overdose, but it reverses benzodiazepines, not opioids.
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Question 5 · Cannabinoids
A college student has been smoking marijuana at a party. Which pair of findings would a clinician most expect?
Show the answer
Answer: A. Rapid heartbeat and bloodshot eyes. Increased heart rate and conjunctival redness are classic acute signs of cannabis intoxication.
The trap: Constricted pupils with slow breathing is tempting as a drug-intoxication pattern, but that pattern belongs to opioids.
Increased heart rate and conjunctival redness are classic acute signs of cannabis intoxication.
The trap: Constricted pupils with slow breathing is tempting as a drug-intoxication pattern, but that pattern belongs to opioids.
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Question 6 · Hallucinogens
A chemist at a pharmaceutical company accidentally absorbs a trace of a compound he has synthesized from ergot fungus and soon experiences vivid visual distortions and a dreamlike state. Which drug had he discovered?
Show the answer
Answer: C. LSD. Hofmann discovered LSD's effects this way after accidental exposure.
The trap: Psilocybin is tempting as another hallucinogen, but it comes from mushrooms, not ergot fungus.
Hofmann discovered LSD's effects this way after accidental exposure.
The trap: Psilocybin is tempting as another hallucinogen, but it comes from mushrooms, not ergot fungus.
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Question 7 · Pharmacological and Neurophysiological Principles
A neurotransmitter released from the end of one neuron crosses a narrow gap and acts on the next cell. What is this gap and its surrounding junction called?
Show the answer
Answer: D. The synapse. The synapse is the junction where chemical messengers pass from one neuron to the next.
The trap: The axon is tempting because the transmitter is released from the axon end, but the axon is part of the sending cell, not the gap.
The synapse is the junction where chemical messengers pass from one neuron to the next.
The trap: The axon is tempting because the transmitter is released from the axon end, but the axon is part of the sending cell, not the gap.
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Question 8 · Anti-Anxiety, Sedative, and Hypnotics
A woman who has taken diazepam every night for two years stops all at once and has a seizure three days later. What best explains the seizure?
Show the answer
Answer: B. Withdrawal after physical dependence on a CNS depressant. Long-term sedative use causes physical dependence. Abrupt cessation causes rebound brain excitability, and seizures are a hallmark of sedative withdrawal.
The trap: Overdose from accumulation is tempting, but she stopped taking the drug. Overdose would cause sedation and slow breathing, not a seizure after abstinence.
Long-term sedative use causes physical dependence. Abrupt cessation causes rebound brain excitability, and seizures are a hallmark of sedative withdrawal.
The trap: Overdose from accumulation is tempting, but she stopped taking the drug. Overdose would cause sedation and slow breathing, not a seizure after abstinence.
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Question 9 · Inhalants
A 15-year-old has sniffed paint thinner for months. His parents notice poor memory, tremor and an unsteady gait that persists even when he is not using. Which explanation fits best?
Show the answer
Answer: C. Solvent chemicals have damaged his brain. Solvents such as toluene can damage myelin and brain tissue, leaving lasting memory and coordination problems.
The trap: Opioid withdrawal is wrong because the described problems are neurological damage, not the flu-like symptoms of withdrawal.
Solvents such as toluene can damage myelin and brain tissue, leaving lasting memory and coordination problems.
The trap: Opioid withdrawal is wrong because the described problems are neurological damage, not the flu-like symptoms of withdrawal.
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Question 10 · Psychomotor Stimulants
Which mechanism best explains cocaine's stimulant effects in the brain?
Show the answer
Answer: A. It blocks reuptake of dopamine, norepinephrine and serotonin. Cocaine blocks the transporters that remove monoamines from the synapse, so more transmitter remains and activates receptors.
The trap: Blocking dopamine receptors is tempting because dopamine is involved, but receptor blockade would reduce dopamine's effect, as antipsychotics do.
Cocaine blocks the transporters that remove monoamines from the synapse, so more transmitter remains and activates receptors.
The trap: Blocking dopamine receptors is tempting because dopamine is involved, but receptor blockade would reduce dopamine's effect, as antipsychotics do.
The DSST Substance Abuse exam at a glance
The DSST Substance Abuse exam is a 120-minute, computer-based test from Prometric with about 100 multiple-choice questions. A score of 400 on the 200–500 scale earns an ACE credit recommendation of 3 semester hours, though each college sets its own policy. The exam covers 14 content areas; the heaviest is Overview of Substance Abuse and Dependence at 13%.
- Questions
- About 100multiple choice
- Time
- 120 minabout 72 seconds a question
- Passing score
- 400on a 200–500 scale
- ACE credit
- 3semester hours
- Exam fee
- $100paid to Prometric
- Calculator
- Nonot allowed
What the exam covers
14 areas, heaviest first. The guide's chapters follow this order.
- Overview of Substance Abuse and Dependence13%
- Alcohol13%
- Tobacco and Nicotine10%
- Opioids10%
- Cannabinoids8%
- Hallucinogens7%
- Pharmacological and Neurophysiological Principles6%
- Anti-Anxiety, Sedative, and Hypnotics6%
- Inhalants6%
- Psychomotor Stimulants6%
- Classification of Drugs4%
- Other Drugs of Abuse4%
- Antidepressants and Mood Stabilizers4%
- Antipsychotic Drugs3%
How it works
- 1Buy once, $5Secure checkout. No subscription needed.
- 2Download the PDFFrom your TransferCredit.org account, right away and any time later.
- 3Study the heaviest areas firstFollow the 2-, 4- or 8-week plan, then read the cram sheet the night before.
Questions students ask
What's in the full DSST Substance Abuse study guide?
50 pages: 14 chapters, one per official content area, heaviest first. 186 terms, each with a plain-English definition and an example, 16 key people, common traps and memory tricks, 70 practice questions with an answer key that explains every answer, question tactics, 2-, 4- and 8-week study plans and a 2-page cram sheet.
How much is the full DSST Substance Abuse study guide?
The full 50-page PDF is $5, a one-time payment. The 10 practice questions on this page are free, with no account.
What does the $29 plan include?
$29 a month gives you all DSST subjects: every DSST study guide plus the full prep course for each subject, and you can cancel anytime. If you only need this exam, the guide on its own is a one-time $5.
How do I get the full guide?
Choose Buy this guide ($5) and check out. Then sign in to your TransferCredit.org account, then open the course and its Download Your Study Guide lesson. The PDF is yours to keep, and you can download it again from your account at any time.
Can I print the guide or use it on my phone?
Yes. It's a PDF, so it opens on phones, tablets and computers, and printing is allowed. Its tick boxes and answer bubbles work in PDF readers that support forms. Copying and editing are turned off.
Is this an official DSST study guide?
No. DSST® is a registered trademark of Prometric, which was not involved in producing this guide and does not endorse it. TransferCredit.org is independent. We built the guide from the official exam outline, and the exam details were checked against Prometric's published exam information in 2026.
Why is this study guide better than a generic review?
It follows the official outline area by area and spends the most pages on what the exam weighs most. Every term comes with an example, each chapter names the traps the exam sets, and the answer key explains why the most tempting wrong answer is wrong, not just which answer is right. It ends with a 2-page cram sheet for the night before.
What is the DSST Substance Abuse exam?
The DSST Substance Abuse exam is a 120-minute, computer-based test from Prometric with about 100 multiple-choice questions. A score of 400 on the 200–500 scale earns an ACE credit recommendation of 3 semester hours, though each college sets its own policy. The exam covers 14 content areas; the heaviest is Overview of Substance Abuse and Dependence at 13%.
More questions about the DSST Substance Abuse exam (21)
How many questions are on the DSST Substance Abuse exam, and how long is it?
It has 100 questions to be answered in 2 hours.
What is the passing score for DSST Substance Abuse?
The passing score is 400 on a 200–500 scale. At 400 or above, the American Council on Education (ACE) recommends 3 semester hours. Each college sets its own passing score and credit award, so check your school's policy before you book.
How much does the DSST Substance Abuse exam cost?
The exam fee is $100, paid to Prometric. Test centers may add their own administration fee. Eligible U.S. military service members can usually test for free through DANTES.
How many college credits is DSST Substance Abuse worth?
ACE recommends 3 semester hours for a passing score of 400. Your college decides how many credits it awards and which course they replace. Check your college's policy.
Is there a penalty for guessing on DSST Substance Abuse?
No. Your score counts only correct answers, so a wrong answer costs nothing. Never leave a question blank: rule out what you can and pick your best guess.
What topics are on the DSST Substance Abuse exam?
14 content areas, from the official outline: Overview of Substance Abuse and Dependence (13%); Alcohol (13%); Tobacco and Nicotine (10%); Opioids (10%); Cannabinoids (8%); Hallucinogens (7%); Pharmacological and Neurophysiological Principles (6%); Anti-Anxiety, Sedative, and Hypnotics (6%); Inhalants (6%); Psychomotor Stimulants (6%); Classification of Drugs (4%); Other Drugs of Abuse (4%); Antidepressants and Mood Stabilizers (4%); Antipsychotic Drugs (3%).
Which DSST Substance Abuse topics should I study first?
Start with the three heaviest: Overview of Substance Abuse and Dependence (13%), Alcohol (13%) and Tobacco and Nicotine (10%). Together they are about 36% of the exam, roughly 36 of 100 questions. The guide's chapters run in that order, heaviest first.
Is the DSST Substance Abuse exam hard?
It depends on what you already know. No single area dominates: the largest, Overview of Substance Abuse and Dependence, is 13% and the smallest, Antipsychotic Drugs, is 3%, so broad coverage matters more than deep expertise in one topic. Take the free diagnostic above to see where you stand in about 10 minutes.
What kinds of questions are on the DSST Substance Abuse exam?
The guide sorts them into 5 types: “Term or definition recall”, “Drug and class matching”, “Scenario: identify the drug or process”, “Effects of a drug” and “Treatment and intervention match”. Every question has 4 answer choices. Try the 10 free questions above to see the style.
How long should I study for DSST Substance Abuse?
Use the diagnostic to decide. If you already know most areas, two weeks of daily review is often enough; if the subject is new to you, plan on eight. The full guide has 2-, 4- and 8-week plans built from the exam weights.
How should I pace myself on the DSST Substance Abuse exam?
On average you have about 72 seconds per question (120 minutes for 100 questions). Be past question 33 a third of the way through and past question 67 two-thirds through. If a question takes more than a minute, pick your best guess, mark it and come back.
What happens if I don't pass DSST Substance Abuse?
You can retake a DSST exam after 30 days. Use the wait to work through the areas the score report and the diagnostic show you missed.
Do colleges accept DSST Substance Abuse for credit?
DSST exams are accepted at more than 1,500 colleges and universities, but each school decides which exams it accepts, the score it requires and the credit it gives. Look up your college's DSST policy before you book.
How up to date is this DSST Substance Abuse guide?
Last updated 2026. The exam details were checked against Prometric's published exam information in 2026. Exams change, so confirm the details on the official exam page before you register.
What should I do the night before the exam?
Read the cram sheet once, slowly. Check your test time, the location or remote-proctoring setup, and the ID you need. Then sleep: a rested brain recalls more than a crammed one. In the morning, skim the memory tricks and common traps, then stop studying.
Is DSST Substance Abuse the same as Drug and Alcohol Abuse?
Yes. It's the renamed version of the former DSST Drug and Alcohol Abuse exam.
What are the DEA drug schedules on the DSST Substance Abuse exam?
The Controlled Substances Act sorts drugs into Schedules I to V by abuse potential and accepted medical use. Schedule I drugs, such as heroin and LSD, have high abuse potential and no accepted medical use, while Schedule V drugs have the lowest abuse potential. Classification of drugs, including DEA schedules and regulations, is 4% of the exam.
Does DSST Substance Abuse test the DSM-5 criteria?
Yes. DSM-5 diagnosis is part of the overview of substance abuse and dependence, 13% of the exam. DSM-5 uses 11 criteria for a substance use disorder and rates severity as mild (2–3 criteria), moderate (4–5) or severe (6 or more).
Does DSST Substance Abuse cover prescription and over-the-counter drugs?
Yes. Sedatives and hypnotics (6%), antidepressants and mood stabilizers (4%) and antipsychotics (3%) each have their own area, and over-the-counter drugs appear under other drugs of abuse (4%) with anabolic steroids, synthetic drugs and club drugs. The opioids area (10%) includes therapeutic use as well as misuse.
Does the exam cover vaping and current trends?
Yes. Vapes are listed under tobacco and nicotine, and current trends appear under opioids, cannabinoids and hallucinogens.
Can I take DSST Substance Abuse online?
Yes. DSST exams can be taken at a test center or online with a remote Prometric proctor.
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DSST® is a registered trademark of Prometric, which was not involved in producing this guide and does not endorse it. TransferCredit.org is independent and not affiliated with Prometric. © 2026 UPI Globale Edu Inc.