Free DSST Substance Abuse Practice Test (2026)

Question 1

Why must patients taking lithium for bipolar disorder have their blood levels checked regularly?

Accepted Answer

Its effective dose is close to a toxic dose (a narrow therapeutic index)

Answer

It is highly addictive and is often misused by patients

Answer

It stops working after a few days unless the dose is doubled

Answer

It is a Schedule I drug, so federal law requires monthly tests

Question 2

Which component of tobacco smoke is most responsible for causing lung cancer?

Accepted Answer

Tar

Answer

Nicotine

Answer

Carbon monoxide

Answer

Menthol flavoring

Question 3

How does the DSM-5 treat what earlier editions called 'substance abuse' and 'substance dependence'?

Accepted Answer

It combines them into one substance use disorder rated mild, moderate or severe

Answer

It keeps them as two separate diagnoses with different criteria

Answer

It removes both and lists only withdrawal syndromes

Answer

It treats them as personality disorders rather than clinical disorders

Question 4

Under the federal Controlled Substances Act, Schedule I drugs are defined as having

Accepted Answer

a high potential for abuse and no currently accepted medical use

Answer

a low potential for abuse and wide medical use

Answer

accepted medical use but a high potential for abuse

Answer

no potential for abuse at all

Question 5

THC, the main psychoactive chemical in marijuana, produces most of its effects by acting on

Accepted Answer

CB1 cannabinoid receptors in the brain

Answer

nicotinic acetylcholine receptors

Answer

mu opioid receptors

Answer

NMDA glutamate receptors

Question 6

Nicotine produces its rewarding effects mainly by

Accepted Answer

activating acetylcholine receptors that trigger dopamine release

Answer

blocking the reuptake of serotonin throughout the brain

Answer

binding to opioid receptors in the brain and spinal cord

Answer

inhibiting the enzyme monoamine oxidase in the liver

Question 7

The body's own opioid-like neurotransmitters are called

Accepted Answer

endorphins and enkephalins

Answer

anandamide and 2-AG

Answer

serotonin and melatonin

Answer

histamine and acetylcholine

Question 8

LSD and psilocybin produce their hallucinogenic effects mainly by acting on which receptor?

Accepted Answer

Serotonin 5-HT2A receptors

Answer

Dopamine D2 receptors

Answer

GABA-A receptors

Answer

Mu opioid receptors

Question 9

'Sudden sniffing death' from inhalant use is most often caused by

Accepted Answer

a sudden irregular heartbeat

Answer

liver failure developing over many years

Answer

a severe allergic skin reaction

Answer

a slow buildup of the drug in body fat

Question 10

Varenicline (Chantix) helps smokers quit because it

Accepted Answer

partly activates nicotine receptors, easing craving and blunting smoking's reward

Answer

makes every cigarette taste strongly of rotten eggs or burnt rubber

Answer

blocks all dopamine release in the brain, so nothing feels rewarding

Answer

causes violent nausea and vomiting whenever the person smokes

Question 11

Long-term use of older (typical) antipsychotic drugs such as haloperidol can cause involuntary movements of the face and tongue. This side effect is called

Accepted Answer

tardive dyskinesia

Answer

serotonin syndrome

Answer

neuroleptic withdrawal

Answer

akathisia

Question 12

Cocaine produces its stimulant effects mainly by

Accepted Answer

blocking the reuptake of dopamine and related transmitters

Answer

activating opioid receptors in the brain and spinal cord

Answer

increasing the activity of the brain's GABA system

Answer

blocking acetylcholine receptors in skeletal muscles

Question 13

Which is a well-documented effect of anabolic-androgenic steroid misuse in men?

Accepted Answer

Shrinking of the testicles and reduced sperm production

Answer

Permanent increase in height in adults

Answer

Lower blood pressure and healthier cholesterol

Answer

Improved liver function

Question 14

Which combination of signs is the classic triad of opioid overdose?

Accepted Answer

Pinpoint pupils, depressed breathing and unconsciousness

Answer

Dilated pupils, fever and agitation

Answer

Rapid breathing, high blood pressure and hallucinations

Answer

Muscle rigidity, sweating and seizures

Question 15

A drug that binds to a receptor but does not activate it, and so blocks the effect of other drugs at that receptor, is called

Accepted Answer

an antagonist

Answer

an agonist

Answer

a reuptake inhibitor

Answer

an enzyme inducer

Question 16

Why can THC be detected in a heavy user's urine for weeks after the person stops using marijuana?

Accepted Answer

It is stored in body fat and released slowly

Answer

It is never broken down by the liver

Answer

It binds permanently to red blood cells

Answer

Urine tests detect only water-soluble drugs

Question 17

Why should a person who has taken high doses of a benzodiazepine for a long time not stop it abruptly?

Accepted Answer

Withdrawal can cause seizures, so the dose is tapered

Answer

Stopping suddenly causes an immediate overdose

Answer

Benzodiazepine withdrawal produces no real symptoms

Answer

The drug stays active in the body for several years

Question 18

A woman and a man of the same body weight drink the same amount of alcohol. Why does the woman usually reach a higher blood alcohol concentration?

Accepted Answer

Women on average have less body water to dilute it

Answer

Women absorb alcohol mainly through the skin

Answer

Women's livers do not break down alcohol at all

Answer

Women's blood contains no water to dilute alcohol

Question 19

PCP and ketamine are called dissociative anesthetics. How do they mainly act in the brain?

Accepted Answer

They block NMDA glutamate receptors

Answer

They activate serotonin 5-HT2A receptors

Answer

They block dopamine reuptake

Answer

They activate CB1 receptors

Question 20

Which set of features is characteristic of fetal alcohol syndrome?

Accepted Answer

Small head, thin upper lip, smooth philtrum, learning problems

Answer

Enlarged head, extra fingers and unusually high intelligence

Answer

Rapid growth, very early puberty and excess body hair

Answer

Normal development, with problems showing only in old age

Question 21

A person finds that he must drink more and more alcohol to feel the same effect he once got from two drinks. This is

Accepted Answer

tolerance

Answer

withdrawal

Answer

sensitization

Answer

cross-dependence

Question 22

Methadone is used in treating opioid addiction because it

Accepted Answer

is a long-acting opioid that prevents withdrawal and eases craving

Answer

is a non-addictive vitamin that repairs damaged brain cells

Answer

blocks all opioid receptors so no opioid has any effect

Answer

is a stimulant that counteracts the sedation caused by opioids

Question 23

Disulfiram (Antabuse) helps some people stop drinking because it

Accepted Answer

makes them feel sick if they drink, by causing acetaldehyde to build up

Answer

blocks all of alcohol's intoxicating effects

Answer

reduces craving by acting on opioid receptors

Answer

speeds up the breakdown of alcohol so they never get drunk

Question 24

Which model views addiction as a chronic, relapsing brain condition that requires treatment, much like diabetes or heart disease?

Accepted Answer

The disease (medical) model

Answer

The moral model

Answer

The sociocultural model

Answer

The learning (behavioral) model

Question 25

Which route of administration usually gets a drug to the brain the fastest?

Accepted Answer

Inhalation (smoking)

Answer

Oral ingestion

Answer

Intramuscular injection

Answer

Transdermal patch

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