Facing Addiction in America (7 credit hours)

Program Summary:  This course takes a comprehensive look at substance use prevention, treatment, and recovery.  The course includes a discussion of the diagnostic criteria for substance use disorder (DSM-5), the affects of substance use on the brain, risk factors and protective factors, evidence-based treatment and prevention interventions, the substance use care continuum, strategies to reduce harm, and recovery. The reading includes Chapters 1-5 from Facing Addiction in America:  The Surgeon General’s Report on Alcohol, Addiction, and Health.  

This course is recommended for social workers, counselors, and therapists and is appropriate for beginning,  intermediate, and advanced levels of practice.  

Course Reading:  Facing Addiction in America:  The Surgeon General’s Report on Alcohol, Addiction, and Health-  Chapters 1-5

Author:  The Office of the Surgeon General, The US Department of Health and Human Services

Find the reading at:  

Chapter 1 Introduction  https://www.freestatesocialwork.com/articles/addictioninamericachapter1.pdf

Chapter 2 Neurobiology  https://www.freestatesocialwork.com/articles/addictioninamericachapter2.pdf

Chapter 3 Prevention  https://www.freestatesocialwork.com/articles/addictioninamericachapter3.pdf

Chapter 4 Treatment https://www.freestatesocialwork.com/articles/addictioninamericachapter4.pdf

Chapter 5 Recovery  https://www.freestatesocialwork.com/articles/addictioninamericachapter5.pdf

Full article https://www.freestatesocialwork.com/articles/addictioninamerica.pdf

Course Objectives:  To enhance professional practice, values, skills, and knowledge by identifying key issues related to substance use prevention, treatment, and recovery.

Learning Objectives:  Identify DSM-5 criteria for a substance use disorder.  Identify the ways in which substance use affects the brain.  Identify risk and protective factors for substance use.  Describe the prevention paradox.  Describe the substance use care continuum.  Identify strategies to reduce harm.  Identify medication-assisted treatment for alcohol and opioid use disorders.  Give an example of a behavioral therapy.  Define the concept of recovery.

Review our pre-reading study guide.

This course includes 128 test questions.  Your computer must be configured to accept cookies to save your answers if you log-out.  

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1: For questions 1-27, please refer to Chapter 1.  The United States spends more than any other country on health care and ranks ____________ in life expectancy.
2: An analysis from the Centers for Disease Control and Prevention demonstrated that alcohol and drug misuse accounted for a roughly ______________ decline in life expectancy among White Americans.
3: A public health approach seeks to improve the health and safety of the population by
4: State and local public health agencies, public safety agencies, health care providers, human service and charity organizations, recreation and arts-related organizations are some of the groups that make up the
5: According to Table 1.1, substances can be divided into three main categories:
6: Which of the following best describes substance misuse?
7: Key Terms:  The most severe form of substance use disorder, associated with compulsive or uncontrolled use of one or more substances best describes
8: Key Terms:  The use of any substance in a manner,  situation, amount, or frequency that can cause harm to users or to those around them best describes which key term?
9: Key Terms:  Binge drinking for men is drinking at least  ____________ standard alcoholic drinks on the same occasion on at least 1 day in the past 30 days.
10: Key Terms:  Heavy drinking, as defined by the CDC, is consuming _____________ drinks per week for women.
11: Almost ______________ of the US population met diagnostic criteria for a substance use disorder for alcohol or illicit drugs.
12: The 2014 prevalence rate for illicit drugs among persons aged 12 and older shows increases in the use of
13: In 2015, 12.5 million individuals misused a pain reliever in the past year.  How many individuals met diagnostic criteria for a prescription medication disorder?
14: Implications of Tables 1.3 and 1.4:  Greater impact is likely to be achieved by reducing substance misuse
15: In 2014, cases of driving under the influence represented nearly ___________ of all traffic-related fatalities in the US.
16: 76% of those who die from alcohol overdose are
17: Low involvement in school is an example of
18: Higher cost of alcohol and other drugs is a
19: Research now indicates that the majority of those who meet criteria for a substance use disorder in their lifetime started using substances during adolescence and met the criteria by age
20: Recent scientific findings indicate that brain development is not complete until approximately age
21: The term 'substance ________' is increasingly avoided by professionals because it can be shaming.
22: The DSM-5 includes criteria for diagnosing
23: Alteration of the body's responsiveness to alcohol or a drug such that higher doses are required to produce the same effect achieved during initial use describes which of the following key terms?
24: Planned surprise confrontations have been demonstrated to be an effective way to engage people in treatment.
25: A recent study by the CDC found that in 2011, only 1 in __________ US adults had ever been asked by a health professional about their drinking behavior.
26: What legislation requires that the financial requirements and treatment limitations imposed by health plans and insurers for substance use disorders be no more restrictive than the financial requirements and treatment limitations they impose for medical and surgical conditions?
27: The average potency of marijuana has _________ over the past decade.
28: For questions 28-48, please refer to Chapter 2.  Well-supported evidence suggests that the addiction process is a three stage cycle:  binge/intoxication, withdrawal/negative affect, and
29: The brain is made of an estimated 86 billion nerve cells called
30: Which region of the brain is involved in stress and the feelings of unease, anxiety, and irritability that typically accompany substance withdrawal?
31: Which region of the brain is involved in executive function including exerting control over substance taking?
32: According to the three-stage addiction cycle, the stage at which one seeks substances again after a period of abstinence is:
33: A person may go though the three-stage addiction cycle over the course of
34: The addiction cycle tends to _____________ over time.
35: The process by which presentation of a stimulus such as a drug increases the probability of a response like drug taking describes which key term?
36: The binge/intoxication stage of the addiction cycle heavily involves the
37: Key Terms:  Antagonists bind to and  ___________ the activation of certain receptors on cells, preventing a biological response.
38: Which of the following describes incentive salience?
39: Which stage follows binge/intoxication?
40: Studies suggest that people addicted to substances experience an overall ___________ in the sensitivity of the brain's reward system, both to addictive substances and also to natural reinforcers, such as food and sex.
41: "Craving' occurs in the
42: To help explain how the prefrontal cortex is involved in addiction, some scientists divide the functions of this brain region into
43: The over-activation of the Go system in the prefrontal cortex promotes
44: Which has the longer half-life?
45: Binge drinking for women is defined as drinking ________ or more standard alcoholic drinks on the same occasion on at least 1 day in the past 30 days.
46: The frontal cortex does not fully develop until
47: About three quarters of 18- to 30-year-olds admitted to treatment programs began using substances at the age of _______________ or  younger.
48: Clinical reports suggest that women who use cocaine, opioids, or alcohol progress from initial use to a disorder at a ____________ rate than do men.
49: For questions 49-79,  please refer to Chapter 3.  Alcohol is involved in about ________ percent of the overdose deaths related to prescription opioid pain relievers.
50: Which are now the leading causes of death for those aged 15 to 24?
51: Early substance misuse, including alcohol misuse, is associated with a greater likelihood of developing a substance use disorder later in life.
52: Research shows that higher alcohol prices _____________ alcohol misuse and related harms.
53: Research has shown that binge drinking is more common among individuals in
54: Which of the following is an example of a community risk factor?
55: The IOM has described three categories of prevention interventions:  universal, selective, and indicated.  Universal interventions are
56: The Prevention Paradox suggests that ______ are likely to have greater benefits.
57: School-based programs that promote social and emotional competencies are an example of
58: The Nurse-Family Partnership program uses trained nurses to provide an intensive home visitation intervention for at-risk, first-time mothers during pregnancy.  This is an example of a(n)
59: Which school-based prevention program has shown long-term preventive effects on substance use among males with high levels of aggression?
60: Which school-based program uses student-developed videos and narratives and has shown positive effects on substance use among Mexican American youth in the Southwester US?
61: Which prevention program is designed to help college students reduce alcohol misuse and the negative consequences of their drinking with two 1-hour interviews and a brief online assessment?
62: Which program provides personalized feedback to at-risk older drinkers, which included a personalized patient report, discussion with a physician, and three phone calls from a health educator?
63: Which community-based coalition model creates a broad-based community coalition to assess and prioritize risk and protective factors and substance use rates, using a school survey of all students in grades 6, 8, 10, and 12?
64: According to a 2009 World Health Organization review, policies that increase alcohol prices
65: A review of studies indicates that increasing the number of days alcohol could be sold was associated with _________ in alcohol misuse and alcohol-related harms.
66: Since the early 1980s, alcohol-related traffic deaths in the US have
67: Preventing alcohol sales to minors is an example of a
68: The National Minimum Drinking Age Act threatened to withhold a portion of states' _____________ if states made the purchase or public possession of alcoholic beverages legal for those under the age of 21.
69: A Community Guide review found that raising the MLDA reduced crashes among drivers aged 18 to 20 by a median of
70: Criminal state social host liability laws require law enforcement to prove _________.
71: Through __________ social host liability laws, adults can be held responsible for underage drinking parties held on their property, regardless of whether they directly provided alcohol to minors.
72: According to Table 3.4, which evidence-based strategy had the highest number of states with a green rating in 2015?
73: Adolescent Use of Marijuana:  One study followed people form age 13 to 38 and found that those who began marijuana use in their teens and developed a persistent cannabis use disorder had up to an ___________ drop in IQ, even if they stopped using in adulthood.
74: Which of the following best describes the key term:  fidelity.
75: Which of the following reflects more current thinking on the "Fidelity-Adaptation Dilemma"
76: Surveys of school administrators indicate that  only _____________ report using EBIs to prevent substance misuse.
77: In one study, the LifeSkills Training program delivered in middle and junior high schools has shown significant, long-term effects on Grade 12 students' alcohol and marijuana use only among students whose teachers delivered at least _________ of the required material.
78: Since the early 1980's more than __________ state laws have been passed to reduce driving after drinking.
79: Which of the following best describes the key term:  dissemination?
80: For questions 80-115, please refer to Chapter 4.   Substance use disorder treatment has historically occurred in which setting?
81: The US Food and Drug Administration has approved medications to treat
82: Studies show that every dollar spent on substance use disorder treatment saves $4 in health care costs and __________ in criminal justice costs.
83: According to Figure 4.1, outpatient services occur at what point in the Substance Use Care Continuum?
84: The first step to early intervention is
85: Ideally substance misuse screening should occur for all individuals who present in
86: Motivational interviewing is a client-centered counseling style that
87: Among all individuals who met criteria for a substance use disorder, _________ was by far the most prevalent substance reported.
88: The most common reason for not seeking substance use treatment is
89: Overdose deaths from opioid pain relievers and heroin have __________ in the past 14 years.
90: If the case of an opioid overdose, there is typically a ____________ hour window in which bystanders can take action to prevent the user's death.
91: In 2015, the FDA approved an ________ form of naloxone to reverse opioid overdose.
92: Withdrawal management or 'detoxification'  __________ an individual's tolerance.
93: When compared with relapse rates for chronic diseases, relapse rates for substance use disorders are
94: The diagnosis of a substance use disorder with 5 symptoms present would be considered ___________ using the DSM-5.
95: Which substance use disorder assessment tool contains 99 scales and subscales and can assess change over time?
96: In general, patients with serious substance use disorders are recommended to stay engaged for at least __________ in the treatment process, which may involve participation in three to four different programs or services.
97: A program that provides support, structure, and an array of evidence-based clinical services in a 24 hour setting that is outside of a hospital best describes which level of the treatment continuum?
98: Acamprosate has been developed to treat
99: Research clearly demonstrates that __________ leads to better outcomes for opioid use disorders.
100: Buprenorphine treatment can be provided by
101: Which medication for opioid use disorders is not abusable?
102: The best candidate for disulfiram are patients
103: Which behavioral therapy suggests that substance use disorders develop, in part, as a result of maladaptive behavior patterns and dysfunctional thoughts?
104: Which behavioral therapy involves giving tangible reward to individuals to support positive behavior change?
105: Which behavioral therapy consists of 16 weeks of group sessions which combine CBT, family education, social support, individual counseling, and urine drug testing?
106: The benefits of TSF stemmed from its ability to increase _____________ in the period after treatment ended.
107: Which family therapy features the 'daily sobriety contract?'
108: Research has shown that incorporating tobacco cessation programs into substance use disorder treatment is associated with a 25%  ___________ in the likelihood of maintaining long-term abstinence from alcohol and drug misuse.
109: Which of the following best describes telemedicine?
110: In the Project QUIT study, patients in the emergency department were found to be significantly more likely to disclose their substance use
111: Among studies evaluating Web-based intervention support as an add-on to standard in-person treatment, preliminary evidence shows _________ among the intervention group.
112: _____________ can be a significant barrier to treatment engagement for Asian patients.
113: On average substance use among LGB youth was __________ higher than for heterosexual youth.
114: Much of the literature on substance use in the military examines the relationship between alcohol and drug use and
115: Many incarcerated individuals will experience a _________ tolerance for substances due to their abstinence while in prison.
116: For questions 116-129, please refer to Chapter 5 Recovery:  The Many Paths to Wellness.  Which of the following describes recovery?
117: Which of the following is a pathway to recovery?
118: Summarizing data from six large studies, one analysis estimated that the proportion of the US adult population that is in remission from a substance use disorder of any severity is approximately __________.
119: Rigorous follow-up studies of treated adult populations, who tend to have the most chronic and severe disorders, show more than _____________ achieving sustained remission, defined as remission that lasted for at least one year.
120: Even after a year or 2 of remission is achieved- through treatment or some other route- it can take ___________  more years before the risk of relapse drops below 15%, the level of risk that people in the general population have of developing a substance use disorder in their lifetime.
121: Which of the following is an example of 'recovery capital?'
122: Mutual aid groups focused on substance use were originally created by
123: AA's 12 steps are ordered in a logical progression beginning with
124: About ________ of adults who begin participation in a 12-step program after participating in a treatment program are still attending 3 years later.
125: More than 80% of Al-Anon members are
126: Peer recovery coaches are
127: At the end of a 2 year period living in an Oxford House, the abstinence rate is ________ times greater than typical outcomes following detoxification and treatment.
128: All of the following describe telephone monitoring except:

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Free State Social Work, LLC, provider #1235, is approved to offer social work continuing education by the Association of Social Work Boards (ASWB) Approved Continuing Education (ACE) program. Organizations, not individual courses, are approved as ACE providers. State and provincial regulatory boards have the final authority to determine whether an individual course may be accepted for continuing education credit. Free State Social Work, LLC maintains responsibility for this course. ACE provider approval period: 9/6/2018 - 9/6/2021. Social workers completing this course receive 7 continuing education credits.

Free State Social Work has been approved by NBCC as an Approved Continuing Education Provider, ACEP NO. 6605. Programs that do not qualify for NBCC credit are clearly identified. Free State Social Work is solely responsible for all aspects of the programs.

G.M. Rydberg-Cox, MSW, LSCSW is the Continuing Education Director at Free State Social Work and responsible for the development of this course.  She received her Masters of Social Work in 1996 from the Jane Addams School of Social Work at the University of Illinois-Chicago and she has over 20 years of experience.  She has lived and worked as a social worker in Chicago, Boston, and Kansas City.  She currently practices in the area of hospital/medical social work.  The reading materials for this course were developed by another organization.