CASAC

18. In Motivational Interviewing, _______________ has been described as a technique in which the individual expresses the benefit for change and the hope that change will come in the future. (a) Change talk (b) Modified conversation (c) Transformation dialogue (d) Conversion exchange

A

ATOD use and the problems that result from it are best viewed _________________. (a) On a continuum (b) As a pattern (c) As one-time events (d) On an individual by individual, situation by situation basis

A

According to HIPAA, client consent is not required for disclosure of confidential information for all the following except: (a) To the client's employer (b) For the opportunity to agree or object (c) For treatment, payment, and health care operations (d) For public interest and benefit activities

A

According to Moral Theory, individuals do not become addicted for all of the following reasons, except: (a) Family history of substance abuse (b) "Maturing out" (c) Willingness to accept responsibility (d) Motivation

A

According to the developmental model of relapse prevention, the following stage is considered the beginning stage of treatment and involves the solving of immediate problems: (a) Stabilization (b) Transition (c) Early recovery (d) Maintenance

A

As a comprehensive prevention approach, Life Skills Training (LST) uses general self-management skills, general social skills, information/skills about drug use, and ______: (a) Booster sessions (b) Motivational speakers (c) Follow-up interviews (d) Group therapy

A

Chronic cocaine users exhibit _______________. (a) loss of movement (b) loss of inhibitions (c) loss of intelligence (d) loss of sensory feeling

A

Compared with normative data from nonclinical families, the families of substance abusers were significantly different on _______________ but not on _______________. (a) Cohesion; adaptability (b) Adaptability; cohesion (c) Compliance; consistency (d) Adaptableness; structure

A

In regard to dual diagnosis, there is often a relationship between: (a) Alcoholism and depression (b) Cocaine abuse and paranoid personality (c) Poly-substance abuse and anxiety (d) Amphetamine use and post-traumatic stress disorder

A

Individual treatment addresses the issue of _______________ in relation to the attachment from the beginning. (a) Grief and loss (b) Relationship with the substance (c) Harm to the body (d) All of the above

A

Problems may arise if a substance abuse counselor and former client attend the same AA meeting for all the following reasons except: (a) The former client will benefit more than the substance abuse counselor (b) It risks the substance abuse counselor anonymity (c) It risks the former client's confidentiality (d) The substance abuse counselor may need censor what they share in the meeting

A

Rational recovery is: (a) Cognitive behaviorally based (b) Psychoeducational (c) Insight driven (d) A and B

A

The best evidence of the populous-held beliefs that moralizes addiction is _______________. (a) The stigma attached to it (b) That some prohibitionist themes continue in our culture (c) That drug suppliers are viewed as "fiends" (d) That drug use is viewed as contagious

A

The decision to have closed group membership is made in the __________ stage of group development. (a) Formation (b) Initial orientation and exploration (c) Transition and dealing with resistance (d) Working or cohesion and productivity

A

The diagnostic categories of "abuse" and "dependence" are separated by the following: (a) Tolerance and withdrawal (b) Length of time used and context of use (c) Length of time used and particular drug identified (d) Withdrawal and recidivism

A

The first, second and third phases of addiction are labeled as: (a) Prodromal, crucial, and chronic (b) Early, middle, and crucial (c) Primary, dependency, and addiction (d) Primary, dependency, and chronic

A

The foundation of all family therapy comes from the literature on: (a) Systems functioning (b) Intergenerational family studies (c) Ecosystems (d) Multiculturalism and diversity

A

The primary learning principle in social behavior is _______________. (a) Operant conditioning (b) Classical conditioning (c) Positive Reinforcement (d) Negative Punishment

A

The structure of the family, how the members are classified according to ability and role definition within their cultural perspective is referred to as _______________. (a) Hierarchy (b) Rules (c) Rank (d) Status

A

Types of parenting associated with an increase in substance abuse do not include which of the following: (a) Authoritative parent (b) Permissive parent (c) Authoritarian parent (d) None of the above

A

What is a treatment plan? (a) A written document that details how problems are defined (b) A map to recovery (c) A verbal client-counselor agreement (d) A counselor created document for client success

A

Which of the following is not a common cognitive behavioral approach? (a) Empty-chair scenario (b) Self-control training (c) Relaxation (d) Mindfulness technique

A

_______________ of the central nervous system include ethanol, barbituates, methaqualone, meprobamate, and all benzodiazepines. (a) Depressants (b) Hallucinogens (c) Stimulants (d) Steroids

A

_______________ reflect specialized boundaries based on particular needs and functions of the group. (a) Subsystems (b) Hiearchy (c) Roles (d) Rules

A

A _______________ category would be used in the case of a weekly voluntary outpatient substance abuse treatment program, where clients generally reside in their homes and attend scheduled meetings with professionals at designated agencies, offices, churches, and/or treatment facilities. (a) Mild (b) Moderate (c) Severe (d) Strict

B

A standard drink is measured as _______________. (a) a 4- or 5-ounce can or bottle of beer, a 4- or 5-ounce glass of wine, or a single shot (about 4.25 ounces). (b) a 12 ounce can or bottle of beer, a 4- or 5-ounce glass of wine, or a single shot (about 1.25 ounces). (c) a 12 ounce can or bottle of beer, a 12 ounce glass of wine, or a single shot (about 12 ounces). (d) variable from restaurant to restaurant or bar to bar.

B

According to CFR 42, Part 2, confidential information may be disclosed with client consent: (a) For a third party payment (b) To medical professionals in an emergency situation (c) To family members in an emergency situation (d) None of the above

B

All of the following are examples of how to break a substance abuse habit, except: (a) Get arrested every time you purchase heroine (b) Have a positive experience every time you smoke marijuana (c) Replace cocaine use with AA meetings (d) Gradually reintegrate back into social situations where alcohol is present

B

An effective procedure in harm reduction is setting _______________ goals. (a) Long-range (b) Proximal (Short-term) (c) Distal (d) Future

B

An example of a harm reduction model would be: (a) Getting intravenous drug users to learn to clean their needles after each use (b) Getting intravenous drug users to exchange their needles for new ones (c) Getting intravenous drug users to not use needles (d) All of the above

B

Cognitive therapy seeks to: (a) help the client take responsibility for others behavior (b) help the client change behavior by first altering his or her thinking or frame of reference through such strategies as mindfulness technique (c) help the client understand their view of reality (d) All of the above

B

Early steps in effective substance abuse prevention programs include needs clarification, assessment, and: (a) Identification of resources and funding sources (b) Development of goals and measurable objectives buttressed by consistent evaluation procedures (c) Clarification of targeted populations (d) Research on leadership and housing

B

Family therapy is successful if: (a) The family does not tolerate conflict amongst the members (b) Used in conjunction with individual and group therapy over the period of treatment and recovery (c) The amount of time the dependent person stays clean and sober is defined (d) The dependent does not deal with hurt, anger and resentment from the past

B

Hazelden, a treatment facility for alcoholics, is considered to be one of the major contributors to the ________________, which has elements of medical, social, and self-help approaches. (a) Inpatient program structure (b) Minnesota Model (c) 12-Step Program (d) Long-term outpatient program

B

Jellinek's _______________ describes the drinking as a total loss of control and the loss of a choice to drink. (a) Prodromal Phase (b) Chronic Phase (c) Crucial Phase (d) Alcoholic Phase

B

Once the intervention has been completed, the person most likely will _______________. (a) Begin using again (b) Begin individual therapy (c) Begin group therapy (d) Be on their own

B

Relapse is now viewed as: (a) An abnormal part of the recovery process (b) A learning experience for the recovering individual (c) A failure of an individual in recovery (d) Seldom occurring when effective treatment is paired with substance-abusing clients

B

Research shows all but one of the following as related to relapse: (a) Client's attitude toward sobriety effects relapse (b) Depression and anxiety exist before use resumes (c) Depression and anxiety have shown to be major detriments of relapse (d) Client's perception of ability to cope and expectations of relapse affect outcome

B

Statistics about substance-abusing families show: (a) That structure and dynamics are less significant (b) That substance use increases other dysfunctional patterns of behavior in families such as domestic violence (c) That 50% of mothers were pathologically enmeshed with their substance-abusing child (d) That the family influences the substance abuser, but the substance abuser seldom influences the family over time

B

The __________ houses the mechanisms that most often interact with substances that cross the blood-brain barrier. (a) Cortex (b) Forebrain (c) Midbrain (d) Right Hemisphere

B

The cortex is significant as related to drug use since it controls (a) Basic, autonomic functions such as hormonal activity, thirst, hunger, temperature, sex drive and sleep (b) Thought, perception, motor function, sensory data processing and vision (c) Emotional behavior and long-term memory (d) Taste and craving

B

The main goal of cognitive therapy is to: (a) Help the client reduce their auditory and visual hallucinations (b) Examine irrational beliefs that maintain maladaptive behavior (c) Reduce panic attacks (d) Improve feelings of self-worth

B

The modality of treatment that is especially indicated for dual-diagnosis patients, possibly after being discharged form inpatient care, is _______________. (a) Residential treatment (b) Day treatment (c) Outpatient treatment (d) Aftercare

B

Time of day of drinking, place of drinking, and association with certain people or emotional states are referred to as _______________. (a) Conditional Precursors (b) Situational antecedents (c) Positional experiences (d) Habitual forerunners

B

To make changes and to be mentally prepared for treatment at any level, DiClemente says the individual must be at the stage of _______________. (a) Contemplation (b) Preparation (c) Action (d) Maintenance

B

Trust is the central concern of the __________ stage of group development. (a) Formation (b) Initial orientation and exploration (c) Transition and dealing with resistance (d) Working or cohesion and productivity

B

Which law does not allow for a breach of confidentiality to warn a third party in imminent danger? (a) HIPAA (b) CFR 42, Part 2 (c) State Law (d) None of the above

B

Which of the following is not among newer models seen in the 1970s and 1980s, following the knowledge-attitudes-behavior (KAB) approach: (a) Affective education (b) Moderation management (c) Values clarification (d) Alternatives to drug use

B

Which of the following statements about codependency is not true? (a) Overinvolvement, reactivity, protection, and attempts to control the abuser are common (b) Codependency is defined as anything that is done to protect the abuser from the consequences of his or her behaviors (c) The person closest to the abuser and the first to react dysfunctionally is often the codependent (d) Codependency is a controversial topic

B

With the exception of neurons in the hippocampus, after being damaged neurons will: (a) Regenerate, but slower than other cells (b) Not regenerate (c) Grow new axons (d) Shrink in size

B

__________ treatment is particularly indicated for dual diagnosis clients. (a) Outpatient (b) Day (c) Residential (d) Inpatient

B

_______________ are considered effective in the short-term treatment of anxiety, regardless of the cause. (a) Barbituates (b) Benzodiazapines (c) Opiates (d) Stimulants

B

_______________ comprises immediate, situational behavioral/cognitive coping, affective states, and perceived effects of substance use. (a) Tonic process (b) Phasic response (c) Ongoing process (d) Stage response

B

_______________ in group treatment is concerned primarily with leadership. (a) Subsystems (b) Hiearchy (c) Roles (d) Rules

B

A major reason that an integrated approach to explaining substance abuse is becoming popular is: (a) Other theories are confusing (b) An integrated approach offers a simple explanation of cause and effect (c) No single theory offers a complete explanation for the cause of substance abuse (d) Integrated theories are concise, offering simple treatment options

C

According to the Institute of Medicine classification, individuals already showing problems as a result of ATOD use are targeted at the: (a) Selective level (b) Tertiary level (c) Indicated level (d) Universal level

C

According to the disease concept and research by Jellinek in the 1950's: (a) There are four stages in the progression of alcoholism (b) There is further evidence for the genetic vulnerability to alcoholism (c) An alcoholic is never cured, only considered "in remission" or "in recovery" (d) Treatment should begin in the later stages when associated problems clearly interfere with functioning

C

Adherents of the disease concept of alcoholism widely recommend which form of treatment? (a) Aversive conditioning (b) Intensive month-long hospitalization programs (c) Alcoholics Anonymous (d) The use of medication

C

Disulfurum (or Antabuse) is a drug that: (a) Makes a person sick if they ingest any kind of opiate (b) Makes a person sick if they ingest any kind of a barbiturate (c) Makes a person sick if they ingest any kind of alcohol (d) Is a stimulant similar to cocaine

C

Dual-diagnosis inpatient settings provide all of the following except: (a) On-site medical and psychiatric care, including 24-hour nursing (b) Psychiatric and substance abuse crisis stabilization (c) More intensive and long-term individual therapy (d) Daily intensive group contact with staff and other clients

C

Emergence of conflict occurs in the __________ stage of group development. (a) Formation (b) Initial orientation and exploration (c) Transition and dealing with resistance (d) Working or cohesion and productivity

C

Family factors such as cultural attitudes and customs of the family involving alcohol and other substances, tolerance toward public intoxication and drug use, and childhood exposure to alcohol and drug use models are all factors found in which of the following theories? (a) Behavioral (b) Moral (c) Sociocultural (d) Genetic

C

Homeostasis: (a) Tends to facilitate a natural change process in the family (b) Works to provide an interaction that "heats up" the family system (c) Affects family behavior in order to maintain a sense of balance, structure, and stability (d) Provides the structure of the family: how it operates

C

In operant conditioning, behavior is strengthened through reward or _______________ and avoidance of punishment or _______________. (a) Positive reinforcement; negative punishment (b) Positive punishment; negative reinforcement (c) Positive reinforcement; negative reinforcement (d) Negative reinforcement, positive reinforcement

C

Moderation Management works best with: (a) Addicted individuals (b) Individuals who deny their addiction (c) Problem users (d) All of the above

C

Moss, Chen, and Yi's more recent study on alcoholic dependence identified five subtypes: (a) Child, Pre-Adolescent, Adolescent, Adult, and Mature Adult (b) Pre-Alcoholic, Alcoholic, Prodromal, Crucial, and Chronic (c) Young Adult, Functional, Intermediate Familial, Young Antisocial, and Chronic Severe (d) Adolescence, Working, Transitional, Rebellious, and Protracted

C

Often a _______________ in Individualized Treatment Plans is used to encourage clients to participate successfully in the program. (a) Reward system (b) Behavior contract (c) Level system (d) Progress report

C

Regarding parental chemical abuse, the effect of a chemically dependent mother is _____________ that of a substance abusing father. (a) The same as (b) More detrimental than (c) Different from (d) Less detrimental than

C

Reinforcing feedback to promote change in the system is ___________, and ___________ brings the system back into balance. (a) Negative feedback, positive feedback (b) Negative feeback, equilibrium (c) Positive feedback, negative feedback (d) Positive feedback, equilibrium

C

The Therapeutic Community movement included all of the following except: (a) Fostered healthy values and reorganizing contributions (b) Offerd a model for unit governance and decision-making (c) Relies on fluid principles and values to meet individual needs (d) Has been used for treatment of personality disorders

C

The criteria that must be met to approach success in family includes all of the following EXCEPT: (a) The family has to value sobriety (b) The family has developed and implemented new problem-solving skills (c) The family chooses family therapy as the treatment of choice for substance abuse (d) The drub using behavior has been accepted as the primary cause of the dysfunction

C

The decision to remove an alcoholic from the demands and consequences of daily life is associated with __________. (a) Prevention (b) Inpatient treatment (c) Residential treatment (d) Intensive outpatient treatment

C

The limbic system is involved in _______________. (a) Basic, autonomic functions such as hormonal activity, thirst, hunger, temperature, sex drive and sleep (b) Relaying information from the upper brain-stem (c) Emotional behavior and long-term memory (d) Thought, perception, motor function, sensory data processing and vision

C

The public health model recognizes the interactive nature of: (a) Population, drug-of-choice, community (b) Population, community, substance risk (c) Agent, individual, and environment (d) Agent, substance, social milieu

C

This 3-pound organ is the central filter for the blood and is the site of 90% of alcohol metabolism. (a) Brain (b) Kidney (c) Liver (d) Bladder

C

What can be compared with the responses given by the client in order to assess the degree of minimization or denial that may be present? (a) Previous behaviors (b) Information gathered from the client on an earlier survey (c) Information gathered from others (d) None of the above. It is not possible to assess the degree of minimization or denial that may be present.

C

Which levels of prevention for particular populations are associated with the public health model? (a) Primary, tertiary, and advanced (b) Early, secondary, and advanced (c) Primary, secondary, and tertiary (d) Early, secondary, and general

C

Which model still continues to show promise and is incorporated into a more comprehensive strategy: (a) Affective education (b) Values education (c) Normative education (d) Alternative education

C

Which of the following is not true about the cognitive-behavioral/social learning model of recovery? (a) It is based on social learning theory (b) It uses drive-reduction theory (c) It uses insight theory (d) It stresses the importance of self-efficacy

C

Which of the following is not true of Alcoholics Anonymous? (a) Arose from the Christian education and spirituality movement (b) Focused on group solidarity verus hierarchy (c) Accepted the moral model (d) Embraced the disease model

C

Which of the following is one of the questions asked of a client as part of the administration of the CAGE Questionnaire? (a) What is your primary drug of choice? (b) Do you drink or use significantly more now than you did two months ago? (c) Do you ever take a morning eye-opener? (d) Have you lost a job in the past year?

C

Which of the following regulations restricts parental access of their children's confidential information without the minor's consent? (a) FERPA (b) IDEA (c) CFR 42, Part 2 (d) PPRA

C

Which system characteristic most determines leadership in group treatment? (a) Boundaries (b) Subsystems (c) Hierarchy (d) Roles

C

Within Behavior Theory, aspects associated with the use of drugs include all of the following except: (a) Coping ability (b) Positive reinforcements (c) Motivation (d) Habit

C

Yin states that studies identify three modes of behavioral control which are important for understanding alcohol addiction: (a) Punishment and reward approach, objective approach, and pattern (b) Positive and negative approach, targeted approach, and fixation (c) Pavlovian approach, goal-direction action, and habit (d) None of the above

C

_______________ are the composite of the rules, roles, boundaries, and subsystems in both the nuclear family and the family of origin. (a) Standards (b) Principles (c) Values (d) Tenets

C

According to CFR 42, Part 2, disclosure of confidential information requires written consent with several elements; which of the following is not one of the required elements? (a) The name of the person or program permitted to make the disclosure (b) The name of the person or program receiving the disclosed information (c) The purpose of the disclosure (d) A statement indicating that the client may revoke consent at any time but only if he or she states that in writing

D

According to the Moral Theory, factors likely to lead to addiction include: (a) A means to cope with painful and threatening emotions (b) Childhood factors such as disrupted families, lack of parental supervision, behavior problems, and drug-using parents (c) Peer substance abuse (d) All of the above

D

All of the following are true for the proactive prevention model except: (a) Empowers abstainers or responsible drinkers to model healthy behaviors (b) Focuses on accurate information on environments (c) Supports health, positive attitudes and behaviors (d) Elaborates on the dangers of substance misuse and abuse

D

An example of harm reduction strategy may include: (a) Encourage an alcoholic to drink moderately (b) Install interlock devices on the cars of persons arrested for DUI (c) Teach heroin addicts to switch from injecting heroin to smoking it (d) All of the above

D

Behavioral symptoms included in the Chronic Phase of substance abuse include all of the following EXCEPT: (a) Impaired judgment and irrational thinking (b) Continuous use of the substance for longer periods (c) Obsessive use of the substance until recovery or death (d) The onset of blackouts

D

Co-occurring disorders is the contemporary term for _______________ (a) Comorbid disorders (b) Dual diagnosis (c) Lookalike disorders (d) Both a and b

D

Common characteristics of the addictive family system include: (a) Hypervigilance (b) Secrecy (c) Denial (d) All of the above

D

Detoxification is: (a) Based on the type of drugs abused and a patient's medical condition (b) Considered the beginning of treatment (c) Begun after medical necessity is established (d) All of these

D

Experiencing a sense of mutuality or shared identity is associated with the __________ stage of group development. (a) Formation (b) Initial orientation and exploration (c) Transition and dealing with resistance (d) Working or cohesion and productivity

D

Factors that impact parental chemical dependence on children include: (a) Period of active abuse and extent of abuse/dependence (b) Sex of abusing parent, and sex and age of the child (c) Employment of abusing parent (d) A and B

D

Family week in substance abuse treatment is usually to _______________ (a) Focus on immediate stressors (b) Practice communicating honestly and express feelings (c) To take appropriate responsibility and establish appropriate boundaries (d) All of the above

D

Feedback loops: (a) Bring the system back into balance, which is sometimes termed "negative feedback" (b) Moves the system toward change, which is sometimes termed "positive feedback" (c) Are the communication between parts of the system or family members (d) All of the above

D

Generally, a/an __________ approach is helpful in clarifying the difference between psychiatric and substance abusing symptoms. (a) Integrative (b) Cognitive (c) Medical Model (d) Longitudinal

D

Having clearly defined goals and objectives is necessary for: (a) Locating funding sources (b) Implementation of follow-up services (c) Gauging risk in targeting populations (d) Evaluation of program effectiveness

D

In social learning theory, substance use is a function of ______________. (a) Positive norms (b) Expectations (c) Modeling from family members and peers who engage in obtaining and using them (d) All of the above

D

Life Skills Training (LST) is a _______________ program that addresses a number of critical components in an integrated manner. (a) Primary prevention (b) School-based (c) Universal classroom (d) All of the above

D

Marijuana affects the parts of the brain that (a) Controls coordination (b) Relates to memory and learning (c) Relates to thinking and problem-solving (d) All of the above

D

Motivational Interviewing operates under the assumption that the _____________ possesses the required element for change. (a) Counselor (b) Group (c) Client (d) All of the above

D

Multifamily groups are most likely to occur in the __________ setting. (a) Outpatient (b) Inpatient (c) Self help (d) Residential

D

Rules of behavior or values that influence a person's attitudes and actions, which set limits or guidelines as framework for ATOD use/abuse are called: (a) Social influences (b) Social factors (c) Attitudes (d) Norms

D

Social factors that appear to protect youngsters from initiating substance use and progressing toward abuse include _______________. (a) Bonding, goal-direction, and monitoring from family, peers, religion, and other societal processes (b) Participating in rewarding activities and prosocial behaviors and increased self-confidence and coping skills (c) Selecting and emulating individuals who model temperance or shun substance use (d) All of the above

D

The Multidimensional Family Therapy (MDFT) program: (a) Is solution-focused (b) Strives to provide immediate practical outcomes that affect all aspects of the family's life (c) Has been demmed to have efficacy and low recidivism (d) All of the above

D

The cornerstone of the AA model is the belief that: (a) To gain control of one's life one must take control by a series of action steps (b) To gain control one must hit bottom and begin recovery (c) Drinking is a on a continuum and the closer to the highest level the more likely one will be motivated to follow the 12 steps (d) To gain control of one's life one must give up control to a higher power

D

The majority of substance abusers also suffer from the personality disorder of: (a) Antisocial personality (b) Narcissistic personality (c) Dependent personality (d) None; there is no significant correlation between substance abuse and personality disorders

D

The most powerful factor in complicating the clinician's ability to make an accurate diagnosis of a substance abuse problem with a client is: (a) Acute intoxication (b) Denial (c) Neurological damage (d) Shame

D

The most serious form of withdrawal is _______________. (a) Hyperarousal (b) Alcoholic hallucinosis (c) Convulsive seizures (d) Delirium tremens

D

The optimal length of residential treatment for alcoholism and other drugs is_______________. (a) 21 days (b) Six Weeks (c) Two months (d) Three months

D

The overall goal of harm reduction is to ______________. (a) Assist the individual to identify copies strategies when faced with harmful events (b) To reduce risky behaviors (c) To reduce injury to the substance abuser (d) All of the above

D

The sociocultural theory addresses substance abuse within the framework of: (a) Motivation to change (b) Individual coping and personality factors (c) Genetic characteristics (d) Social and environmental factors

D

Treatment programs for addictive families often: (a) Do not have clinicians who are trained in family systems theory (b) Compartmentalize individual and family therapy (c) Are dictated by the politics and finances of managed care for substance abuse treatment (d) All of the above

D

Use of cocaine (a) Has been shown to increase activity and involvement with family (b) Has been shown to reduce the brains ability to feel pleasure (c) Is addictive as crack, but not in powder form (d) None of the above

D

Which of the following is not a characteristic of an ethical dilemma? (a) A choice between two courses of action must be made (b) There are significant consequences for not selecting either of the options (c) Each decision is supported by ethical principles (d) One of the decisions is supported by state regulations

D

Which of the following is not one of the common problem domains that reflect the three major models of substance abuse according to Richard J. Laban? (a) Initial treatment (b) Interpersonal relations (c) Home environment (d) Work environment

D

Which of the following is/are type(s) of plan identification? (a) Early Treatment (b) Comprehensive Treatment (c) Modified (d) Early treatment, comprehensive treatment, modified

D

A

The diagnostic categories of "abuse" and "dependence" are separated by the following: (a) Tolerance and withdrawal (b) Length of time used and context of use (c) Length of time used and particular drug identified (d) Withdrawal and recidivism