Your FREE CADC Flashcards 2026 – 200+ Cards

The neurotransmitter most drugs of abuse manipulate in the brain's mesolimbic reward pathway, reinforcing drug-taking behavior.

A decreased response to a substance after repeated use, so more is needed to get the same effect; a pharmacological criterion of SUD.

A substance-specific syndrome when a heavy, long-term user stops or cuts back; for alcohol and sedatives it can be life-threatening.

A strong urge or desire to use a substance; one of the 11 DSM-5-TR substance use disorder criteria.

The brain's ability to reorganize and form new neural connections in response to experience — the basis for both addiction and recovery.

A drug class that slows CNS activity — alcohol, benzodiazepines, barbiturates; their withdrawal can be fatal (seizures, delirium tremens).

A drug class binding opioid receptors (heroin, fentanyl, oxycodone, morphine); overdose causes respiratory depression, reversed by naloxone.

A drug class that speeds CNS activity (cocaine, methamphetamine, amphetamines); withdrawal is a 'crash,' not a medical emergency.

A psychoactive drug class (THC) that impairs memory and coordination; withdrawal is mild — irritability, sleep, and appetite changes.

A drug class that alters perception and thought (LSD, psilocybin, PCP, ketamine); dissociatives like PCP raise risk of dangerous behavior.

A pure opioid antagonist that rapidly reverses an opioid overdose; an emergency rescue medication, not maintenance.

A full opioid agonist for opioid use disorder that prevents withdrawal and craving; dispensed through licensed opioid treatment programs.

A partial opioid agonist with a ceiling effect for opioid use disorder; often combined with naloxone (Suboxone) to deter misuse.

An opioid antagonist that blocks opioid effects and treats both opioid and alcohol use disorder; the client must be opioid-free first.

An aversive medication for alcohol use disorder that causes an unpleasant reaction if the client drinks, supporting abstinence.

A medication that reduces craving and supports continued abstinence after a client with alcohol use disorder has stopped drinking.

A mental health disorder and a substance use disorder in the same person at once; best treated with integrated, coordinated care.

When combining drugs (e.g., alcohol + benzodiazepines) produces an effect greater than the sum of each — a major overdose risk.

When tolerance to one drug carries over to another drug in the same pharmacological class.

The view of addiction as a chronic, relapsing brain disease marked by compulsive use and lasting changes in brain function.

The dopamine circuit from the ventral tegmental area to the nucleus accumbens that mediates reinforcement and is hijacked by addictive drugs.

A brain region central to the reward pathway where dopamine release reinforces pleasurable behaviors, including drug use.

The brain region governing judgment, impulse control, and decision-making; addiction weakens its regulation over reward-driven craving.

The percentage of alcohol in the blood; 0.08% is the legal driving limit in most U.S. states, and very high levels risk fatal respiratory depression.

The most severe alcohol withdrawal, with confusion, hallucinations, autonomic instability, and seizures; a medical emergency that can be fatal.

Brain damage from thiamine (vitamin B1) deficiency in chronic alcohol use; Wernicke's is acute and reversible, Korsakoff's causes lasting memory loss.

A chronic, often irreversible amnestic disorder from thiamine deficiency, marked by severe memory loss and confabulation.

A range of lifelong physical, behavioral, and cognitive impairments caused by prenatal alcohol exposure; entirely preventable.

CNS depressants (e.g., diazepam, alprazolam) used for anxiety and to manage alcohol withdrawal; abrupt cessation can cause fatal seizures.

Older CNS depressant sedatives with a narrow margin between therapeutic and lethal dose; withdrawal can be life-threatening.

A synthetic opioid roughly 50–100 times more potent than morphine; a leading driver of overdose deaths, often found in adulterated drug supplies.

Pinpoint (constricted) pupils, respiratory depression, and decreased consciousness — the classic signs of opioid overdose.

Sudden, severe withdrawal triggered when an opioid antagonist or partial agonist displaces a full agonist; a risk when starting buprenorphine too early.

A potent, long-acting stimulant causing dopamine release, with risks of psychosis, dental damage ('meth mouth'), and cardiovascular harm.

A short-acting stimulant that blocks dopamine reuptake; risks include cardiac arrhythmia, stroke, and a depressive 'crash' on withdrawal.

The post-binge withdrawal phase marked by fatigue, depression, hypersomnia, and intense craving; not usually medically dangerous but high suicide risk.

A highly addictive stimulant in tobacco; dependence is treated with nicotine replacement therapy, bupropion, or varenicline.

The most widely used psychoactive stimulant; DSM-5-TR recognizes caffeine intoxication and withdrawal but not a caffeine use disorder.

Volatile substances (glues, solvents, aerosols, nitrites) inhaled for intoxication; can cause sudden sniffing death and lasting neurological damage.

A dissociative hallucinogen causing distorted perception, agitation, and violent or self-injurious behavior at high doses.

A dissociative anesthetic with hallucinogenic effects; misused recreationally and studied therapeutically for treatment-resistant depression.

A stimulant-hallucinogen ('empathogen') that releases serotonin; risks include hyperthermia, dehydration, and serotonin depletion.

The time for the body to eliminate half of a drug's concentration; longer half-lives produce slower onset and milder, more prolonged withdrawal.

How a drug enters the body (oral, intranasal, inhaled, injected); faster routes like IV and smoking produce more intense, addictive effects.

A physiological adaptation in which the body needs a drug to function normally, producing tolerance and withdrawal — not the same as addiction.

An emotional or mental reliance on a drug to feel normal or cope, marked by craving and preoccupation, with or without physical dependence.

The use of more than one drug, either together or over time; complicates withdrawal management and raises overdose risk.

The user's mindset (set) and physical/social environment (setting), which shape a drug's subjective effects.

The phenomenon in which repeated alcohol or sedative withdrawals make each subsequent withdrawal more severe, raising seizure risk.

A change in one drug's effect caused by another drug, food, or condition; can be additive, synergistic, or antagonistic.

A substance that binds a receptor and activates it to produce a drug effect (e.g., methadone at opioid receptors).

A substance that binds a receptor and blocks it, preventing a drug effect (e.g., naloxone or naltrexone at opioid receptors).

A substance that activates a receptor less fully than a full agonist and has a ceiling effect (e.g., buprenorphine).

A dose above which a drug produces no additional effect; buprenorphine's ceiling limits respiratory depression and overdose risk.

The theory that use of one substance increases the likelihood of using others; a correlational, debated model of progression.

Childhood trauma and household dysfunction that strongly raise the lifetime risk of substance use disorders and other health problems.

Conditions that raise (e.g., trauma, family history) or lower (e.g., strong attachments, school engagement) the likelihood of developing an SUD.

Heritable factors that account for roughly half of the risk for substance use disorders, interacting with environment.

Tremors and anxiety begin 6–24 hours after the last drink, seizures peak 12–48 hours, and delirium tremens emerges around 48–72 hours.

A bloodborne viral liver infection commonly transmitted by shared injection equipment; a key reason for syringe services and screening.

A brief, first-pass step to detect whether a problem is likely and worth a fuller look; it is not a diagnosis.

The comprehensive, in-depth process that confirms a problem, yields a diagnosis and severity, and produces a treatment plan.

A four-item alcohol screen — Cut down, Annoyed, Guilty, Eye-opener; two or more 'yes' answers suggest a clinically significant problem.

The WHO's 10-item Alcohol Use Disorders Identification Test for hazardous and harmful drinking; AUDIT-C is the 3-item short form.

The Drug Abuse Screening Test — a self-report screen for drug use other than alcohol.

A substance-use screening tool designed specifically for adolescents (Car, Relax, Alone, Forget, Friends, Trouble).

Screening, Brief Intervention, and Referral to Treatment — an evidence-based public-health approach to addressing risky use early.

A structured clinical interview rating the severity of problems across seven life domains to guide treatment planning.

An intake gathering biological, psychological, and social information to understand the whole client in context.

A structured snapshot of current functioning — appearance, mood, affect, thought, perception, cognition, insight, and judgment.

A diagnosis based on 11 criteria in four groups: impaired control, social impairment, risky use, and pharmacological (tolerance, withdrawal).

Set by criteria met in 12 months: mild = 2–3, moderate = 4–5, severe = 6 or more.

A framework that assesses a client across six dimensions to match them to the right level of care.

A continuum from early intervention (0.5) and outpatient (1) through residential (3) to medically managed intensive inpatient (4).

Intoxication/withdrawal; biomedical; emotional/behavioral/cognitive; readiness to change; relapse potential; recovery environment.

The Michigan Alcoholism Screening Test — a longer self-report instrument detecting alcohol problems over the lifetime.

A brief alcohol screen validated for use in pregnancy — Tolerance, Worried, Eye-opener, Amnesia, Cut down.

The Global Appraisal of Individual Needs — a comprehensive standardized biopsychosocial assessment used in many treatment settings.

A brief co-occurring screening tool that flags both substance use and mental health concerns for further assessment.

A structured or semi-structured conversation gathering history, presenting problem, and context as the core of assessment.

Data from family, records, or other providers (with proper consent) that supplements and corroborates the client's self-report.

Urine or other drug testing that objectively detects recent substance use; a clinical tool, not a substitute for clinical judgment.

Evaluating a client's danger to self or others, including suicide and violence risk, with attention to means, plan, and intent.

The Columbia-Suicide Severity Rating Scale — a structured tool for assessing the presence and severity of suicidal ideation and behavior.

The Clinical Institute Withdrawal Assessment for Alcohol, revised — a validated scale quantifying alcohol withdrawal severity to guide medication.

The Clinical Opiate Withdrawal Scale — an 11-item clinician-rated measure of opioid withdrawal severity used to time buprenorphine induction.

The counselor's working diagnostic conclusion drawn from assessment data, within their scope and pending any required diagnosis by a licensed clinician.

The process of distinguishing among conditions with overlapping symptoms — e.g., separating a primary mental disorder from substance-induced symptoms.

Psychiatric symptoms (e.g., depression, psychosis) caused directly by intoxication or withdrawal that typically resolve with abstinence.

Using ASAM Criteria across the six dimensions to place a client in the least intensive setting that can meet their needs safely.

Acute intoxication and/or withdrawal potential — the dimension assessing the need for medically managed detoxification.

Readiness to change — the dimension assessing the client's motivation and engagement with treatment.

Outpatient services — fewer than nine hours of structured programming per week for adults.

Intensive outpatient (IOP) — typically nine or more hours of structured programming per week for adults.

Residential and inpatient services providing a 24-hour structured treatment environment.

Medically managed intensive inpatient services — 24-hour care with full medical and nursing resources for acute, unstable conditions.

An approach that identifies the client's resources, supports, and resilience alongside problems to inform treatment.

Assessing how the client's cultural identity, beliefs, and context shape their experience of substance use and help-seeking.

Examining the antecedents, behaviors, and consequences (the ABCs) of substance use to identify triggers and reinforcement.

A simple scaling tool asking the client to rate importance of and confidence in changing on a 0–10 scale to gauge motivation.

The consistency of an assessment instrument in producing the same results across time and raters.

The degree to which an assessment instrument actually measures what it claims to measure.

Standardized reference scores from a representative population used to interpret an individual's assessment results.

A collaborative, client-centered style that resolves ambivalence and evokes change talk; you roll with resistance rather than argue.

The core MI micro-skills: Open-ended questions, Affirmations, Reflective listening, and Summaries.

Prochaska & DiClemente's model: precontemplation, contemplation, preparation, action, maintenance — match the intervention to the stage.

A structured, present-focused approach that changes distorted thoughts and maladaptive behaviors driving substance use.

A behavioral approach using tangible rewards to reinforce abstinence or attendance; especially effective for stimulant use disorders.

Marlatt's CBT-based approach: identify high-risk situations and triggers and build coping skills before a lapse becomes a relapse.

FDA-approved medications combined with counseling and behavioral therapy; medication alone is not treatment.

Strategies that reduce the harms of drug use without requiring abstinence — naloxone, syringe services, fentanyl test strips.

A structured approach that actively connects clients to mutual-help groups such as AA or NA.

Providing clients and families with information about substance use disorders and the recovery process.

A collaborative document tying measurable goals and objectives to the assessment, naming interventions, level of care, and progress criteria.

An objective that is Specific, Measurable, Achievable, Relevant, and Time-bound — e.g., 'attend 3 group sessions per week for 30 days.'

A goal is the broad, longer-term outcome; an objective is a specific, measurable, time-bound step toward that goal.

A documentation format: Subjective (client report), Objective (observed/measured), Assessment (interpretation), and Plan (next steps).

Treating a co-occurring mental health and substance use disorder together rather than separately or sequentially.

Linking the client to medical, housing, vocational, legal, and mutual-help resources; refer out when a need exceeds your scope.

Ongoing support that begins during treatment, not after discharge — building the network and coping skills for recovery.

The collaborative, trusting bond between counselor and client; one of the strongest predictors of treatment outcomes.

The accurate understanding and reflection of a client's feelings and perspective; a core counselor condition for change.

Rogers' core condition of nonjudgmental acceptance and respect for the client regardless of their behavior.

Rogers' core condition in which the counselor is authentic and transparent rather than playing a role.

Client statements favoring change (desire, ability, reasons, need, commitment); the counselor evokes and reinforces it in MI.

Client statements favoring the status quo; in MI the counselor responds without amplifying or arguing against it.

An MI principle of avoiding argument and using the client's own momentum rather than confronting ambivalence head-on.

An MI strategy that highlights the gap between a client's values or goals and their current behavior to motivate change.

Restating or paraphrasing the client's meaning to show understanding and deepen exploration; the backbone of MI.

A question that invites elaboration rather than a yes/no answer, encouraging the client to do most of the talking.

Treatment delivered to several clients together, using peer support, modeling, and feedback; a primary modality in SUD treatment.

Curative elements of group therapy such as universality, instillation of hope, cohesiveness, and interpersonal learning.

The sense of belonging and trust among group members that supports disclosure, accountability, and change.

The view that the family operates as an interconnected system, so one member's substance use affects and is shaped by the whole.

Behavior by others that unintentionally shields a person from the consequences of substance use, allowing it to continue.

A relational pattern of excessive caretaking and reliance on another's approval, often seen in families affected by addiction.

A treatment approach that recognizes the prevalence of trauma, avoids re-traumatization, and emphasizes safety and trust.

An evidence-based, present-focused model for treating co-occurring trauma/PTSD and substance use without requiring trauma narration.

A skills-based therapy teaching mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness; useful for co-occurring disorders.

A behavioral treatment that rearranges environmental and social reinforcers to make a sober life more rewarding than using.

A goal-oriented approach emphasizing the client's strengths, exceptions to the problem, and a preferred future rather than problem analysis.

Inaccurate, biased thought patterns (e.g., all-or-nothing thinking, catastrophizing) that CBT helps clients identify and reframe.

An internal state or external cue (people, places, emotions) associated with past use that prompts craving.

A circumstance that threatens a client's sense of control and raises relapse risk; identifying these is central to relapse prevention.

Cognitive and behavioral strategies clients use to manage triggers, cravings, and stress without returning to substance use.

A lapse is a single slip; a relapse is a full return to the prior pattern of use. A lapse need not become a relapse.

The guilt and all-or-nothing thinking after a single slip that can drive a full relapse; relapse prevention reframes the lapse as a learning event.

Early cognitive, emotional, and behavioral changes (e.g., isolation, romanticizing use) that precede a return to substance use.

The internal and external resources — social support, housing, employment, motivation — a person can draw on to sustain recovery.

Peer-led recovery supports such as AA, NA, SMART Recovery, and Refuge Recovery that supplement professional treatment.

A secular, science-based mutual-help program using cognitive-behavioral and motivational tools as an alternative to 12-step groups.

A coordinated network of services supporting long-term recovery and wellness rather than just acute episodes of treatment.

Services delivered by people with lived experience of recovery to model hope, provide support, and aid navigation.

Coordinating a client's services across systems — medical, housing, vocational, legal — to address needs beyond direct counseling.

Preparing a client for transition out of a level of care, with continuing-care arrangements, supports, and a relapse plan.

Immediate, short-term help to stabilize a client in acute distress, ensure safety, and connect them to ongoing care.

A documentation format recording Data, Assessment, and Plan as a streamlined alternative to SOAP.

A dated record of each contact documenting the client's status, interventions delivered, and progress toward treatment-plan goals.

The clear, traceable link from assessment to diagnosis to treatment-plan goals to progress notes that documentation should maintain.

A scheduled reassessment of goals, objectives, and progress, updating the plan as the client's needs change.

A short, structured conversation (often FRAMES-based) that raises awareness and motivates change in risky but non-dependent users.

Elements of effective brief intervention: Feedback, Responsibility, Advice, Menu of options, Empathy, and Self-efficacy.

A client's belief in their own ability to succeed at change; building it is a core aim of motivational counseling.

A written, individualized plan identifying triggers, coping strategies, supports, and emergency steps to maintain recovery.

Comprehensive, individualized supports surrounding the client and family across life domains to sustain recovery.

Periodic post-treatment monitoring that re-engages clients early if substance use resumes, treating addiction as a chronic condition.

The client's voluntary agreement to treatment after being told its nature, goals, fees, confidentiality limits, and rights; an ongoing process.

The federal rule protecting SUD records from federally assisted programs; generally requires specific written consent and is stricter than HIPAA.

Part 2 is stricter for SUD records — even confirming a person attends a program is a protected disclosure requiring specific written consent.

A second role with a client (social, financial, sexual) that risks impairing judgment or harming the client; avoid harmful ones.

Counselors practice only within their training and competence; refer out when a need exceeds it.

The obligation to take reasonable steps to protect an identifiable victim from a client's serious, imminent threat.

A legal duty to report reasonable suspicion of child, elder, or dependent-adult abuse; it overrides confidentiality.

Disclosure may occur in a medical emergency, for mandated abuse reporting, under the duty to warn, or with a qualifying court order.

An ordinary subpoena alone does not pierce Part 2 protections; only a court order meeting Part 2's specific requirements can compel disclosure.

Autonomy (self-determination), beneficence (do good), nonmaleficence (do no harm), justice (fairness), and fidelity (loyalty).

Respecting the client's right to make their own informed decisions about treatment.

The duty to do no harm and avoid actions that could injure the client.

A structured process to use when a dilemma isn't squarely covered by the code; pair it with supervision and documentation.

The International Certification & Reciprocity Consortium — develops the Alcohol and Drug Counselor (ADC) exam used by many CADC boards.

The ethical standards of the Association for Addiction Professionals, guiding counselor conduct, client welfare, and professional responsibility.

The ethical and legal duty to protect client information from unauthorized disclosure; for SUD records it is reinforced by 42 CFR Part 2.

A legal protection (varying by state) that shields certain counselor-client communications from being disclosed in court.

A 42 CFR Part 2 contract allowing a program to share protected records with an outside service provider without separate client consent.

A valid release must name the program, recipient, purpose, information disclosed, an expiration, and the client's signature and right to revoke.

Under 42 CFR Part 2, a recipient of SUD records may not redisclose them without further consent and must attach a notice prohibiting redisclosure.

Provider-to-provider disclosure of SUD records is permitted without consent to treat a bona fide medical emergency, with documentation required.

Whether parental consent is required for a minor's SUD treatment and records depends on state law governing minor consent.

The ethical duty to act in the client's best interest and promote their well-being.

The ethical principle of treating clients fairly and equitably and providing equal access to services.

The ethical duty of loyalty — keeping promises, honoring commitments, and maintaining the trust placed in the counselor.

The ethical duty of honesty and truthfulness in dealings with clients and others.

The professional limits that protect the counselor-client relationship; clear boundaries prevent exploitation and role confusion.

A crossing is a minor, often benign deviation from the norm; a violation is a harmful or exploitative breach of the boundary.

Sharing personal information with a client; appropriate only when brief, purposeful, and clearly in the client's interest.

A client's unconscious redirection of feelings about a past figure onto the counselor.

The counselor's emotional reactions toward a client rooted in their own history; must be recognized and managed through supervision.

A formal, ongoing professional relationship supporting a counselor's skill development, ethical practice, and accountability.

Deliberate practices that sustain a counselor's well-being and prevent impairment that could harm clients.

Emotional exhaustion, depersonalization, and reduced accomplishment from chronic work stress; an ethical risk if it impairs care.

The cumulative emotional toll of working with traumatized clients, which can erode empathy and effectiveness.

A condition (illness, substance use, burnout) that compromises a counselor's ability to practice safely; requires action to protect clients.

The ongoing development of awareness, knowledge, and skills to work effectively with clients across cultures and identities.

A lifelong stance of self-reflection, openness, and respect for the client as the expert on their own culture and experience.

The ethical duty to provide services without bias based on race, ethnicity, gender, sexual orientation, religion, disability, or other status.

The duty to keep accurate, timely, secure records that support continuity of care and meet legal and ethical standards.

The requirement to keep client records for a period set by state and federal law and to dispose of them securely afterward.

Clients generally have a right to access their own records, subject to limited exceptions and applicable law.

Ethically ending the counseling relationship with adequate notice, summary, and referral when goals are met or services are no longer appropriate.

Improperly ending services without notice, transition, or referral, leaving a client in need without care — an ethical violation.

Accepting gifts or trading services for fees can blur boundaries; both require caution, documentation, and attention to client culture and need.

A situation in which a counselor's personal or financial interest could compromise their professional judgment or the client's welfare.

A document given to clients describing the counselor's credentials, services, fees, policies, and the limits of confidentiality.

Ongoing training required to maintain certification and ensure the counselor's knowledge and skills stay current.

The professional duty to address, and when warranted report, a colleague's unethical or impaired practice to protect clients.

Standards for remote services covering privacy, secure platforms, informed consent, jurisdiction, and managing technology limits.

Clients referred by the legal system; the counselor clarifies confidentiality limits and what information will be reported to the court.