Addiction MCQs With Answer offers B. Pharm students a focused, clinical overview of substance use disorders, mechanisms, pharmacotherapy, and harm‑reduction strategies. This set emphasizes core concepts: neurobiology (mesolimbic dopamine, GABA, glutamate), diagnostic criteria (DSM‑5), tolerance, withdrawal syndromes, and key medications (methadone, buprenorphine, naloxone, naltrexone, disulfiram, acamprosate, varenicline, bupropion). Questions integrate pharmacokinetics, receptor pharmacology, screening tools (CAGE, CIWA‑Ar), and treatment principles including detox, maintenance, and relapse prevention. Each MCQ is designed to deepen understanding and prepare you for exams and clinical decision‑making in pharmacy practice. Now let’s test your knowledge with 30 MCQs on this topic.
Q1. Which neural pathway is most directly associated with the rewarding effects of addictive drugs?
- Mesolimbic dopamine pathway
- Corticospinal tract
- Dorsal column medial lemniscus
- Spinothalamic tract
Correct Answer: Mesolimbic dopamine pathway
Q2. What major diagnostic change did DSM‑5 introduce for substance disorders?
- Separated abuse and dependence into two disorders
- Combined abuse and dependence into a single Substance Use Disorder
- Removed withdrawal as a diagnostic criterion
- Changed all diagnoses to behavioral addictions only
Correct Answer: Combined abuse and dependence into a single Substance Use Disorder
Q3. What is the best definition of pharmacologic tolerance?
- Development of new side effects after drug exposure
- Need for increased dose to achieve the same effect
- Immediate hypersensitivity reaction to a drug
- Persistent therapeutic effect after discontinuation
Correct Answer: Need for increased dose to achieve the same effect
Q4. Which term describes a characteristic set of symptoms that occur after abrupt cessation of a substance?
- Dependence liability
- Tolerance
- Withdrawal
- Craving
Correct Answer: Withdrawal
Q5. Activation of which receptor subtype produces opioid analgesia and euphoria and is central to opioid addiction?
- Delta opioid receptor
- Kappa opioid receptor
- Mu opioid receptor
- Nicotinic acetylcholine receptor
Correct Answer: Mu opioid receptor
Q6. Naloxone reverses opioid effects by which mechanism?
- Monoamine oxidase inhibition
- Competitive opioid receptor antagonism
- Enhancement of GABAergic transmission
- Irreversible inhibition of opioid receptors
Correct Answer: Competitive opioid receptor antagonism
Q7. Which medication is a partial opioid agonist commonly used for maintenance therapy in opioid dependence?
- Methadone
- Buprenorphine
- Morphine sulfate
- Fentanyl
Correct Answer: Buprenorphine
Q8. The most life‑threatening complication of severe alcohol withdrawal is:
- Alcoholic hallucinosis
- Delirium tremens
- Wernicke encephalopathy
- Fatty liver
Correct Answer: Delirium tremens
Q9. Disulfiram reduces alcohol consumption by inhibiting which enzyme?
- Alcohol dehydrogenase
- Aldehyde dehydrogenase
- CYP2E1
- Monoamine oxidase
Correct Answer: Aldehyde dehydrogenase
Q10. Naltrexone helps treat alcohol dependence primarily through which action?
- GABA receptor agonism
- NMDA receptor antagonism
- Opioid receptor antagonism reducing reward
- Aldehyde dehydrogenase inhibition
Correct Answer: Opioid receptor antagonism reducing reward
Q11. Acamprosate’s therapeutic effect in alcohol dependence is mainly due to:
- Selective serotonin reuptake inhibition
- Modulation of glutamatergic and GABAergic neurotransmission
- Opiate receptor blockade
- Enhancement of alcohol metabolism
Correct Answer: Modulation of glutamatergic and GABAergic neurotransmission
Q12. Varenicline aids smoking cessation by acting as a:
- Full agonist at muscarinic receptors
- Partial agonist at α4β2 nicotinic acetylcholine receptors
- Dopamine D2 receptor antagonist
- Monoamine oxidase inhibitor
Correct Answer: Partial agonist at α4β2 nicotinic acetylcholine receptors
Q13. Bupropion’s mechanism relevant to smoking cessation is best described as:
- Selective serotonin reuptake inhibition
- Alpha‑2 adrenergic agonism
- Norepinephrine‑dopamine reuptake inhibition
- GABAergic potentiation
Correct Answer: Norepinephrine‑dopamine reuptake inhibition
Q14. The CAGE questionnaire is primarily used to screen for:
- Opioid overdose
- Benzodiazepine dependence
- Alcohol use disorders
- Nicotine dependence
Correct Answer: Alcohol use disorders
Q15. Which tool is commonly used to assess severity of alcohol withdrawal and guide benzodiazepine dosing?
- AUDIT
- CIWA‑Ar
- CAGE
- MMSE
Correct Answer: CIWA‑Ar
Q16. The primary enzyme responsible for ethanol oxidation in the liver is:
- CYP3A4
- Alcohol dehydrogenase (ADH)
- Aldehyde dehydrogenase (ALDH)
- Monoamine oxidase
Correct Answer: Alcohol dehydrogenase (ADH)
Q17. For managing severe alcohol withdrawal, a long‑acting benzodiazepine commonly preferred is:
- Lorazepam
- Alprazolam
- Diazepam
- Triazolam
Correct Answer: Diazepam
Q18. Cocaine produces its stimulant and addictive effects mainly by:
- Blocking dopamine reuptake transporters
- Antagonizing NMDA receptors
- Inhibiting monoamine oxidase irreversibly
- Directly activating opioid receptors
Correct Answer: Blocking dopamine reuptake transporters
Q19. Methamphetamine increases extracellular dopamine primarily by:
- Inhibiting COMT enzyme
- Blocking vesicular monoamine transporter 2 (VMAT2) and reversing transporters
- Enhancing aldehyde dehydrogenase activity
- Acting as a dopamine receptor agonist
Correct Answer: Blocking vesicular monoamine transporter 2 (VMAT2) and reversing transporters
Q20. The main central receptor targeted by Δ9‑tetrahydrocannabinol (THC) is:
- CB1 cannabinoid receptor
- CB2 cannabinoid receptor
- NMDA receptor
- Mu opioid receptor
Correct Answer: CB1 cannabinoid receptor
Q21. Classic serotonergic hallucinogens such as LSD primarily agonize which receptor?
- Dopamine D1 receptor
- 5‑HT2A receptor
- GABA‑A receptor
- Histamine H1 receptor
Correct Answer: 5‑HT2A receptor
Q22. Which statement best defines harm reduction in addiction care?
- A strategy requiring immediate abstinence as the only goal
- Methods to reduce negative consequences of drug use without necessarily stopping use
- Legal penalties to prevent drug use
- Use of high‑dose agonist therapy for all patients
Correct Answer: Methods to reduce negative consequences of drug use without necessarily stopping use
Q23. Increased dopamine release in which brain region is most associated with drug‑induced reinforcement?
- Hippocampus
- Nucleus accumbens
- Medulla oblongata
- Cerebellum
Correct Answer: Nucleus accumbens
Q24. Excitotoxicity during alcohol withdrawal is largely mediated by which receptor type?
- GABA‑B receptor
- NMDA glutamate receptor
- Beta‑adrenergic receptor
- Serotonin 5‑HT1A receptor
Correct Answer: NMDA glutamate receptor
Q25. Which best describes buprenorphine’s receptor actions?
- Full mu agonist and full kappa agonist
- Partial mu agonist and kappa antagonist
- Muscarinic antagonist and nicotinic agonist
- Monoamine oxidase inhibitor
Correct Answer: Partial mu agonist and kappa antagonist
Q26. Which opioid is a long‑acting full agonist commonly used in maintenance therapy for opioid dependence?
- Methadone
- Buprenorphine
- Codeine
- Naloxone
Correct Answer: Methadone
Q27. Which pharmacologic option is specifically indicated as a first‑line prescription therapy for smoking cessation?
- Varenicline
- Clonidine
- Diazepam
- Disulfiram
Correct Answer: Varenicline
Q28. Which factor is strongly associated with increased lifetime risk of developing substance addiction?
- Late initiation of use after age 30
- Early age of first substance use
- Exclusive use of prescription medications under supervision
- Single brief exposure only once
Correct Answer: Early age of first substance use
Q29. In DSM‑5, severity of a Substance Use Disorder is determined by:
- Duration of use only
- Presence of withdrawal symptoms only
- Number of diagnostic criteria met
- Type of substance used only
Correct Answer: Number of diagnostic criteria met
Q30. Which statement about naloxone distribution for opioid overdose is correct?
- Naloxone has no role in community overdose response
- Intranasal naloxone should be available to lay rescuers for suspected opioid overdose
- Naloxone is only effective if given as an oral tablet
- Naloxone permanently prevents opioid dependence
Correct Answer: Intranasal naloxone should be available to lay rescuers for suspected opioid overdose
I am a Registered Pharmacist under the Pharmacy Act, 1948, and the founder of PharmacyFreak.com. I hold a Bachelor of Pharmacy degree from Rungta College of Pharmaceutical Science and Research. With a strong academic foundation and practical knowledge, I am committed to providing accurate, easy-to-understand content to support pharmacy students and professionals. My aim is to make complex pharmaceutical concepts accessible and useful for real-world application.
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