Drug addiction MCQs With Answer — This concise, student-focused introduction reviews core concepts of drug addiction, substance abuse, dependence, tolerance, withdrawal, neurobiology and pharmacotherapy tailored for B. Pharm students. It emphasizes mechanisms of action, receptor changes, pharmacokinetics influencing abuse potential, clinical screening tools, detoxification protocols and key medications such as methadone, buprenorphine, naltrexone, disulfiram and acamprosate. The content links basic pharmacology to therapeutic strategies, harm reduction and monitoring for adverse effects. Clear, exam-oriented multiple-choice practice will reinforce understanding of treatment principles, pharmacodynamics, and clinical decision-making in addiction medicine. Now let’s test your knowledge with 30 MCQs on this topic.
Q1. Which definition best matches “drug addiction” in clinical pharmacology?
- A chronic, relapsing brain disease characterized by compulsive drug seeking and use despite harmful consequences
- Any experimental use of recreational drugs without tolerance
- Occasional social drug use with no physiological changes
- Acute intoxication resolved within 24 hours
Correct Answer: A chronic, relapsing brain disease characterized by compulsive drug seeking and use despite harmful consequences
Q2. What primarily distinguishes physical dependence from tolerance?
- Physical dependence is manifested by withdrawal symptoms; tolerance is reduced response to a drug over time
- Dependence means increased effect; tolerance means decreased compliance
- Dependence refers to psychological craving; tolerance refers to metabolic breakdown only
- There is no difference; both terms are synonymous
Correct Answer: Physical dependence is manifested by withdrawal symptoms; tolerance is reduced response to a drug over time
Q3. Which neurotransmitter is most directly implicated in the mesolimbic reward pathway associated with addiction?
- Serotonin
- Dopamine
- Acetylcholine
- Glycine
Correct Answer: Dopamine
Q4. Alcohol enhances the effects of which receptor system contributing to its acute CNS depressant effects?
- NMDA glutamate receptors
- GABA-A receptor chloride channels
- Dopamine D2 receptors
- Nicotinic acetylcholine receptors
Correct Answer: GABA-A receptor chloride channels
Q5. Disulfiram reduces alcohol consumption by inhibiting which enzyme?
- Aldehyde dehydrogenase
- Alcohol dehydrogenase
- CYP3A4
- Monoamine oxidase
Correct Answer: Aldehyde dehydrogenase
Q6. Naltrexone is used in alcohol and opioid dependence primarily because it is a:
- Non-selective benzodiazepine antagonist
- Opioid receptor antagonist that blocks euphoria
- GABA agonist that prevents withdrawal
- Serotonin reuptake inhibitor reducing cravings
Correct Answer: Opioid receptor antagonist that blocks euphoria
Q7. Acamprosate aids alcohol relapse prevention by modulating which systems?
- Enhancing dopamine and norepinephrine transmission
- Modulating GABAergic and glutamatergic neurotransmission
- Blocking opioid receptors
- Inhibiting alcohol dehydrogenase
Correct Answer: Modulating GABAergic and glutamatergic neurotransmission
Q8. Which statement correctly contrasts methadone and buprenorphine for opioid dependence?
- Methadone is a partial agonist; buprenorphine is a full agonist
- Methadone is a full opioid agonist; buprenorphine is a partial agonist with a ceiling effect
- Both are pure antagonists at opioid receptors
- Neither is effective for maintenance therapy
Correct Answer: Methadone is a full opioid agonist; buprenorphine is a partial agonist with a ceiling effect
Q9. Which drug is the first-line emergency treatment for opioid overdose due to rapid opioid receptor antagonism?
- Naltrexone oral tablet
- Methadone
- Naloxone
- Clonidine
Correct Answer: Naloxone
Q10. The Clinical Opiate Withdrawal Scale (COWS) is used to:
- Diagnose alcohol dependence
- Quantify severity of opioid withdrawal symptoms
- Measure blood opioid concentrations
- Assess liver function in chronic users
Correct Answer: Quantify severity of opioid withdrawal symptoms
Q11. What is the recommended pharmacologic approach to benzodiazepine withdrawal in chronic users?
- Immediate cessation with no medical support
- Switch to a long-acting benzodiazepine and gradual taper
- Use high-dose antipsychotics to control symptoms
- Replace with opioid therapy to reduce anxiety
Correct Answer: Switch to a long-acting benzodiazepine and gradual taper
Q12. Nicotine replacement therapy (NRT) supports smoking cessation mainly by:
- Blocking nicotine receptors permanently
- Providing controlled nicotine to reduce withdrawal and cravings
- Increasing monoamine oxidase activity
- Acting as a vaccine against nicotine
Correct Answer: Providing controlled nicotine to reduce withdrawal and cravings
Q13. Varenicline aids smoking cessation via which mechanism?
- Full agonist at muscarinic receptors
- Partial agonist at α4β2 nicotinic acetylcholine receptors
- Opioid receptor antagonist
- Monoamine oxidase inhibitor
Correct Answer: Partial agonist at α4β2 nicotinic acetylcholine receptors
Q14. Which pharmacokinetic property generally increases a drug’s abuse potential?
- Slow oral absorption and delayed onset
- Rapid brain entry and fast onset of effects
- Extensive first-pass metabolism reducing bioavailability
- High protein binding with slow elimination
Correct Answer: Rapid brain entry and fast onset of effects
Q15. Controlled substance scheduling primarily reflects which factor?
- Cost of manufacture
- Therapeutic efficacy only
- Potential for abuse and dependence
- Color of the tablet
Correct Answer: Potential for abuse and dependence
Q16. The CAGE questionnaire is a screening tool for which substance-related disorder?
- Opioid dependence
- Alcohol use disorder
- Tobacco dependence
- Benzodiazepine prescription misuse
Correct Answer: Alcohol use disorder
Q17. Motivational interviewing in addiction treatment primarily aims to:
- Force patients into abstinence with strict rules
- Enhance intrinsic motivation to change behavior
- Prescribe higher doses of medication
- Provide immediate detoxification under anesthesia
Correct Answer: Enhance intrinsic motivation to change behavior
Q18. Which is an example of a harm reduction strategy in substance use?
- Mandatory incarceration for users
- Needle and syringe exchange programs
- Complete prohibition without support
- Eliminating all opioid agonist therapies
Correct Answer: Needle and syringe exchange programs
Q19. Urine drug testing most commonly detects which of the following?
- Only the parent compound for all drugs
- Drug metabolites produced by the body
- Genetic susceptibility to addiction
- Exact time of last dose within seconds
Correct Answer: Drug metabolites produced by the body
Q20. Combining benzodiazepines with opioids increases risk primarily due to:
- Enhanced renal clearance
- Synergistic respiratory depression
- Opposing cardiovascular effects that cancel out
- Decreased CNS penetration of both drugs
Correct Answer: Synergistic respiratory depression
Q21. Delirium tremens, a severe alcohol withdrawal condition, typically occurs within what timeframe after last drink?
- Within minutes
- 48–72 hours
- After several months
- Only after one week
Correct Answer: 48–72 hours
Q22. Which statement about opioid withdrawal is correct?
- Opioid withdrawal is usually life-threatening and requires ICU care
- Opioid withdrawal is extremely uncomfortable but rarely fatal
- Withdrawal never causes autonomic hyperactivity
- Opioid withdrawal is best treated with disulfiram
Correct Answer: Opioid withdrawal is extremely uncomfortable but rarely fatal
Q23. Clonidine may be used in opioid withdrawal primarily to:
- Stimulate opioid receptors to reduce craving
- Reduce sympathetic overactivity and autonomic symptoms
- Block acetylcholine receptors
- Induce sedation by opioid agonism
Correct Answer: Reduce sympathetic overactivity and autonomic symptoms
Q24. Cognitive Behavioral Therapy (CBT) in addiction focuses on:
- Modifying maladaptive thoughts and teaching coping skills
- Providing long-term opioid replacement only
- Administering rapid detox under anesthesia
- Replacing medication with hypnosis exclusively
Correct Answer: Modifying maladaptive thoughts and teaching coping skills
Q25. Which is a contraindication to starting naltrexone for opioid-dependent patients?
- Patient is fully detoxified from opioids for 7–10 days
- Acute opioid intoxication
- Confirmed abstinence from opioids for several weeks
- No history of liver disease
Correct Answer: Acute opioid intoxication
Q26. The “ceiling effect” of buprenorphine means:
- Increasing doses indefinitely increases respiratory depression
- After a certain dose, further agonist effects and respiratory depression plateau
- It has no effect on opioid receptors
- It is a pure antagonist with no agonist activity
Correct Answer: After a certain dose, further agonist effects and respiratory depression plateau
Q27. Methadone maintenance therapy is effective because methadone is a:
- Long-acting full opioid agonist that prevents withdrawal and reduces craving
- Short-acting opioid antagonist used only during detox
- GABA agonist used for alcohol dependence
- Nicotine partial agonist used for smoking cessation
Correct Answer: Long-acting full opioid agonist that prevents withdrawal and reduces craving
Q28. Rapid opioid detoxification under anesthesia is generally discouraged because:
- It guarantees permanent abstinence
- It carries high medical risk without clear benefit for long-term outcomes
- It is the cheapest treatment option
- It is universally recommended by guidelines
Correct Answer: It carries high medical risk without clear benefit for long-term outcomes
Q29. Which formulation provides a long-acting option for opioid antagonist therapy in relapse prevention?
- Oral naloxone daily
- Monthly intramuscular extended-release naltrexone injection
- Immediate-release methadone syrup
- Short-acting buccal benzodiazepine
Correct Answer: Monthly intramuscular extended-release naltrexone injection
Q30. Pharmacovigilance in addiction pharmacotherapy is important because it:
- Is unnecessary once a drug is approved
- Monitors adverse effects, interactions and safety in real-world patients
- Replaces the need for counseling or psychosocial care
- Only tracks cost-effectiveness
Correct Answer: Monitors adverse effects, interactions and safety in real-world patients
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