CASAC Cheat Sheet | ExamFinch

Scientific Principles

25% of exam
Pharmacology Brain and Risk Substances Co-occurring Withdrawal

Screening and Assessment

20% of exam
DSM-5 Diagnosis Screening Tools ASAM Dimensions Biopsychosocial Toxicology

Treatment and Counseling

30% of exam
Modalities Stages of Change ASAM Levels 12 Core Functions Treatment Planning

Professional Ethics

25% of exam
Confidentiality Boundaries Scope of Practice Documentation Cultural Competence

Quick Facts

Exam IC&RC ADC
Questions 150 (125+25)
Time 3 hours
Pass Scaled 500/800
Retake Every 90 days
Renewal 3 years 60 CE
Fee $245
Admin Pearson VUE

Tolerance vs Dependence SC

Tolerance

Need more drug
Pharmacological adaptation
Receptor down-regulation

Dependence

Withdrawal on stop
Physical adaptation
Can exist alone
Dose effect vs stop effect

Pharmacology SC

Tolerance Need more for effect
Dependence Withdrawal on stop
Cross-tolerance Tolerance to related drug
Agonist Activates receptor
Antagonist Blocks receptor
Withdrawal Stop symptoms cluster
Delirium tremens Severe alcohol withdrawal
Naloxone Opioid overdose reversal

Agonist vs Antagonist SC

Agonist

Activates receptor
Mimics substance effect
Methadone buprenorphine

Antagonist

Blocks receptor
Prevents effect
Naltrexone naloxone
Activate vs block

Brain and Risk SC

Reward pathway Mesolimbic dopamine circuit
Dopamine Reinforcement neurotransmitter
Risk factors Genetics trauma peers
Protective factors Family support coping
Disease model Chronic relapsing brain disease

Physical vs Psychological Dependence SC

Physical

Withdrawal symptoms
Measurable physiological
Detox may be needed

Psychological

Craving and coping
Emotional drive to use
Reward-driven
Body vs mind drive

Substances SC

Alcohol Depressant; DTs risky
Opioids Respiratory depression overdose
Stimulants Cocaine meth paranoia
Benzodiazepines Sedative; seizure withdrawal
Cannabis Mild withdrawal low overdose
Nicotine Cessation craving dysphoria

Co-occurring Disorders SC

Dual diagnosis SUD plus mental disorder
Self-medication Using to relieve symptoms
Integrated care Treat both concurrently
Substance-induced Resolves with abstinence
Independent disorder Persists despite abstinence

DSM-5 Severity SC

2-3 mild 4-5 moderate 6+ severe
2-3 mild 4-5 moderate 6+ severe 11 total criteria

Screening vs Assessment SC

Screening

Brief first check
Flag possible problem
CAGE AUDIT DAST

Assessment

Full biopsychosocial
Diagnose and plan
ASI dimensions
Flag vs diagnose

Screening Tool Picker SC

Quick alcohol flag → CAGE ( 4 questions )
WHO standard screen → AUDIT ( 10 items )
Non-alcohol drugs → DAST ( 10 items )
Primary-care public health → SBIRT ( Brief intervene refer )
Full severity profile → ASI ( Multi-domain interview )
Objective drug use → Toxicology screen ( Urine blood oral )

DSM-5 Diagnosis SC

11 criteria Control social risky Pharma
Mild 2-3 criteria met
Moderate 4-5 criteria met
Severe 6+ criteria met
Impaired control Using more longer
Risky use Danger despite consequences

Screening Tools SC

CAGE 4-question alcohol screen
AUDIT 10-item WHO alcohol
DAST Drug abuse screen
SBIRT Screen brief intervene refer
ASI Addiction severity index
SASSI Substance subtle screening
CIWA Alcohol withdrawal scale

ASAM Dimensions SC

Dim 1 Intoxication withdrawal risk
Dim 2 Biomedical conditions
Dim 3 Emotional behavioral complications
Dim 4 Readiness to change
Dim 5 Relapse potential
Dim 6 Recovery environment

OARS MI Skills TR

Open Affirm Reflect Summarize
Open questions Affirmations Reflective listening Summaries

MI vs Confrontation TR

Motivational Interviewing

Elicit change talk
Roll with resistance
OARS skills

Confrontation

Argue for change
Increase defensiveness
Power struggle
Elicit vs impose

ASAM Level Picker TR

Acute intoxication → Level 3.7 detox ( Medical withdrawal mgmt )
Severe withdrawal risk → Level 4 inpatient ( Medically managed )
Unstable home → Level 3 residential ( 24h structured )
Day support needed → Level 2.5 PHP ( Partial hospital )
Work school flexible → Level 2.1 IOP ( 9h week )
Stable low risk → Level 1 outpatient ( 1-2h week )
Psychoeducation only → Level 0.5 ( Early intervention )
Co-occurring crisis → Integrated referral ( Both disorders )

Counseling Modalities TR

CBT Thoughts feelings behaviors
MI Elicit change talk
12-step facilitation AA NA engagement
Relapse prevention Cope high-risk situations
Harm reduction Reduce harm no abstinence
Group therapy Peer feedback cohesion
Family systems System not individual

FRAMES Brief Intervention TR

Feedback Responsibility Advice Menu Empathy Self-efficacy
Feedback Responsibility Advice options Empathy Self-efficacy

Lapse vs Relapse TR

Lapse

Single use event
Brief isolated
Learning opportunity

Relapse

Return to patterns
Sustained problematic use
Reevaluate plan
Slip vs return

MI Response Picker TR

Sustain talk → Reflect ( Do not argue )
Resistance → Roll with it ( Reframe not oppose )
Low motivation → OARS ( Open questions )
Goal behavior gap → Develop discrepancy ( Client own words )
Commitment language → Strengthen ( Elicit plan )

Stages of Change TR

Precontemplation No problem awareness
Contemplation Ambivalent considering change
Preparation Ready planning action
Action Actively changing behavior
Maintenance Sustaining preventing relapse

Stages of Change TR

Pre Con Prep Act Maintain
Precontemplation Contemplation Preparation Action Maintenance

ASAM Levels TR

Level 0.5 Early intervention
Level 1 Outpatient
Level 2.1 Intensive outpatient
Level 2.5 Partial hospitalization
Level 3 Residential
Level 4 Medically managed inpatient

ASAM Levels TR

0.5 1 2 3 4 continuum
0.5 early 1 outpatient 2 IOP PHP 3 residential 4 inpatient

12 Core Functions TR

Screening Brief problem check
Intake Admit to program
Assessment Biopsychosocial evaluation
Treatment planning Goals objectives dates
Counseling Individual group family
Referral Link to services

Treatment Planning TR

SMART goals Specific measurable achievable
Individualized plan Collaborative written goals
Continuum of care Match intensity to need
Continuing care Aftercare recovery support
Discharge planning Transition and termination

Confidentiality vs Duty to Warn PR

Confidentiality

Protect all records
42 CFR Part 2
Written consent required

Duty to Warn

Break for danger
Warn foreseeable victim
Tarasoff principle
Protect vs prevent harm

Confidentiality PR

42 CFR Part 2 Stricter than HIPAA
HIPAA General health privacy
Duty to warn Protect foreseeable victim
Tarasoff Duty to protect case
Informed consent Voluntary ongoing agreement
Mandated reporting Report suspected child abuse

Professional Boundaries PR

Dual relationships Avoid exploitative roles
Scope of practice CASAC cannot prescribe
Supervision Consult senior clinician
Cultural competence Awareness of bias
Documentation If not written not done

Common Traps

Tolerance vs dependence

Tolerance equals need more ≠ Dependence equals withdrawal

Screen vs diagnose

Screening flags risk ≠ Assessment diagnoses plans

Part 2 vs HIPAA

Part 2 is stricter ≠ HIPAA is general privacy

Lapse vs relapse

Lapse is single use ≠ Relapse is sustained return

Agonist vs antagonist

Agonist activates receptor ≠ Antagonist blocks receptor

Sequential vs integrated

Sequential treats one first ≠ Integrated treats both together

Change talk vs sustain

Change talk favors movement ≠ Sustain talk favors status quo

Last Minute

1. 150 Q = 125 scored + 25 pretest
2. Pass equals scaled 500 of 800
3. Domains 25 20 30 25%
4. DSM-5 2-3 mild 4-5 mod 6+
5. ASAM 6 dims pick level
6. Part 2 stricter than HIPAA
7. OARS equals MI core skills
8. Stages Pre Con Prep Act Maintain
9. Retake 90d; renew 3yr 60h
10. Duty to warn breaks confidentiality
11. 12 Core Functions equals scope

CASAC

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