Licensed Clinical Social Worker (LCSW) Practice Exam

Which substance is most likely to cause seizures during withdrawal if used heavily and for a prolonged period?

1. Cocaine

2. Marijuana

3. Alcohol

4. Opioids

The correct answer is: Alcohol

Alcohol is the substance most likely to cause seizures during withdrawal if used heavily and for a prolonged period. This phenomenon is well-documented in cases of alcohol dependency, where abrupt cessation can lead to withdrawal symptoms that include seizures, hallucinations, tremors, and, in severe cases, delirium tremens (DTs). The mechanism behind this is related to how alcohol affects the central nervous system. Chronic alcohol use results in neuroadaptations; as the brain becomes accustomed to the depressant effects of alcohol, it adjusts its own neurotransmitter systems. When alcohol intake is suddenly reduced or stopped, this can lead to a hyperexcitable state in the brain, resulting in increased neuronal firing and potentially leading to seizures. In contrast, while cocaine and marijuana may have withdrawal symptoms, they do not typically result in seizure activity upon discontinuation. Opioid withdrawal symptoms can be severe and uncomfortable but are not generally associated with seizures. Understanding the specific withdrawal syndromes and physiological effects of various substances is crucial in clinical practice, particularly when assessing and treating individuals with substance use disorders.