Substance withdrawal and substance intoxication both come up regularly in social work practice. Don’t be surprised to find them on the ASWB exam! 

Here's a breakdown of each term, followed by some substance-by-substance specifics and a free practice question:

Substance Intoxication

Substance intoxication, on the other hand, refers to the acute effects of using a substance. It involves the temporary changes in cognition, mood, behavior, and physiological functioning that occur when a person consumes a drug or substance. Intoxication can vary based on the specific substance and the dose taken. Common signs of intoxication include:

  • Euphoria or elation
  • Impaired judgment and coordination
  • Slurred speech
  • Altered perception of reality
  • Agitation or aggression
  • Drowsiness or sedation
  • Impaired memory and concentration
  • Paranoia or hallucinations (with certain substances)

The effects of intoxication can be short-lived, but they can impair a person's ability to function and make safe decisions. Some substances can lead to dangerous intoxication, putting individuals and others at risk, such as impaired driving or accidents.

Substance Withdrawal

 Substance withdrawal refers to the physiological and psychological symptoms that occur when a person who has developed a physical dependence on a substance suddenly stops using or significantly reduces their intake of that substance. Withdrawal symptoms can vary widely depending on the specific substance and the individual's history of use. Some common examples of withdrawal symptoms include:

  • Nausea and vomiting
  • Tremors and shaking
  • Anxiety and restlessness
  • Sweating and chills
  • Insomnia or disrupted sleep
  • Irritability and mood swings
  • Muscle aches and pains
  • Hallucinations (in some cases)
  • Seizures (in severe cases)

Withdrawal symptoms can be very uncomfortable and, in some cases, dangerous, especially if not managed properly. Medically supervised detoxification is often necessary for individuals who are experiencing withdrawal symptoms when discontinuing certain substances.

Specifics, by substance


  • Intoxication: Slurred speech, impaired coordination, impaired judgment, slowed reflexes, memory impairment, mood swings, nausea, vomiting, and potentially blackouts or loss of consciousness.
  • Withdrawal: Tremors, anxiety, sweating, elevated heart rate, hallucinations, seizures, insomnia, nausea, vomiting, and confusion (can progress to delirium tremens in severe cases).

Opioids (e.g., Heroin, Prescription Painkillers):

  • Intoxication: Euphoria, drowsiness, slowed breathing, constricted pupils, constipation, nausea, and itching.
  • Withdrawal: Agitation, anxiety, muscle aches, yawning, runny nose, sweating, dilated pupils, abdominal cramps, diarrhea, vomiting, insomnia, and goosebumps ("cold turkey").

Stimulants (e.g., Cocaine, Methamphetamine):

  • Intoxication: Increased energy, alertness, elevated heart rate, dilated pupils, increased body temperature, reduced appetite, heightened euphoria, irritability, and potentially aggression or paranoia.
  • Withdrawal: Fatigue, depression, increased appetite, disrupted sleep patterns, intense cravings, and in some cases, vivid and unpleasant dreams.

Benzodiazepines (e.g., Xanax, Valium):

  • Intoxication: Sedation, relaxation, impaired coordination, memory impairment, slurred speech, and potentially impaired judgment.
  • Withdrawal: Anxiety, restlessness, insomnia, irritability, muscle tension, sweating, tremors, seizures (in severe cases), and rebound symptoms of the conditions the medication was initially prescribed for.


  • Intoxication: Euphoria, altered sensory perception, altered time perception, increased appetite ("munchies"), impaired memory and concentration, and bloodshot eyes.
  • Withdrawal: Irritability, mood disturbances, decreased appetite, insomnia, and restlessness.

Hallucinogens (e.g., LSD, Psilocybin (mushrooms)):

  • Intoxication: Altered perception of reality, hallucinations, altered sense of time, synesthesia (mixing of sensory experiences), and potentially profound insights or anxiety/panic reactions.
  • Withdrawal: Hallucinogens are generally not considered to cause physical withdrawal, but some individuals might experience psychological effects like persistent changes in perception or mood.

Keep in mind that the severity of both withdrawal and intoxication symptoms can be influenced by factors such as the frequency and duration of use, the amount consumed, individual tolerance, and overall health. (We’re mostly social work exam preppers here, but if you or someone you know is struggling with substance use or experiencing withdrawal symptoms, seeking professional medical and psychological help is recommended.)

Free Practice Question

What will this look like on the social work licensing exam? Something like this:

A client reports taking a “mystery drug” at a weekend-long party which resulted in a combination of euphoria, increased energy, and heightened alertness. Coming down, they experienced fatigue, some depression, and difficulty sleeping. Which of the following substances did the client most likely use?

A) Alcohol
B) Cocaine
C) Marijuana
D) Heroin

What do you think?

The client's description of euphoria, increased energy, and heightened alertness aligns with the effects of a stimulant. Cocaine is the only stimulant listed, so there you have it. 

Put your knowledge of substance use and the wide array of other ASWB exam topics to the test with SWTP’s full-length practice tests.

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August 14, 2023
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