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Page 1: Introduction · 2021. 1. 21. · True False 57. Stilton cheese can cause extremely frightening psychedelic dreams. It comes from England and smells like feet. True False 58. Potential
Page 2: Introduction · 2021. 1. 21. · True False 57. Stilton cheese can cause extremely frightening psychedelic dreams. It comes from England and smells like feet. True False 58. Potential

Kim Rosenthal, MD OTB Recovery Quiz Two 2

Introduction

Welcome to the Outside-the-Box Recovery

Quiz Booklet Two. This quiz is written for

substance abuse counselors to use with their

clients. It’s educational. It’s serious. And it’s

a little odd.

True/False statements include information

about potential side effects, mortality/injury

rate, legal/cultural aspects of substances of

abuse, recovery – and much more. As

promised in the title, there’s also a statement

about fish. Good luck!

Instructions

1. Use this booklet as warm-up, open-book

test, or homework for clients. It is meant

to educate and to promote conversation. It

is not meant to replace treatment.

2. Each page features a set of ten True/False

statements. Make one copy for each client.

Put the answers aside for later (pages 10-

15).

3. Either as a group or individually, have

your clients read each statement and

determine if it’s true or false. They should

circle the corresponding answer.

4. Review the answers as a group, discussing

additional questions that may arise.

Contents

Introduction……………………………….….2

Quiz……………………………………….….3

Answers …………………………………….10

About the Author ………………………...…16

More Booklets ………………………………17

Page 3: Introduction · 2021. 1. 21. · True False 57. Stilton cheese can cause extremely frightening psychedelic dreams. It comes from England and smells like feet. True False 58. Potential

Kim Rosenthal, MD OTB Recovery Quiz Two 3

True False 1. Spiders weave superior-quality webs when high on marijuana.

True False 2. Methamphetamine and cocaine users sometimes hallucinate bugs creeping under

their skin.

True False 3. Shaming, detaching, and punishing a person with a substance use disorder is the

best way to get them to quit.

True False 4. One study found that opioid addicts treated in the emergency room with a drug

called buprenorphine were twice as likely to be in treatment 30 days later than

patients who were just given a brochure with addiction resources.

True False 5. A $3 million lottery winner was sentenced to 21 years in prison after using his

winnings to finance a meth trafficking ring.

True False 6. Some people lick brightly colored frogs

to get high.

True False 7. Expecting someone to quit drugs without

treatment and never use again is extremely

realistic.

True False 8. Smoking is associated with wrinkles,

yellow teeth, bad breath, stinky clothes, and

bear bites.

True False 9. All drug and alcohol recovery programs

are the same.

True False 10. In Zambia, people ferment human waste

to get high.

Decide whether the following statements are True or False. The answers are found on pages 10-15.

Page 4: Introduction · 2021. 1. 21. · True False 57. Stilton cheese can cause extremely frightening psychedelic dreams. It comes from England and smells like feet. True False 58. Potential

Kim Rosenthal, MD OTB Recovery Quiz Two 4

True False 11. Smokeless tobacco does not cause cancer.

True False 12. Reindeer urine contains psychoactive properties due to Fly Agaric mushrooms, a

common diet staple of wild reindeer.

True False 13. Opioid use and addiction is linked to 50% of all major crimes and violent crimes.

True False 14. Singapore gives random drug tests to tourists and locals before they can enter the

country. They must be negative or they’re denied entry.

True False 15. Repeated drug use can reset the brain’s pleasure meter, so that without the drug, you

feel hopeless and sad. Eventually your brain finds it impossible to feel joy.

True False 16. Babies can’t become physically addicted to a drug through breast milk.

True False 17. Alcohol kills one person every

ten seconds worldwide.

True False 18. 20% of rock star deaths are

related to drugs or alcohol.

True False 19. Ecstasy increases blood pressure,

taxes the heart, raises body

temperature, and bad taste in shoes,

all of which can lead to kidney, liver,

and heart failure, strokes, seizures,

and death.

True False 20. In Ohio, it’s illegal to get a fish

drunk.

Decide whether the following statements are True or False. The answers are found on page 10-15.

Page 5: Introduction · 2021. 1. 21. · True False 57. Stilton cheese can cause extremely frightening psychedelic dreams. It comes from England and smells like feet. True False 58. Potential

Kim Rosenthal, MD OTB Recovery Quiz Two 5

Decide whether the following statements are True or False. The answers are found on page 10-15.

True False 21. Bees that are high on cocaine make excessive, super-charged honey.

True False 22. Animals, including humans, can become so addicted to drugs that they choose

drugs over food.

True False 23. Chronic alcohol consumption can cause vitamin deficiencies, anemia, excessive

growth of hair on the back, permanent problems walking, double chin, heart failure,

liver failure, hematemesis (vomiting blood), ascites (loose fluid in the abdomen),

brain failure (dementia), esophageal cancer, mouth cancer, liver cancer, and

gullibility.

True False 24. During the CIA’s experiments in brainwashing/mind control, a mental health

patient was subjected to 174-day acid trip.

True False 25. If someone has passed out from drinking, put them to bed.

True False 26. Heavy alcohol consumption

increases risk of breast cancer.

True False 27. If you’re using medication-

assisted therapy (like Methadone,

Suboxone, Campral, or Revia),

you’re not really sober.

True False 28. Addicts can be identified

easily because they are poor and

homeless.

True False 29. People with addiction usually

see the light when consequences

get bad enough.

True False 30. Every year, 24 Americans die

after being hit with

a champagne cork when opening

the bottle.

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Kim Rosenthal, MD OTB Recovery Quiz Two 6

Decide whether the following statements are True or False. The answers are found on page 10-15.

True False 31. If you ask Siri on your i-phone, “How many bottles of beer are there on the wall?”

she will sing the entire “100 bottles of beer on the wall” song.

True False 32. Vodka is great for removing foot odor.

True False 33. More teens die from abusing prescription drugs than heroin or cocaine.

True False 34. It takes five minutes for alcohol to reach your bloodstream.

True False 35. In Singapore, possessing narcotic drugs is punished by the death penalty.

True False 36. Every year over 100,000 babies

are born addicted to cocaine in the

USA.

True False 37. Alcohol and drugs contribute to

over 50% of all suicides.

True False 38. Alcohol and drugs contribute to

over 80% of all domestic violence

cases.

True False 39. Some users take alcohol rectally,

called “plugging.”

True False 40. Methamphetamine use can lead to

issues with concentration, memory

and learning, problems seeing the

color red, and stroke.

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Kim Rosenthal, MD OTB Recovery Quiz Two 7

True False 41. There’s no worm in tequila.

True False 42. When mixed with coffee, sprinkling crushed marijuana leaves over dead flowers

can bring the flowers back to life again.

True False 43. Types of substance abuse treatment include 12-step, cognitive behavioral therapy,

Matrix Model, Self-Management and Recovery Training (SMART), mindfulness, and

bat-bear therapy.

True False 44. Each day, 140 Americans die from a drug overdose.

True False 45. Somebody is selling cocaine laced with an opioid called Fentanyl. Cocaine

addicts are accidently overdosing and dying because of this.

True False 46. There’s a spider called Spiderus Hallucinogenesis (The Leg Spider) whose legs

have frightening hallucinogen properties if you swallow them with lemon juice.

True False 47. Pre-corroboration and

Corroboration are the first two

Stages of Change in addiction

recovery.

True False 48. Withdrawal from opioids is

excruciating and miserable but not

life-threatening.

True False 49. Purdue Pharma paid over 600

million dollars for intentionally

masking the risks of OxyContin,

an opioid that is highly addictive.

The company makes a billion

dollars/year.

True False 50. Naloxone is a drug that

reverses the effects of opioids like

heroin. It can save lives after an

overdose.

Decide whether the following statements are True or False. The answers are found on page 10-15.

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Kim Rosenthal, MD OTB Recovery Quiz Two 8

True False 51. Bath salts can cause people to crave and eat human flesh.

True False 52. Studies show that smoking cannabis/pot as a teenager can chronically lower IQ.

True False 53. The only goal of recovery is to be clean and sober.

True False 54. Radiological studies show that drugs and alcohol can cause anatomical injuries to

brain.

True False 55. In Bhutan, marijuana grows wild, but nobody smokes it.

True False 56. According to the Department of Health and Human Services, 92,000 children

entered the foster system in 2016 because of the opioid crisis, i.e. due to neglect,

abuse, or losing parents because of opioids.

True False 57. Stilton cheese can cause

extremely frightening

psychedelic dreams. It comes

from England and smells like

feet.

True False 58. Potential side effects of

cocaine include bruxism, low

sex drive, hallucinations of

insects crawling under the skin,

high blood pressure,

depression, irregular heart rate,

heart attack, brain

bleeds/stroke, and death.

True False 59. Marijuana was discovered

in 1673 by sisters Mary and

Jane.

True False 60. Smoking marijuana during

pregnancy produces a happy-

go-lucky baby.

Decide whether the following statements are True or False. The answers are found on page 10-15.

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Kim Rosenthal, MD OTB Recovery Quiz Two 9

True False 61. Empress Catherine I from Russia banned men from drinking alcohol but not

women.

True False 62. Snake venom is a drug of abuse.

True False 63. You must hit bottom to quit using drugs and alcohol.

True False 64. You’re only sober if you’re in Alcoholics Anonymous.

True False 65. Buprenorphine is used to treat heroin addiction. It doesn’t cause as much of a

high as heroin and can cause withdrawal if mixed with other opioids.

True False 66. Marijuana can cause paranoia

and psychosis with heavy use.

True False 67. Sharing straws to use cocaine

does NOT spread infections like

Hepatitis C. The only ways you

can get Hepatitis C is through

needles and sex.

True False 68. Rapid detox from opioids

involves anesthesia.

True False 69. There’s only one way to

recover from addiction.

True False 70. Relapse is a normal part of

recovery.

Decide whether the following statements are True or False. The answers are found on page 10-15.

Page 10: Introduction · 2021. 1. 21. · True False 57. Stilton cheese can cause extremely frightening psychedelic dreams. It comes from England and smells like feet. True False 58. Potential

Kim Rosenthal, MD OTB Recovery Quiz Two 10

Answers 1. False. Marijuana messes up a spider’s web-weaving abilities. See below.

2. True. The experience is called formication and can be extremely itchy and distressing.

People sometimes dig deep holes in their skin trying to get the bugs out. This is seen in both

cocaine and amphetamines.

3. False. Shaming, detachment, and confrontation have been shown to do more damage than

good. Instead, some families use the CRAFT approach, which involves empathy, compassion,

and positive reinforcement but allows for natural consequences. CRAFT stands for

Community Reinforcement and Family Training. Look it up!

4. True. A 2015 Yale study found that, when treated with a medication called Buprenorphine,

emergency room patients with opioid addiction were far more likely to be in treatment 30 days

later than patients who were just given a brochure on resources. Like Methadone,

Buprenorphine is a medication used to treat opioid addiction.

5. True. If you win 3 million dollars, don’t finance a methamphetamine trafficking ring.

6. True. Amphibians of the Bufonidae family secrete poison through their skin that coats their

necks and backs, protecting them from predators. When humans lick this poison, it can cause

psychoactive effects like hallucinations. However, licking wild animals is inherently

unsanitary and may also lead to medical complications, like infections, poisoning (if you lick

the wrong frog), and death. Please don’t lick frogs.

7. False. If it were that easy, you would have quit long time ago. But what makes it so difficult

for an addict to stop using? (Turns out chemical dependency is a brain disease that makes

people need and crave a chemical even when it’s bad for them.)

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Kim Rosenthal, MD OTB Recovery Quiz Two 11

Answers (continued)

8. False. All side effects are true except for the bear. However, we recommend you don’t

smoke near bears.

9. False. How do programs vary? There are many types, depending on location, focus,

population treated, length of stay, etc. Examples of recovery programs include 12-step,

religion-based, holistic, harm-reduction, medical-model, Matrix-model, SMART (Self-

management and Recovery), and farm, work, and wilderness programs.

10. True. Human waste is collected from sewers and bottled up for several weeks. Upon

opening the bottle, a balloon is attached to the top and fermented gas fills it, which can then be

detached and inhaled. This gas reportedly causes hallucinations. Don’t try this at home.

11. False. Chewing tobacco and snuff cause oral, throat, and upper respiratory cancers.

12. True. Fly-Agaric mushrooms have psychoactive effects when eaten raw but also cause

nausea and vomiting. When the mushrooms pass through a reindeer’s urinary system, the

mushroom apparently loses the nauseating side effect. We’re not sure how users collect

reindeer urine but find the idea rather distasteful.

13. True. All drugs are linked to increased levels of crime (including alcohol and marijuana),

but heavy opioid use has the highest rate of serious and violent crimes.

14. True. Singapore gives random drug tests to tourists and locals before they can enter the

country. As an aside, possessing chewing gum, not flushing the toilet, and littering are all

illegal. Disciplinary action and crimes are often dealt with by caning, and canes can readily be

bought by parents in most grocery stores.

15. True. Drugs trigger the brain’s pleasure center until it stops working properly. Eventually

the user finds it impossible to feel joy. This effect can last months to years after quitting.

16. False. Babies can become physically addicted to a drug through their mother’s breast milk.

They experience withdrawal when they stop breastfeeding.

17. True. Alcohol kills one person every ten seconds worldwide.

18. False. 31% (not 20%) of rock star deaths are related to drugs or alcohol.

19. False. Ecstasy does everything except the shoe-taste thingee. People high on ecstasy tend

to dance excessively and NOT drink enough fluid. They overheat and, along with high blood

pressure and taxing the heart, they have muscle breakdown and liver & kidney failure. This

often leads to death.

20. True. Please don’t feed fish alcohol. Don’t do it!

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Kim Rosenthal, MD OTB Recovery Quiz Two 12

Answers (continued)

21. False. Bees that are intoxicated with cocaine tend to over-estimate the amount of honey

they’ve made, causing a shortage during winter and eventually colony death.

22. True. Lab animals often choose drugs over food. As an aside, when offered multiple drug

options, different animals of the same species frequently have their own “drug of choice,”

much like humans. Scientists are still trying to figure out the mechanism by which an

individual gets hooked on one drug instead of another. This has huge treatment implications.

23. False. All are true except the back hair and double chin. Gullibility is a matter of opinion.

24. True. The CIA ran hundreds of experiments on various subjects: college students, mental

health patients, men who visited prostitutes, prisoners, even random people off the street. One

man, Whitey Bulger, jailed for armed robbery and hijacking, was given LSD on a near daily

basis and had frightening hallucinations for 15 months – without being told what it was. He

thought he was taking an experimental drug to cure Schizophrenia.

25. False. Someone who is unconscious from drinking too much alcohol might not be able to

protect their airway and could potentially die. If you find someone passed out because of

alcohol, consider calling an ambulance.

26. True. Alcohol increases the risk of mouth, throat, esophagus, larynx (voice box), liver, and

breast cancer.

27. False. Medication-assisted treatment promotes abstinence and recovery. It involves using

a prescribed medication, along with counseling and behavioral therapy, as part of one’s

recovery plan. The prescribed medication helps reduce or avoid drug misuse, reducing

intoxication, cravings, and dangerous drug-seeking behaviors.

28. False. People say that addicts come from all walks of life, that you can’t recognize an

addict by the way they look. Substance abuse affects all walks of life, ranging from nuns to

teachers to elementary school students to lawyers to millionaires… Why is this?

29. False. Even when consequences get serious, people with addictions often don’t stop using.

That’s part of addiction.

30. True. More people die from cork missiles every year than from spider bites. This is partly

because a champagne cork leaves a bottle at over 55mph – that’s enough to break glasses, a

phone screen, or a champagne bottle!

31. False, we think. We’ve never tried it.

32. True.

33. True. The Center for Disease Control (CDC) reports that more people (including

teenagers) die from prescription drugs than from illegal drugs like heroin or cocaine.

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Kim Rosenthal, MD OTB Recovery Quiz Two 13

Answers (continued)

34. False. Alcohol is absorbed through the lining of your mouth and stomach and hits the

blood stream in less than 90 seconds.

35. True. In Singapore, possessing or using narcotic drugs is punishable by the death penalty,

unless you’re lucky enough to receive life imprisonment and caning (corporal punishment).

36. True. After birth, drug-addicted babies can develop a neonatal abstinence syndrome, with

irritability, vomiting, diarrhea, problems feeding, and sweating. They can also have long-term

problems, like mental retardation, developmental delays, and behavioral problems.

37. True. This statistic is scary.

38. True. This statistic is even scarier than 37.

39. False. People typically don’t take alcohol rectally.

40. False. All are true except for problems seeing the color red. Long-term methamphetamine

use can damage the brain permanently.

41. True. There is no worm in tequila. The worm is in mezcal, and it’s not a worm, it’s a

caterpillar. The practice of adding a caterpillar to mezcal started in 1950 and was likely a

marketing gimmick.

42. False. Marijuana and coffee don’t bring flowers back to life.

43. False. All are real examples except “bat-bear” therapy. Cognitive behavioral therapy

(CBT) involves changing thoughts and actions to promote recovery and health. Matrix model

uses CBT, coping skill training, and mentoring to help people get past stimulant use disorders.

SMART is a 12-step-like group-oriented therapy that focuses on skills-training and

socialization. Mindfulness is a skill that allows the practitioner to appreciate the moment. This

is a partial treatment list!

44. True. 140 individuals die from drug overdose every day, 91 of them from opioids. Opioid

deaths have quadrupled in the past 30 years.

45. True. Fentanyl is a major cause of death among addicts. It’s 80-100 times stronger than

morphine. People who unwittingly take Fentanyl often die before help is available.

46. False. Please don’t try this.

47. False. Corroboration ain’t a stage. The real Recovery Stages of Change include Pre-

contemplation (“Don’t want to quit”), Contemplation (“Maybe ready to quit”), Preparation

(“Getting ready to quit”), Action (“I’m quitting”) and Maintenance (“Been quit a while”).

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Kim Rosenthal, MD OTB Recovery Quiz Two 14

Answers (continued)

49. True. The company makes billions of dollars/year but only paid 600 million dollars’ worth

in fines.

50. True. Also called Narcan, Naloxone is used to reverse opioid overdose. It’s a good idea for

actively using opioid addicts to have Narcan available. Opioids include heroin and prescription

pills like Oxycontin, Percocet, Methadone, and Buprenorphine.

51. True. There are reported cases of people eating parts of themselves and others while high

on bath salts.

52. True. Weed is bad for the developing brain.

53. False. The goal of recovery is to become a fully-functioning individual able to live an

authentic life without relying on drugs or alcohol to live that life. Okay, it’s probably more

than that. How do you define recovery?

54. True. Some changes are permanent.

55. True. It’s used as a feed for pigs.

56. True. That’s almost 100,000 kids removed from their parents!

57. True. Best to avoid.

58. True. All are true.

59. False. Marijuana was probably first grown about 2500 years ago, although some reports

suggest it goes back 5000 years.

60. False. There’s no happy-go-lucky baby about it. According to some studies, smoking

marijuana during pregnancy can cause low birth rate, delayed development, chronic problems

with concentration, and difficulty learning.

61. False. Empress Catherine I from Russia banned women from drinking alcohol, not men.

62. True. Also called recreational envenomation, users purposefully get bitten by snakes.

63. False. The idea that an addict must hit bottom to want to quit is a harmful belief, as it can

make a person delay treatment until the consequences are severe. It’s very possible to quit

drugs without losing everything, and many people do. It’s just as possible to not quit drugs

despite devastating consequences.

64. False, we say. There are dozens of routes to sobriety. Some might not agree. What do you

think?

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Kim Rosenthal, MD OTB Recovery Quiz Two 15

Answers (continued)

65. True. Buprenorphine is an example of harm-reduction. It is part of the medication

Suboxone. When a heroin addict is started on Buprenorphine, they often (1) engage in fewer

drug-seeking/criminal behaviors, (2) use less heroin than they would without it, and (3) stop or

reduce the need for needles, which lowers the risk of viral hepatitis, HIV, infections, and

death. Suboxone can also cause withdrawal if mixed with other opioids, making it less likely

the addict will continue using.

66. True. Marijuana can cause paranoia and psychosis with long-term, heavy use.

67. False. Hepatitis C is most often spread via needles, sex, and transfusions. It can also be

passed on by sharing straws or rolled up dollar bills to snort cocaine; cocaine causes damage

and bleeding in the nasal passage, tinging the straw or bill with droplets of blood and exposing

others to Hepatitis B and C.

68. True. Medical opioid detoxification is a medical procedure by which a person is rapidly

withdrawn from opioids while under sedation. It’s best done in an intensive care unit.

69. False. Some might disagree, but life is complicated. What do you think?

70. Ah, this is a tricky one. Say yes, and people believe it’s just part of recovery and use it as

an excuse to relapse. Say no, and there’s infinite shame and bewilderment after each relapse.

Let’s say it’s sort of true but not really. Relapse happens, but it doesn’t have to be part of

recovery. But if you do relapse, tell yourself it’s okay, pick yourself up, and start over.

END OF ANSWERS.

Do you have any True/False statements you’d like to see included in the Outside-the-Box

Recovery Booklet Three when it comes out? Send your statement, the answer, and an

explanation to [email protected]!

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Kim Rosenthal, MD OTB Recovery Quiz Two 16

About the Author

When not writing True/False quizzes, Kim Rosenthal practices life as a psychiatrist at a state

hospital in North Carolina. She’s known for her arm-flailing, humored “live life!” lectures and

often has fireside chats with her patients, topics ranging from the woes of heroin to opening a

business or understanding Mandela.

The author has spent most of her career as a travelling doctor. She holds medical licenses in

North Carolina, Maine, and Hawaii, and has cared for 10’s of thousands of patients over the

years in many settings — including hospitals, clinics, detox centers, residential rehabs, ACT

team programs (home-visiting teams), emergency rooms, forensic settings, nursing homes, as

well as at VA centers serving our veterans. She’s board-certified by the National Board of

Psychiatry and Neurology and has a medical degree equivalent in Spain.

Dr. Kim is currently working on a publication for recovering addicts. It’s called the Outside-the-

Box Recovery Workbook and accompanies the reader on a 30-day journey through a world of

sobriety. It’s hard work. It’s also creative and entertaining and splashed over with artwork.

Worksheets range from “Why Quit” and “Dealing with Guilt” to alter egos, art therapy, puzzles,

strange scenarios, and movie-writing.

If you want to read more by Dr. Kim, check out kimrosenthalmd.com. The site includes 110+

mental health posts, half a dozen free and low-cost recovery e-booklets (like this one), a couple

videos, plus information on the Outside-the-Box Recovery Workbook.

Page 17: Introduction · 2021. 1. 21. · True False 57. Stilton cheese can cause extremely frightening psychedelic dreams. It comes from England and smells like feet. True False 58. Potential

Kim Rosenthal, MD OTB Recovery Quiz Two 17

That’s all,

folks!

See you next time, next booklet…

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