MRCPsych Paper B: Substance Misuse & Addictions | Questions & Revision
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MRCPsych Paper B · Revision

Substance Misuse & Addictions

Substance misuse is one of the 9 areas assessed in MRCPsych Paper B. Here is what the exam tests, the high-yield subtopics, and worked example questions referenced to New Oxford Textbook of Psychiatry.

What Paper B tests in Substance Misuse

Paper B is a written paper of about 150 questions (single-best-answer MCQs and extended matching items) sat over three hours, blueprinted against the RCPsych syllabus. Questions from this domain typically cover:

  • Alcohol, Detoxification
  • Stimulants & Club Drugs
  • Alcohol, Wernicke-Korsakoff Syndrome
  • Alcohol, Withdrawal
  • Alcohol, Dependence Syndrome
  • Alcohol, Fetal Alcohol Syndrome
  • Opioids, Overdose
  • Opioids, Withdrawal
  • Opioids, Opioid Substitution Therapy
  • Cannabis
  • Stimulants, Cocaine
  • Stimulants, Amphetamines
In our question bank
72 questions in this section (EMIs counted per stem), each with a full explanation and a reference to the recommended text (New Oxford Textbook of Psychiatry). Balanced answer keys, MCQs and EMIs.

Worked example

This is a real question from the Substance Misuse & Addictions section, the kind you will see in Paper B:

Acute cocaine intoxication characteristically produces:

  1. Hypothermia
  2. Sympathomimetic effects: dilated pupils, tachycardia, hypertension and euphoria
  3. Cerebellar ataxia
  4. Pinpoint pupils and respiratory depression
  5. Profound sedation
Answer: B. Cocaine, a stimulant, produces sympathomimetic effects, mydriasis, tachycardia, hypertension, euphoria and increased energy, and carries risks of arrhythmia, myocardial infarction, seizures and stroke. Opioids, by contrast, cause pinpoint pupils and respiratory depression.

How to revise this section for Paper B

Work in short, active blocks: attempt questions first, read the explanation whether right or wrong, and log the subtopics you miss. Our weakness tracker flags any subtopic where you score below 60% so you can target revision rather than re-reading everything. Anchor your reading to the recommended text (New Oxford Textbook of Psychiatry) so your facts match the exam blueprint.

Related revision

See the full MRCPsych Paper A guide or browse all 14 revision sections.

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