The Substance Abuse DSST is one of the more recently refreshed exams. It used to go by the name "Drug and Alcohol Abuse"; so if you come across any study guides for that exam, it's the old version. The subject material itself was updated, but much of the old study guides will still apply. The topics and study recommendations below are all based on the refreshed version. Since this is considered an upper-level exam by most schools, you might be expecting it to be extremely difficult. Thankfully, that’s not really the case. It’s definitely something you should study for—don’t blow it off—but there’s no need to panic. With a reasonable amount of prep, most test-takers find it very manageable.