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Substance Abuse - Screening Tool

Should I be concerned that I may have an alcoholic/drug problem?

  1. Do you lose time from work due to drinking/drugging?
  2. Is drinking/drugging making your home life unhappy?
  3. Do you drink/use drugs because you are shy with other people?
  4. Is drinking/drugging affecting your reputation?
  5. Have you ever felt remorse after drinking/drugging?
  6. Have you ever got into financial difficulties as a result of drinking/drugging?
  7. Do you turn to lower companions and an inferior environment when drinking/drugging?
  8. Does drink/drug make you careless of your family welfare?
  9. Has your ambition decreased since drinking/drugging?
  10. Do you crave for a drink/drug at a definite time daily?
  11. Do you want a drink/drug the next morning?
  12. Does drinking/drugging cause you to have difficulty in sleeping?
  13. Has your efficiency decreased since drinking/drugging?
  14. Is drinking/drugging jeopardizing your job or business?
  15. Do you drink/drug to escape from worries or trouble?
  16. Do you drink/use drugs alone?
  17. Have you ever had a complete loss of memory as a result of drinking?
  18. Has a physician ever treated you for drinking?
  19. Do you drink to build up your self-confidence?
  20. Have you ever been in a hospital or institiution on account of drinking?