Addiction Self-Assessment

Have you used prescription drugs at higher doses than recommended or needed to obtain a new prescription before the due date?

Have you had "blackouts" or "flashbacks" as a result of substances (including alcohol) use?

Have you been arrested for possession of illegal substances (including alcohol)?

Have you engaged in illegal activities in order to obtain substances (including alcohol)?

Have you lost a job because of substance use (including alcohol)?

Have you neglected your family because of your use of substances (including alcohol)?

Are you unable to stop using substances (including alcohol) when you want to?

Have you been in trouble at work because of substance use (including alcohol)?

Has substance use (including alcohol) created problems between you and your spouse or your parents?

Have you ever experienced withdrawal symptoms (felt sick) when you stopped taking substances (including alcohol)?

Does your spouse (or parents) ever complain about your involvement with substances (including alcohol)?

Have you gone to anyone for help for a substance problem (including alcohol)?

Do you use more than one substance at a time (including alcohol)?

Have you had medical problems as a result of your substance use (e.g. memory loss, hepatitis, convulsions, bleeding, etc.)?

Have you gotten into fights when under the influence of substances (including alcohol)?

Have you been involved in a treatment program specifically related to substance use (including alcohol)?

Have you used substances (including alcohol) other than those required for medicinal reasons?

Are you unable to get through the week without using substances (including alcohol)?

Have you lost friends because of your use of substances (including alcohol)?

Do you ever feel bad or guilty about your substance (including alcohol) use?