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Drug & Alcohol Self Assessment Quiz

  • Do you drink or use to overcome shyness or to feel more confident? * Required
  • Are you having money troubles because of drinking or using? * Required
  • Do you ever stay home from work because of drinking or using? * Required
  • Is drinking or using causing trouble in your family? * Required
  • Is drinking or using giving you a bad reputation? * Required
  • Have you lost a job or a business because of drinking or using? * Required
  • Do you drink or use to escape your problems? * Required
  • Do you drink or use when you are alone? * Required
  • Do you have blackouts? (Loss of memory for events that happened or of actions you performed while drinking or using?) * Required
  • Do you feel remorse after drinking or using? * Required
  • Do you need a drink at a definite time every day? * Required
  • Do you drink in the morning? * Required
  • Have you ever been in a hospital because of drinking or using? * Required
  • Has a doctor ever treated you for your drinking or using? * Required
  • Do you drink or use too much at the wrong time? * Required
  • Do you make promises to yourself or others about your drinking or using? * Required
  • Do you have to keep on drinking or using once you have started? * Required
  • Is drinking or using making it hard for you to sleep? * Required
  • Have you had an accident because of drinking or using? * Required
  • Do you drink or use to relieve the painfulness of living? * Required
  • Do you have trouble disposing of cans or bottles? * Required
  • Are you less particular about people you are with and the places you go when you are drinking or using? * Required
  • Have you been arrested more than once for drunk driving or driving under the influence of drugs? * Required
  • Has drinking or using affected your health? * Required

Putting Patients on the Path to Recovery