Alcohol Addiction Self-Assessment Questionnaire

Alcohol Addiction Self-Assessment

This one-minute questionnaire will help you identify the triggers behind your alcohol addiction and offer doable solutions, in just two simple steps.

This questionnaire can give you an insight into your drinking problem if you’re a:

  • male drinking more than 2 alcoholic beverages every month.
  • female drinking more than 1 alcoholic beverage every month.

Note: We take your privacy very seriously, so please give honest answers. We’ll never sell or share your personal info, read our privacy policy for more details.

Welcome to your Alcohol Screening

Name

Email


male or Female icon

Q1. You are:





Q2. How often do you drink alcoholic beverages?



*Here is what we mean by an alcoholic beverage. Please give an answer based on following standard drink sizes.
• Regular beer (12 ounces).
• Table wine (5 ounces).
• 80-proof Distilled spirits (1.5 ounces).
• Malt liquor (8-9 ounces)
This table will help you determine the standard size of different alcoholic beverages.





Q3. On a typical day when you're drinking, how many alcoholic drinks do you have?

Q4. How many times do you have 6 or more drinks in one sitting?

Q5. How often in the last 12 months did you end up drinking more than you intended?

Q6. How often in the last 12 months have you failed to fulfil your responsibilities because of drinking?

Q7. How often in the last 12 months you had to have a drink in the morning after a drinking session, just to keep yourself going?

Q8. In the last 12 months, how often have you felt guilty after drinking?

Q9. In the last 12 months, how often have you failed to remember what happened last night due to the hangover?

Q10. Have your drinking habits caused injury to you or anyone around?

Q11. Has there been an incidence where a friend, relative, healthcare worker or your doctor has suggested you to try to cut down on your drinking habit?


Be sure to click Submit Quiz to see your results!



Disclaimer: The information available at AddictionResource.com is not a substitute for professional medical help.