Q1. You are:

Male

Female

None

Q2. How often do you use drugs, for reasons other than any medical issue or at higher doses than recommended?

Monthly (or Less)

2-4 times a month

2-3 times a week

4 or more times a week

None

Q3. How often in the past 12 months have you abused the prescription given by your doctor?

Never

Once or twice during the last year

Less than once a month

At least once a month

None

Q4. How often in the last 12 months have you failed to fulfil your responsibilities because of drugs?

Never

Once a month or less

Monthly

Weekly

Daily (or almost daily)

None

Q5. Do you ever have "blackouts" or periods you can't remember while using drugs or drinking?

Never

At least once, during the past one year

More than three times during the past one year

None

Q6. How often during the last 12 months did you feel guilty because of taking drugs?

Never

Less than monthly

Monthly

Weekly

Daily (or almost daily)

None

Q7. During the last 12 months, has a friend, relative, colleague, health-care worker or doctor suggested you to quit?

No

Yes, but not in the past one year

Yes, during the past one year

None

Q8. Do you crave to use drugs at least once in three days?

No

No, but I crave to use drugs at least once in nine days.

Yes.

None

Q9. How often have you used illegal drugs?

Never

Just a few times (and not on the past one year)

One or more times in the past one year

Once a month

None

Q10. During the past 12 months, did you participate in illegal activities to get your drugs?

Never

I did, but not in the past 12 months

Yes

None

Q11. Do you ever experience medical issues including, but not limited to, seizures, flashbacks and blackouts that (in your opinion) are related to your drug use?

No

Maybe once or twice in the past one year

Monthly

At least once a week

None

Archives: Quizzes & Surveys

Drug Addiction Self-Assessment

Alcohol Screening

Q1. You are:

Q2. How often do you drink 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?

Your addiction does not have to define who you are.

You deserve excellent care and a rewarding life in recovery.

Q1. You are:

Q2. How often do you drink 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?

Disclaimer

Disclaimer

Your addiction does not have to define who you are.

You deserve excellent care and a rewarding life in recovery.