Self Test for Alcoholism and Drug Addiction
Please answer yes or no to the following questions:
1. Do you lose time from work due to your drinking or drug use?
2. Is drinking or drug use making your home life unhappy?
3 .Do you drink or use drugs because you are shy with other people?
4. Is drinking or using drugs affecting your reputation?
5. Have you ever felt remorse after drinking or drug use?
6. Have you gotten into financial difficulties as a result of your drinking or drug use?
7. Do you turn to lower companions and an inferior environment when drinking or using drugs?
8. Does your drinking or using drugs make you careless of your family’s welfare?
9. Has your ambition decreased since drinking or using drugs?
10. Do you crave a drink or drugs at a definite time daily?
11. Do you want a drink or drugs the next morning?
12. Does drinking or drug use cause you to have difficulty in sleeping?
13. Has your efficiency decreased since drinking or using drugs?
14. Is drinking or using drugs jeopardizing your job or business?
15. Do you drink or use drugs to escape from worries or troubles?
16. Do you drink or use drugs alone?
17. Have you ever had a complete loss of memory as a result of your drinking or drug use?
18. Has your physician ever treated you for drinking or drug use?
19. Do you drink or use drugs to build up your self-confidence?
20. Have you ever been in a hospital or institution on account of drinking or drug use?
Please contact me for a more comprehensive confidential assessment. 314-956-3139
This test was written at Johns Hopkins University to assess for alcoholism and drug addiction.