Alcoholism - Substance Abuse Self-Assessment Quiz

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Substance Abuse Self-Assessment Quiz

Alcoholism

DO YOU HAVE A DRINKING PROBLEM?

Take this questionnaire to determine if it is a problem for you.

1. Do you feel you are a normal drinker? ("normal" - drink as much or less
than most other people)
Yes No

2. Have you ever awakened the morning after some drinking the night before and found that you could not remember a part of the evening?
Yes No

3. Does any near relative or close friend ever worry or complain about your drinking?
Yes No

4. Can you stop drinking without difficulty after one or two drinks?
Yes No

5. Do you ever feel guilty about your drinking?
Yes No

6. Have you ever attended a meeting of Alcoholics Anonymous (AA)?
Yes No

7. Have you ever gotten into physical fights when drinking?
Yes No

8. Has drinking ever created problems between you and a near relative or close friend?
Yes No

9. Has any family member or close friend gone to anyone for help about your drinking? Yes No

10. Have you ever lost friends because of your drinking?
Yes No

11. Have you ever gotten into trouble at work because of drinking?
Yes No

12. Have you ever lost a job because of drinking?
Yes No

13. Have you ever neglected your obligations, your family, or your work for two or more days in a row because you were drinking?
Yes No

14. Do you drink before noon fairly often?
Yes No

15. Have you ever been told you have liver trouble such as cirrhosis?
Yes No

16. After heavy drinking have you ever had delirium tremens (D.T.'s), severe shaking, visual or auditory (hearing) hallucinations?
Yes No

17. Have you ever gone to anyone for help about your drinking?
Yes No

18. Have you ever been hospitalized because of drinking?
Yes No

19. Has your drinking ever resulted in your being hospitalized in a psychiatric ward? Yes No

20. Have you ever gone to any doctor, social worker, clergyman or mental health clinic for help with any emotional problem in which drinking was part of the problem?
Yes No

21. Have you been arrested more than once for driving under the influence of alcohol? Yes No

22. Have you ever been arrested, even for a few hours because of other behavior while drinking?
Yes No

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Call to see if yours will cover the cost of your treatment.

California Certified Alcohol and Drug Program #370101AP

Call for help (858) 453-4315

6046 Cornerstone Court W. #113

San Diego, CA 92121