Substance Abuse Self-Assessment Quiz

1. Have you ever used more cocaine than you planned?
Yes No

2. Has the use of cocaine interfered with your job?
Yes No

3. Is your cocaine use causing conflict with your spouse or family?
Yes No

4. Do you feel depressed, guilty or remorseful after you use cocaine?
Yes No

5. Do you use whatever cocaine you have, almost continually, until the supply is exhausted?
Yes No

6. Have you ever experienced sinus problems or nosebleeds due to cocaine use?
Yes No

7. Do you ever wish you had never taken that first line, hit or injection of cocaine?
Yes No

8. Have you experienced chest pains or rapid or irregular heartbeats when using cocaine?
Yes No

9. Do you have an obsession to get cocaine when you do not have it?
Yes No

10. Are you experiencing financial difficulties due to your cocaine use?
Yes No

11. Do you experience an anticipation high just knowing you are about to use cocaine?
Yes No

12. After using cocaine, do you have difficulty sleeping without taking a drink or other drug?
Yes No

13. Are you absorbed with the thought of getting loaded even while interacting with a friend or loved one?
Yes No

14. Have you begun to use drugs alone or drink alone?
Yes No

15. Do you ever have feelings that people are talking about you or watching you?
Yes No

16. Do you have to use larger amounts of drugs or alcohol to get the same high you once experienced?
Yes No

17. Have you tried to quit or cut down on your cocaine use, only to find that you could not?
Yes No

18. Have any of your friends or family suggested that you may have a problem?
Yes No

19. Have you ever lied to or misled those around you about how much or how often you use?
Yes No

21. Are you afraid that if you stop using cocaine or alcohol, your work will suffer or you will lose your energy?
Yes No

21. Have you been arrested more than once for driving under the influence of alcohol?

Yes No

22. Do you spend time with people or in places you otherwise would not be around, but for the availability of drugs?
Yes No

23. Have you ever stolen drugs or money from friends or family?
Yes No