Questions for Clients Regarding Drugs and Alcohol

Please answer the questions as honestly as possible

1. Have you ever felt guilty or ashamed of your drinking and/or drug use?

2. Is drinking and/or using drugs making your home life unhappy?

3. Do you drink and/or use drugs because you are shy around other people?

4. Is drinking and/or drug use affecting your reputation?

5. Have you ever felt remorse after drinking and/or drug use?

6. Have you gotten into financial difficulties as a result of your drinking and/or drug use?

7. Do you turn to lower companions and an inferior environment when drinking and/or using drugs?

8. Does your drinking and/or drug use make you careless concerning the welfare of your family?

9. Is your drinking and/or drug use jeopardizing your job or business?

10. Do you lose time from work due to drinking and/or drug use?

11. Has your ambition decreased since drinking and/or using drugs?

12. Has your efficiency decreased since drinking and/or using drugs?

13. Do you crave a drink and/or a drug at a certain time every day?

14. Do you want a drink and/or drug in the morning?

15. Does your drinking and/or drug use cause you to have difficulty sleeping?

16. Do you drink and/or use drugs to escape from worries or troubles?

17. Do you drink and/or use drugs alone?

18. Have you ever had a complete loss of memory due to drinking and/or drug use?

19. Has a physician or health care provider ever treated you for drinking and/or drug use?

20. Do you drink and/or use drugs to build your self-confidence?

21. Have you ever felt you should cut down on your drinking and/or drug use?

22. Have you ever been annoyed when people have commented on your drinking and/or use of drugs?

23. Do you drink and/or use drugs even when you don’t want to?

24. Do you ever want to stop drinking and/or using drugs?

25. Have you ever been in a hospital or institution due to drinking or drug use?

If you have answered “yes” to any of the above questions, this is your warning that alcohol and/or drugs are negatively affecting your life.

How many questions did you answer “yes” to?

If you have answered “yes”to any 3 of the above questions, your recreational use may be becoming dangerous.

If you’ve answered “yes” to more than 3 questions, you are encouraged to take the next step: seek professional help in determining if you have an alcohol or drug problem from a doctor or drug addiction specialist.

If you have answered “yes” to 4-7 of the above questions, you may be in the early stages of dependency; it’s time to seriously consider stopping.

If you answered “yes” to 7-10 of the above questions, you are becoming dependent, which is very dangerous. It is highly recommended that you seek help right away.

If you answered “yes” to more than 10 of the above questions, you are dependent and it is seriously affecting your life and your wellbeing. It’s time to break out of the cycle and seek professional help!

Source: Based on The Twenty Questions: Are You An Alcoholic? developed in the 1930s by Dr. Robert Seliger, Department of Psychiatry, Johns Hopkins Hospital; intended as a self-assessment questionnaire to determine the extent of one’s alcohol abuse.