Self-Assessment
Self Assessment: An Alcohol and Drug Abuse Questionnaire*
The following list of questions is important to consider in assessing your own use of alcohol and other drugs. If you answer YES to more than three of these questions (or are concerned about someone you know), you should seek help.
| Yes | No | |
| 1. Have you ever cut classes in order to drink or use drugs or because of the after effects? | ||
| 2. Do you drink or use drugs while studying? | ||
| 3. Have you ever done poorly on an exam or assignment because of drinking or using drugs? | ||
| 4. Have friends or family ever told you that you drink too much or complained about your drug use? | ||
| 5. Have you ever lost a friend or has a relationship suffered from your drinking or drug use? | ||
| 6. Have you ever done or said anything while drinking or using drugs that you later regretted? | ||
| 7. Do you urge friends to drink or use drugs so that you won’t stand out? | ||
| 8. Have you begun to associate with a heavier drinking group of friends or a group that uses drugs? | ||
| 9. Have you ever been hurt while drinking or using drugs? | ||
| 10. Have you ever awakened after drinking or using drugs and wondered what happened the night before? | ||
| 11. Do you ever feel guilty about your use of alcohol or other drugs? | ||
| 12. Do you drink or use drugs to forget your problems? | ||
| 13. Do you drink or use drugs to feel more confident? | ||
| 14. Have you ever been broke or gone into debt because you spent money on alcohol or other drugs? | ||
| 15. Have you ever destroyed or damaged property while drinking? | ||
| 16. Do you ever drive while drinking or using drugs? | ||
| 17. Have you ever been in trouble with College authorities because of alcohol /drug
use or because of something you did while under the influence? |
||
| 18. Do you use more than you planned? | ||
| 19. Do you ever have difficulty stopping once you’ve started drinking or using drugs? | ||
| 20. Do you find yourself drinking or using drugs when you first wake up? | ||
| 21. Do you drink or use drugs while alone? |
*Courtesy of Dartmouth College; permission to reproduce.
