Can't find what you are looking for? Try my
Search Page
| |
The questions asked in this test describe things that happen to people who are addicted to alcohol or
drugs. Completing this questionnaire will help you to see if you might be addicted and if so, how
serious your problem may be. This test is not meant to replace a formal assessment by a licensed or
certified addiction treatment professional. It can help you determine if you have a problem. This test is
based on the Jellinek Chart for addiction. The problems described do not happen to people who do
not have a substance use disorder.
Instructions: Read each question and think back over your alcohol and/or drug use history. If you
have had the experience described in the question, mark the check box Yes. If you have never
experienced anything like what is described in the question, mark the check box No. When you have
finished the test, you will see scoring instructions.
This test will take you five to ten minutes to complete.
The test is confidential; Recovery Lane collects no record of this test.
Do you find that you use alcohol or drugs to try and solve your problems and things that bother you?
- Do you find that it is taking more alcohol or more of a drug to achieve the desired effect; than it used to? Has the amount you consume increased significantly over time?
- Are there times that you find it hard to remember what happened when you were using alcohol or drugs? (Example – Can’t remember how I got home last night)
Do you ever hide how much you drink or use from others? This might be because you don’t want others to know how much or how often you are using or because you don’t want to share what you have.
Do you ever feel that in order to have fun or feel good that you must use alcohol or drugs? Do you find that most of the activities you are involved in include drinking or drug use?
Does your first drink or two go down faster than the others in order to get a “quick start?” Do you use drugs more quickly at the beginning of a using episode because you want to “get high” fast?
Do you ever feel guilty about using alcohol or drugs or about the things you do when you are under the influence?
Have others (family, friends, employer, etc.) expressed concern about your drinking or drug use? Do you listen to their concerns or “tune out” the concerns?
Have you experienced repeated times where you could not recall what happened when you were drinking or using and gotten into trouble because of your use?
Have you ever used the problems in your life as an excuse to drink or use drugs? Do you feel you have to use to be able to deal with these problems?
Have there been times that you found yourself drinking or using more than most people? Have you looked for people who drink or use as much as you do so that you “fit in?”
- Have you felt bad about how your drinking or using hurts others? Have you felt that you didn’t know what to do to about it?
Have you ever “shown off” or gotten cocky with others to feel better about yourself? Do you ever feel you must do this to prove you are okay?
Have you ever made promises to yourself or others that you would “shape up” and get your life in order; only to watch your efforts crumble and fail? Have you ever made attempts to quit drinking or using only to return to use again?
Have you ever made attempts to limit or control you use; only to find that in a short time you were right back at it? Have you found yourself drinking or using at times when it was not appropriate?
Have you given up activities and stopped doing things because they don’t involve drinking or drug use?
Have you given up activities, changed jobs, left a relationship, relocated to try and make your life better but it doesn’t make any difference in your pattern of drinking or drug use?
Have you had times where your drinking or using caused work or money problems? Have there been times you couldn’t work because of your use?
Do you avoid old friends or family members that don’t use or don’t approve of your use, unless you really need something or are
forced to interact with them because of a social obligation?
Have there been times that you have not eaten regularly, or not eaten healthy foods when you were drinking or using?
Do you find that you resent others or feel that they are trying to “control” you and your drinking or drug use?
Have you ever found yourself getting ill (withdrawal) because you had to stop drinking or using? Have you had the “shakes,” sweats, nausea, fever, chills or severe depression because you were
deprived of your drugs or alcohol?
Do you find that you avoid making decisions, even about small things, because you are “high” or “wasted” most of the time?
- Have you experienced health problems because of your use? Have you lost weight, feel physically bad, or just have no energy
because of your use?
Have you found that it is now taking less alcohol or drugs than it used to too get high?
Have you found yourself behaving in ways that are very contradictory to the way you were raised or vastly different than your value system? Have you crossed lines and done things you
told yourself you would never do?
Have there been times that you drank or used all the time, whenever you could and don’t even try to live a normal life? Do you spend excessive amounts of time either recovering from you drinking and using or spent lots of time obtaining your drug of
choice?
Have you sought out people who are worse off than you, just so you could feel okay or better about yourself?
Have you found there are times that even when you are not using alcohol or drugs that you find it difficult to function? Do you have a hard time thinking clearly, remembering things, or even doing
things that used to be simple?
Have you had period when you felt a sense of pending doom, that something terrible was about to happen? Have you felt that people were out to do you harm or that you constantly had to be on
guard?
Have there been times that you just “give up” and settle for the way things are? Do you see that your drinking or drug use is the cause of your problems and just wait to see what happens?
Do you ever feel that drinking or using is your whole life? Has getting something to drink or use, using, and getting over the use become your whole existence?
Have you felt that you need a miracle, Devine intervention to save you from yourself?
Have you gotten to the point that you don’t pretend that life will get better; you know you are addicted to alcohol or drugs and believe that it will never change? Have you felt hopeless?
Have you reached a point of desperation and become willing to try anything to find a way out of the insanity of life?
Have you been locked up in jails, hospitals, or mental wards for extended periods of time because of your use of alcohol or drugs? Has you use robbed you of your freedom?
Scoring Instructions:
Go back and count the number of “Yes” answers you had for questions 1-12. If you answered yes to one or more of these questions there are times that you misuse or abuse alcohol or drugs. You are showing increased risk for becoming addicted. The closer your total is to twelve, the more likely that you are in trouble with your use of alcohol or drugs.
Count the number of “Yes” answers you had for questions 13-24. Any yes answers in this section would be a clear indication that you have crossed the line. It is likely that you are already experiencing negative consequences from your use. If you answered yes to three or more of these questions, there is a clear indication that you are addicted to alcohol or drugs. The more yes responses you have in this section the more seriously you are psychologically “hooked.”
Count the number of “Yes” responses to questions 25-37. Yes answers in this section of questions would indicated that your addiction is serious and in the latter stages. Continued use will result or already has resulted in severe consequences. Continued use will only make matters worse, it is just a matter of when. The more yes responses you have in this section, the more likely that you are becoming or already are physically addicted. Your chances of premature death increase with each day that you continue to use alcohol or drugs.
Note: Look back over the questions typed in blue. Think back over just the last year. How many of these things have happened in that time frame? If you answered, “Yes” to three or more of these questions (for the past year), then you meet the diagnosis of substance dependence as written in the DSM-IV (A manual used by physicians, therapists, and counselors to diagnosis addiction.
Author: John W. Stiemke
Copyright © 2000 Recovery Lane All rights reserved.
Revised: October 21, 2000 .
 
|
