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Addiction Quiz

The purpose of this self-test is to give you some insight into whether or not you may have a problem with Alcohol and/or Drugs.  This self-test is not intended to be used for the diagnosis or treatment of any medical or psychological condition. We advise you to consult your doctor about any concerns you may have regarding this questionnaire.

1. Do you lose time from work due to your drinking or drugging? ___Yes ___No

2. Is your drinking/drugging making your home life unhappy? ___Yes ___No

3. Do you drink or drug because you are shy with other people?___Yes ___No

4. Is drinking or drugging affecting your reputation? ___Yes ___No

5. Have you ever felt remorse after drinking or drugging? ___Yes ___No

6. Have you gotten into financial difficulties because of your drinking or drugging? ___Yes ___No

7. Do you turn to lower companions and inferior environment when drinking or drugging?    ___Yes___No

8. Does your drinking or drugging make you careless of your family’s welfare? ___Yes ___No

9. Has your ambition decreased since dinking or drugging? ___Yes ___No

10. Do you crave a drink or a drug at a definite time daily? ___Yes ___No

11. Do you want a drink or drug the next morning? ___Yes ___No

12. Does drinking or drugging cause you difficulty in sleeping? ___Yes ___No

13. Has your efficiency decreased since drinking or drugging? ___Yes ___No

14. Is drinking or drugging jeopardizing your job or business? ___Yes ___No

15. Do you drink or drug to escape from worries or troubles? ___Yes ___No

16. Do you drink or drug alone? ___Yes ___No

17. Have you ever had a complete loss of memory as a result of drinking or drugging?       ___Yes___No

18. Has your physician ever treated you for drinking or drugging? ___Yes ___No

19. Do you drink or drug to build up your self-confidence? ___Yes ___No

20. Have you ever been in a hospital or institution on account of drinking or drugging?   ___Yes___No

This test has been used as a screening tool by Johns Hopkins Hospital and may give you some insight into whether or not you may have a problem with Alcohol and/or Drugs.

For additional information or referrals, submit a confidential inquiry to empower@womensctr.org