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1. Have I ever been arrested or hospitalized
after drinking alcohol and/or using drugs?
2. Have I ever used more than I intended?
- Did I do it
more than once...twice…three times?
3. Have I ever made a resolution to control my
use of alcohol and/or drugs?
- How did that
work?
- Was I able to
consistently control it?
4.
Have I ever quit on a voluntary basis?
5. For how long did I stop? Did I stay
stopped? What was I
thinking or feeling just before I began using again?
6. Have I ever been asked to quit or cut down?
- By spouse?
- By
family member?
- By employer?
- By clients?
- By court?
- By
attorney?
- By doctor?
- By
therapist/counselor?
7. Have I ever experienced lapses in memory
(blackouts) while drinking
alcohol or using drugs?
8. Have I ever had an accident (car, falls, etc)
after drinking or using drugs?
9. Have I ever lost a job or a relationship
related to use of alcohol or drugs?
10. Have I ever been embarrassed by my behavior when
drinking or using drugs?
11. Do I ever hide my drinking or drug use from
anyone…significant
other…doctor…employer…therapist?
12. Do I ever drink alcohol in the morning?
13. After drinking heavily the day before, have I ever
began drinking the next day to feel better?
14. Do I ever use alcohol or drugs to wake up, go to
sleep, increase or decrease my energy?
15. Do I ever feel a need for alcohol or drugs to feel
OK, especially in social situations?
16.
Have I ever hurt or threatened anyone when drinking
alcohol or using drugs
17.
Do I ever have a strong physical or emotional craving
for alcohol or drugs?
18.
Do I ever drink alcohol or use drugs alone?
19.
Does using alcohol or drugs ever interfere
with the quality of any aspect of my life?
20.
Does my drinking or drug use ever make me
unhappy
or remorseful? |