Am I Addicted?

A Self Assessment Questionnaire

Answer the following questions honestly to see if you or someone you know has a problem with an addiction to alcohol or drugs.

1. Have you used drugs other than specifically for medical treatment?

Yes          No

2. Have you misused prescription drugs?

Yes          No

3. Have you misused more than one drug at a time?

Yes          No

4. Can you get through the week without using drugs?

Yes          No

5. Are you always able to stop using drugs?

Yes          No

6. Do you misuse drugs on a continuous basis?

Yes          No

7. Do you try to limit your use of drugs to certain situations?

Yes          No

8. Have you had “blackouts” or “flashbacks” as a result of drug use?

Yes          No

9. Does your spouse ever complain about your involvement with drugs?

Yes          No

10. Do your friends or relatives know or suspect that you misuse drugs?

Yes          No

11. Has misuse of drugs created problems between you and your spouse (or parents?)

Yes          No

12.  Has any family member ever sought help for problems related to your use of drugs?

Yes          No

13. Do you ever feel bad about your drug misuse?

Yes          No

Have you ever:

14. Lost friends because of your use of drugs?

Yes          No

15. Neglected your family or missed work because of your use of drugs?

Yes          No

16. Been in trouble at work because of drug misuse?

Yes          No

17. Lost a job because of drug misuse?

Yes          No

18. Gotten into fights under the influence of drugs?

Yes          No

19. Been arrested because of unusual behavior while under the influence of drugs?

Yes          No

20. Been caught driving while under the influence of drugs?

Yes          No

21. Engaged in illegal activities to obtain drugs?

Yes          No

22. Been arrested for possession of illegal drugs?

Yes          No

23. Experienced withdrawal symptoms as a result of heavy drug intake?

Yes          No

24. Had medical problems as a result of your drug use (memory loss, hepatitis, convulsions or bleeding)?

Yes          No

25. Gone to anyone for help for a problem with drugs?

Yes          No

26. Been in a hospital for medical problems related to your use of drugs?

Yes          No

27. Been involved in a treatment program specifically related to drug use?

Yes          No

28. Been treated as an outpatient for problems related to drug dependence or misuse?

Yes          No

Answering “No” to 4, 5, or 7 is equal to one point. For all other questions, each “yes” answer equals one point. A score of six or more is considered reasonable basis for seeking help.

This questionnaire was adapted from Addictive Behavior by H.A. Skinner.