Worried About Your Alcohol Or Other Drug Use?

If you are worried about your alcohol or other drug use, you could fill out the no-obligation free test below.

 

DSM-IV Diagnosis – Alcohol and other Drugs

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The following questions ask about your alcohol and/or other drug use in the past 12 months. Please answer them by selecting a response for each question from the drop-down boxes below.

If you are in prison, please refer to the 12-month period immediately before you were locked up; that is, the last time you were in the “free world.”

Also, alcohol is a drug. Your answers to questions about drug use need to include alcohol use, such as drinking beer or wine.

 

Admin

 

During the last 12 months (before being locked up, if applicable) –

Questionnaire
 

 

 

 

 

 

 

 

 

 

 

 

 

Question 11: Drug Use in Last Month

How often did you use each type of drug during the last month?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Thank you for completing this questionnaire


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