Alcohol and Drug Assessment Questionnaire (free version)

Assessment SheetPlease answer the questions below. Your answers will determine a final score, which will be totaled instantly upon completion as well as recommendations for further alcohol and/or drug education. This is a FREE alcohol and drug assessment and is meant to be used for educational purposes only. If you need a formal alcohol assessment or evaluation, please contact our office.

Please answer each question with a single answer. After you have completed the assessment, press the Submit Answers button and we will instantly show you your assessment results.

Your Information

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Assessment Questions

1. Do you drink or use drugs the most when you are stressed, depressed or life isn't going well at the time?
2. Are you able to drink/use more now than when you first started?
3. Do you ever "black out" or forget about things that happened while you were using?
4. Do you ever “sneak” a drink when other people aren’t aware of it?
5. Do you ever get nervous or uncomfortable if alcohol or drugs are not accessible?
6. Are you feeling the need to start drinking or using early in the day?
7. I often have a hard time knowing or understanding how others feel or how my behavior might be affecting them
8. My internal dialog is often negative and I often tell myself how stupid I am or other are
9. Are you noticing any problems with your memory?
10. Do you feel the need to keep drinking or using even when others have stopped?
11. I often get enraged when driving.
12. When you’re completely sober, do you often reflect on your behavior when you were under the influence and regret it?
13. Have you noticed that you are feeling depressed or anxious before or after you drink or use?
14. Have you ever had a DUI, DWI or other legal issue related to your drinking or using drugs?
15. Do you find yourself trying to quite but simply break the commitment each time?
16. Do you avoid loved ones when you are using?
17. Is your drinking or using affecting your ability to function normally at work, school, home or with friends and family?
18. Have you been told by a doctor that your using is dangerous or harmful and you need to stop?
19. Do you find that you don’t eat much when you are using?
20. Have you ever had the “shakes” when you wake up in the morning and decide having a small amount of alcohol or drugs helps to alleviate this?
21. Have you noticed that you need more to get the same buzz?
22. Are there situations where you have been drunk or high for more than one day at a time?
23. Have you sought help for your usage?
24. Has your using ever caused you to see or hear things that aren’t there?
25. Do you have any relatives that are addicts?
26. Is your use creating general health problems?
27. Have you ever lost a job or been fired as a result of your using?
28. Has your drinking or drug use affected your sexual functioning?