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How often do you have mood swings
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How often do you smoke a cigarette within an hour after you wake up?
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How often have any of your family members, including parents and grandparents, had a problem with alcohol or drugs?
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How often have any of your close friends had a problem with alcohol or drugs?
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How often have others suggested that you have a drug or alcohol problem?
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How often have you attended an AA or NA meeting?
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How often have you taken medication other than the way that it was prescribed?
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How often have you been treated for an alcohol or drug problem?
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How often have your medications been lost or stolen?
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How often have others expressed concern over your use of medication?
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How often have you felt a craving for medication?
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How often have you been asked to give a urine screen for substance abuse?
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How often have you used illegal drugs (for example, marijuana, cocaine, etc.) in the past five years?
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How often, in your lifetime, have you had legal problems or been arrested?
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Total Score
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