Substance Abuse Free Treatment Scree...

Name or Nickname (optional)

Email

Phone

When thinking about drug use, include illegal drug use and the use of prescription drug other than prescribed.

Have you ever felt that you ought to cut down on your drinking or drug use?

Yes

No

Have people annoyed you by criticizing your drinking or drug use?

Yes

No

Have you ever felt bad or guilty about your drinking or drug use?

Yes

No

Have you ever had a drink or used drugs first thing in the morning to steady your nerves or to get rid of a hangover?

Yes

No