Do you think you may have a problem with drugs or alcohol? Take the following questionnaire to learn more....

1. Do you drink or use to feel more confident or overcome shyness?
   Yes No
2. Are you having money problems because of drinking or using?
   Yes No
3. Are you ever absent from work because of drinking or using?
   Yes No
4. Have you been fired or lost a business because of drinking or using?
   Yes No
5. Have you been admitted to hospital because of drinking or using?
   Yes No
6. Do you have a bad reputation from drinking or using?
   Yes No
7. Do you drink or use when you are alone?
   Yes No
8. Do you feel remorse after drinking or using?
   Yes No
9. Do you drink in the morning?
   Yes No
10. Is your family suffering from your drinking or using?
    Yes No
11. Do you drink or use to escape your problems?
    Yes No
12. Do you make promises to yourself or others about your drinking or using?
    Yes No
13. Have you had an accident because of drinking or using?
    Yes No
14. Do you have poor judgment about the people you are with and the places you go when you are drinking or using?
    Yes No
15. Have you been arrested more than once for drunk driving or driving under the influence of drugs?
    Yes No
16. Is your health affected by your drinking or using?
    Yes No
17. Do you drink or use to relieve the painfulness of living?
    Yes No
18. Once you have started, do you have to keep on drinking or using?
    Yes No
19. Do you have blackouts? (Forgetting events that happened or actions you performed while drinking or using?)
    Yes No
20. Has as a doctor ever treated you for your drinking or using?
    Yes No