Solutions for Substance Abuse

1137 Emerald Bay Rd.
South Lake Tahoe, CA 96150
530-541-5190

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TWENTY QUESTIONS LIST

Are You An Alcohol/Chemically Dependent Person?

	Yes	No
1. Do you lose time from work due to drinking/using?	_____	_____
2. Is drinking/using making your home life unhappy?	_____	_____
3. Do you drink/use because you are shy with other people?	_____	_____
4. Is drinking/using affecting your reputation?	_____	_____
5. Have you ever felt remorse after drinking/using?	_____	_____
6. Have you gotten into financial difficulties as a result of drinking/using?	_____	_____
7. Do you turn to lower companions and an inferior environment when drinking/using?	_____	_____
8. Does your drinking/using make you careless of your family's welfare?	_____	_____
9. Has your ambition decreased since drinking/using?	_____	_____
10. Do you crave a drink/drug at a definite time daily?	_____	_____
11. Do you want a drink/drug the next morning?	_____	_____
12. Does drinking/using cause you to have difficulty in sleeping?	_____	_____
13. Has your efficiency decreased since drinking/using?	_____	_____
14. Is drinking/using jeopardizing your job or business?	_____	_____
15. Do you drink/use to escape from worries or troubles?	_____	_____
16. Do you drink/use alone?	_____	_____
17. Have you ever had a complete loss of memory as a result of drinking/using?	_____	_____
18. Has your physician ever treated you for drinking/using?	_____	_____
19. Do you drink/use to build up your self-confidence?	_____	_____
20. Have you ever been in a hospital or institution because of your drinking/using?	_____	_____

If you answered YES to any one of the questions, there is a warning that you may be alcohol dependent/chemically dependent.

If you answered YES to any two, the chances are that you are alcohol/chemically dependent.

If you have answered YES to three or more, seek help immediately.

The above questions are used by Johns Hopkins University Hospital, Baltimore, MD, in deciding whether or not a patient is alcohol dependent. The questions have been revised by CompCare to include other drug dependencies.

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