Perceived Benefit of Drinking/Drug Scale
Name
*
First Name
Last Name
Date
*
-
Month
-
Day
Year
Date
Drinking helps me forget my problems.
*
True
False
Drinking helps me be friendly.
*
True
False
Drinking helps me feel good about myself.
*
True
False
Drinking helps me relax.
*
True
False
Drinking helps me be friends with others that driknk.
*
True
False
Drugs help me forget my problems.
*
True
False
Drugs help me be friendly.
*
True
False
Drugs help me feel good about myself.
*
True
False
Drugs help me relax.
*
True
False
Drugs help me be friends with others that do drugs.
*
True
False
Submit
Should be Empty: