Drug Addiction Test Form

  • Drug Addiction Test Form

    measures symptoms and severities
  • Do you ever use drugs or illegal substances to relax or wind down?

  • Do you ever use drugs or illegal substances to cope with your feelings?

  • Do you ever use drugs or illegal substances to fit in with other people?

  • Do you ever use drugs or illegal substances to feel more comfortable during sex?

  • Have you ever been late to work, school or important occasions because of drugs or illegal substances?

  • Do you ever hide your drugs or illegal substances?

  • Have you ever been arrested, detained, or ticketed as a result of drugs or illegal substances?

  • Have you ever had a terrible drugs or illegal substance hang over (dope sick)?

  • Are people questioning or bothering you about your drugs or illegal substances?

  • Do you use drugs or illegal substances every week or day?

  • Is using drugs or illegal substances a part of special occasions?

  • Do you think or talk about drugs or illegal substances?

  • Are you a heavy user?

  • Can you stop using when you want to, every time that you want to?

  • Do you have any past trauma?

  • Do you count on a lot of people for favors?

  • Do you ever change your using patterns or substances of choice?

  • Are you looking for the best way to manage your drugs or illegal substances use?

  • Do you ever crave a drugs or illegal substances?

  • Do most of your "good times" involve drugs or illegal substances?

  • Do you feel panic with the idea of never using again?

  • Are you afraid to live without drugs or illegal substances?

  • Are you ready for help but afraid to ask?

  • Who are you willing to speak with? (if other, please add their name and email address)

  • By submitting I hereby confirm that the information I have given above is true, and that I will be receiving an email response to my submission and an invitation to discuss the results with a nonprofessional.

  • Should be Empty: