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Are You Addicted to Drugs or Alcohol?

To answer these questions ask yourself the following questions and answer them as
honestly as you can.
Y N
1. Do you lose time from work due to drinking / drugging? ____ ____

2. Is drinking / drugging making your home life unhappy? ____ ____

3. Do you drink / drug because you are shy with other people? ____ ____

4. Is drinking / drugging affecting your reputation? ____ ____

5. Have you ever felt remorse after drinking / drugging? ____ ____

6. Have you ever felt gotten into financial difficulties as a result of


drinking / drugging? ____ ____

7. Do you turn to lower companions and an inferior environment ____ ____


when drinking / drugging?

8. Does your drinking / drugging make you careless of your ____ ____
familys welfare?
____ ____
9. Has your ambition decreased since drinking / drugging?
____ ____
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 / drugging cause you to have difficulty in ____ ____
sleeping?
____ ____
13. Has your efficiency decreased since drinking / drugging?
____ ____
14. Is drinking / drugging jeopardizing your job or business?
____ ____
15. Do you drink / drug to escape from worries or trouble?
____ ____
16. Do you drink / drug alone?

17. Have you ever had a complete loss of memory as a result of ____ ____
drinking / drugging?
____ ____
18. Has your physician ever treated you for drinking / drugging?
____ ____
19. Do you drink / drug to build up your self-confidence?

20. Have you ever been to a hospital or institution on account of ____ ____
drinking / drugging?
DO NOT TURN THE PAGE UNTIL COMPLETELY ANSWERED!
If you have answered YES to any one of these questions, there is a definite warning that

YOU MAY BE AN ALCOHOLIC / ADDICT

If you have answered YES to any two of these questions, the chances are

YOU ARE AN ALCOHOLIC / ADDICT

If you have answered YES to three or more,

YOU ARE DEFINITELY AN ALCOHOLIC / ADDICT

(The above Test Questions are used by Johns Hopkins


University Hospital, Baltimore, Maryland, in deciding
whether or not a patient is an alcoholic / addict.)