fbpx

Substance Use Self-Assessment

 

Instructions:

To help assess if you might have a problem with drug or alcohol use in addition to disordered eating, please select yes for any statement you feel describes you. After filling out this quiz, you will get your results and automatically be signed up for our Food Freedom emails.

Disclaimer: This quiz is not intended to diagnose any conditions, but might be a useful tool in determining whether you have problem and need to seek help.

First Name
Email address
Do you drink or use to overcome shyness or to feel more confident?
Are you having money troubles because of drinking or using?
Do you ever stay home from work because of drinking or using?
Is drinking or using causing trouble in your family?
Have you lost a job or a business because of drinking or using?
Do you drink or use to escape your problems?
Do you drink or use when you are alone?
Do you have blackouts? (Loss of memory for events that happened or of actions you performed while drinking or using?)
Do you feel remorse after drinking or using?
Do you need a drink at a definite time every day?
Do you drink in the morning?
Have you ever been treated by a doctor because of drinking or using?
Do you drink or use too much at the wrong time?
Do you make promises to yourself or others about your drinking or using?
Do you have to keep on drinking or using once you have started?
Is drinking or using making it hard for you to sleep?
Have you had an accident because of drinking or using?
Have you had any legal issues because of drinking or using?
Has drinking or using affected your health?
Quiz source: © 2020 Cottonwood Tucson