Drug Abuse & Dependence Questionnaire

1. Have you used drugs other than those required for medicinal reasons?
2. Have you abused prescription drugs?
3. Do you have trouble getting through the day without using drugs?
4. Do you ever feel bad or guilty about your drug use?
5. Does your spouse (or parents) ever complain about your involvement with drugs?
6. Has drug abuse created problems between you and your spouse or your parents?
7. Have you lost friends because of your use of drugs?
8. Have you neglected your family because of your use of drugs?
9. Have you been in trouble at work because of drug abuse?
10. Have you lost a job because of drug abuse?
11. Have you gotten into fights when under the influence of drugs?
12. Have you engaged in illegal activities in order to obtain drugs?
13. Have you been arrested for possession of illegal drugs?
14. Have you had medical problems as a result of your drug use (e.g. memory loss, hepatitis, convulsions, bleeding, etc.)?
15. Have you gone to anyone for help for a drug problem?
16. Have you been involved in a treatment program specifically related to drug use?

If you answered “yes” to one or more of these questions, you are abusing drugs and at least at risk for drug dependence… addiction.