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Drug Abuse Screening Test

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The following questions concern information about your potential involvement with drugs except alcohol and tobacco during the past 12 months.
Carefully read each statement and decide if your answer is “Yes” or “No”.
Then, click the appropriate response below the question.
In the statements “drug abuse” refers to
(1) the use of prescribed or over the counter drugs in excess of the directions eg codeine or ‘tramadol’
(2) any non-medical use of drugs.
The various classes of drugs may include:
cannabis (e.g. marijuana, hash), solvents, tranquilizers (e.g.Valium), barbiturates, cocaine, stimulants (e.g. speed), hallucinogens (e.g. LSD) or narcotics (e.g. heroin).
Remember that the questions do not include alcoholic beverages.
Please answer every question. If you have difficulty with a statement, then choose the response that is mostly right.

1.Have you used drugs other than those required for medical reasons?
2.Do you abuse more than one drug at a time?
3.Are you always able to stop using drugs when you want to? (If never use drugs, answer “Yes.”)
4.Have you had “blackouts” or “flashbacks” as a result of drug use?
5.Do you ever feel bad or guilty about your drug use? If never use drugs, choose “No.”
6.Does your spouse (or parents) ever complain about your involvement with drugs?
7.Have you neglected your family because of your use of drugs?
8.Have you engaged in illegal activities in order to obtain drugs?
9.Have you ever experienced withdrawal symptoms (felt sick) when you stopped takin g drugs?
10.Have you had medical problems as a result of your drug use (e.g., memory loss, hepatitis, convulsions, bleeding, etc.)?

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