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1. National Council on Alcoholism and Drug Abuse (Instrument #1) | 2. Johns Hopkins University Drinking Scale (Instrument #2)
3. Michigan Alcoholism Screening Test (MAST) (Instrument #3) | 4. 12 questions of Alcoholics Anonymous (Instrument #4)

Self Assessment Instrument #1

WHAT ARE THE SIGNS OF ALCOHOLISM?

by the National Council on Alcoholism and Drug Abuse

This is a self-assessment test to help you review the role alcohol is playing in your life. These questions incorporate many of the common symptoms of alcoholism. This test is intended to help you determine if you or someone you know needs to find out more about alcoholism.
   
Yes
No
1.
Do you occasionally drink heavily after a disappointment, a quarrel or when a boss gives you a hard time?
   
2.
When you have troubles or feel under pressure, do you always drink more heavily than usual?
   
3.
Have you noticed that you are able to handle more liquor than you did when you first started drinking?
   
4.
Did you ever wake up on the "morning after" and discover that you could not remember part(s) of the evening before, even though your friends tell you that you did not "pass out?"
   
5.
When drinking with other people, do you try to have a few extra drinks when others will not know it?
   
6.
Are there certain occasions when you feel uncomfortable if alcohol is not available?
   
7.
Have you recently noticed that when you begin drinking you are in more of a hurry to get the first drink than you used to be?
   
8.
Do you sometimes feel a little guilty about your drinking?
   
9.
Are you secretly irritated when your family or friends discuss your drinking?
   
10.
Have you recently noticed an increase in the frequency of your memory "blackouts"?
   
11.
Do you often find that you wish to continue drinking after your friends say they have had enough?
   
12.
Do you usually have a reason for occasions when you drink heavily?
   
13.
When you are sober, do you often regret things you have said or done while drinking?
   
14.
Have you tried switching brands or following different plans for controlling your drinking?
   
15.
Have you often failed to keep the promises you have made to yourself about controlling or cutting down on your drinking?"
   
16.
Have you ever tried to control your drinking by changing jobs, moving to a new location, or promising to yourself to drink only when you are at home, or only on weekends, or only on odd numbered days, etc.?
   
17.
Do you try to avoid family or close friends while you are drinking?
   
18.
Are you having an increasing number of financial, legal (getting D.U.I.s), relational and work related problems?
   
19.
Do more people seem to be treating you unfairly for good reason?
   
20.
Do you eat very little or irregularly when you are drinking?
   
21.
Do you sometimes experience the "shakes" in the morning and find that it helps to have a little drink?
   
22.
Have you recently noticed that you cannot drink as much as you once did?
   
23.
Do you sometimes stay drunk for several days at a time?
   
24.
Do you sometimes feel very depressed and wonder whether life is worth living?
   
25.
Sometimes, after periods of drinking, do you see or hear things that aren't there?
   
26.
Do you get terribly frightened after you have been drinking heavily?
Assessment Score:

 

ASSESSMENT SCALE
Any "yes" answer indicates a probable symptom of alcoholism.
"Yes" answers to several questions indicate the following stages of alcoholism:

1 - 8:   Early Stage.

9 - 21:   Middle Stage

22 - 26:   The Beginning of Final Stage

For more information or to make an appointment, please call 305-251-8609 or email me by Clicking Here


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Dita Teitelbaum, MSW LCSW
14440 SW 80th Avenue
Miami, FL 33158
Phone: 305-251-8609
Fax: 305-251-8609

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