Alcohol and Drug Use Self Assessment

The following two automated self assessments for alcohol and drug use have been developed to assist you in understanding if you might have a problem. For more information, please contact Spirit Lodge.

Alcohol Use Self Assessment Tool

This brief test for alcohol abuse is an American Society of Addiction Medicine (ASAM) version of the CAGE Assessment Tool, a universally accepted assessment tool and one of the most popular alcohol use disorders identification tests.

Yes No  
1. Have you ever felt you should CUT DOWN on your drinking or drug use?
2. Have people ANNOYED you by criticizing or complaining about your drinking or drug use?
3. Have you ever felt bad or GUILTY about your drinking or drug use?
4. Have you ever had a drink or drug in the morning (EYE OPENER) to steady your nerves or to get rid of a hangover?
5. Do you use any drugs other than those prescribed by a physician?
6. Has a physician ever told you to cut down or quit use of alcohol or drugs?
7. Has your drinking or drug use caused family, job or legal problems?
8. When drinking or using drugs have you ever had a memory loss (blackout)?

Drug Use Self Assessment Tool

This brief test for drug abuse is has been adapted from Richard Fields' copyrighted version of the Cocaine Assessment Questionnaire.

Yes No  
1. Are you using more drugs than you plan to use and do you find that you are enjoying it less? That is, your tolerance is developing and despite not feeling very well, you continue to use.
2. Are you experiencing 3 or more of the following physical signs?
  • Excessive periods of fatigue, itching, scratching, and/or skin lesions
  • Sinus problems and nose bleeds
  • Trouble breathing and/or catching your breath
  • Chest pains or palpitations
  • Decreased appetite or weight loss
  • Tremors and poor coordination
  • Sleep disturbances, sleepiness, or excessive sleep
3. Do you feel apathetic, disinterested, depressed; have you lost the ability to concentrate?
4. Do you experience mood swings, irritability, short temperedness, emotional outbursts, rage or excessive sadness, paranoid and/or frantic bizarre behavior?
5. As a result of drug use, have you been absent, late, or exhibited inappropriate behavior at work?
6. Are family members and friends suggesting that you have a problem with drug use and/or are you lying about your frequency of drug use?

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National Association of Addiction Treatment Providers

NAADAC, the Association for Addiction Professionals