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Home
We Treat
Alcohol
Cocaine
Depression
Heroin
Marijuana
Relapses
Pharmaceuticals
Synthetic Drugs
Tik
Specials
Our Rehab
Team
Admission
Inside Addiction
About
Alcohol
Cocaine
Depression
Heroin
Marijuana
Pharmaceuticals
Relapse
Synthetic Drugs
Tik Drug
Blog
Contact
Home
We Treat
Alcohol
Cocaine
Depression
Heroin
Marijuana
Relapses
Pharmaceuticals
Synthetic Drugs
Tik
Specials
Our Rehab
Team
Admission
Inside Addiction
About
Alcohol
Cocaine
Depression
Heroin
Marijuana
Pharmaceuticals
Relapse
Synthetic Drugs
Tik Drug
Blog
Contact
5 Minute Self-Assessment Quiz
1. Have you used drugs other than those required for medicinal reasons?
*
Yes
No
2. Have you abused prescription drugs?
*
Yes
No
3. Do you abuse more than one drug at a time?
*
Yes
No
4. Can you get through the week without using drugs?
*
Yes
No
5. Are you always able to stop using drugs when you want to?
*
Yes
No
6. Have you had "blackouts" or "flashbacks" as a result of drug use?
*
Yes
No
7. Do you ever feel bad or guilty about your drug use?
*
Yes
No
8. Does your spouse (or parents) ever complain about your involvement with drugs?
*
Yes
No
9. Has drug abuse created problems between you and your spouse or your parents?
*
Yes
No
10. Have you lost friends because of your use of drugs?
*
Yes
No
11. Have you neglected your family because of your use of drugs?
*
Yes
No
12. Have you been in trouble at work because of drug abuse?
*
Yes
No
13. Have you lost a job because of drug abuse?
*
Yes
No
14. Have you gotten into fights when under the influence of drugs?
*
Yes
No
15. Have you engaged in illegal activities in order to obtain drugs?
*
Yes
No
16. Have you been arrested for possession of illegal drugs?
*
Yes
No
17. Have you ever experienced withdrawal symptoms (felt sick) when you stopped taking drugs?
*
Yes
No
18. Have you had medical problems as a result of your drug use (e.g. memory loss, hepatitis, convulsions, bleeding, etc.)?
*
Yes
No
19. Have you gone to anyone for help for a drug problem?
*
Yes
No
20. Have you been involved in a treatment program specifically related to drug use?
*
Yes
No
Name
This field is for validation purposes and should be left unchanged.
