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How often do you use drugs other than alcohol? (See 'Drugs List' above).

Never
Monthly or
less
2 to 4 times
a month
2 to 3 times
a week
4 or more
times a week
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Do you use more than one type of drug on the same occasion?

Never
Monthly or
less
2 to 4 times
a month
2 to 3 times
a week
4 or more
times a week
Submit Answer

How many times do you take drugs on a typical day when you use drugs?

None
1-2 times
3-4 times
5-6 times
7 or more
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How often are you influenced heavily by drugs?

Never
Less than
monthly
Monthly
Weekly
Daily or
almost daily
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Over the past year, have you felt that your longing for drugs was so strong that you could not resist it?

Never
Less than
monthly
Monthly
Weekly
Daily or
almost daily
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Has it happened, over the past year, that you have not been able to stop taking drugs once you started?

Never
Less than
monthly
Monthly
Weekly
Daily or
almost daily
Submit Answer

How often over the past year have you taken drugs and then neglected to do something you should have done?

Never
Less than
monthly
Monthly
Weekly
Daily or
almost daily
Submit Answer

How often over the past year have you needed to take a drug the morning after heavy drug use the day before?

Never
Less than
monthly
Monthly
Weekly
Daily or
almost daily
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How often over the past year have you had guilt feelings or a bad conscience because you used drugs?

Never
Less than
monthly
Monthly
Weekly
Daily or
almost daily
Submit Answer

Have you or anyone else been hurt (mentally or physically) because you used drugs?

No
Yes, but not in the last year
Yes, during the last year
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Has a relative or a friend, a doctor or a nurse, or anyone else, been worried about your drug use or said to you that you should stop using drugs?

No
Yes, but not in the last year
Yes, during the last year
Submit Answer

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