Volume 1 No.4
DRUG QUESTIONNAIRE
Have you or anyone you know:                                                                                                                   
Ever drank or gotten high alone? 
                                                                                                             
Drink or get high regularly on weekends or before, during, or after school/work? 
                                 
Find it hard to have a good time if not drinking or getting high?
                                                       
Ever blacked out or forgotten what happened while drinking or getting high?  
                          
Need to drink or get high more than before in order to feel drunk or high? 
                                 
Tried to use less or stop, and failed to do so?  
                                                                                   
Ever lied about drinking or using drugs? 
                                                                                               
Feel guilty about drinking or drug use?                                                              
                                     
Feel more run down, depressed, or hopeless lately?                                                               

Had school or job performance suffer from the effects of drinking or drug use? 
                      
Ever had an encounter with the law as a result of drinking or using drugs?              
                    
Ever used alcohol or drugs because of emotional pain or stress?      
                                            
Continued to use despite negative consequences?   
                                                                        
Lost friends because of drinking or using drugs?  
                                                                              
Gotten into fights when under the influence of alcohol or drugs?  
                                                 
Ever pressured someone to drink or use drugs?  
                                                                                
Lost interest in meaningful things such as: school, work, or relationships?  
                                            
Put themselves or others at risk while drunk or stoned by driving or having sex?  
                       
Thought a lot about drinking or using drugs?   
                                                                                     
Expressed the desire to seek help for drinking or using drugs?  

                      
Persistent Problems Need Professional Help!
Don’t let the fear of fear stop you from reaching out for help
TRY THIS ONE:
“If you haven’t got all the things you want, be grateful for the things you don‘t have that you don‘t want.”
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