Alcohol Use Questionnaire
Are you familiar with the signs of alcohol abuse or dependence? The following questionnaire will help you to gauge your own drinking habits, and whether or not they are cause for concern. Please read the following statements, recording the indicated numeric score for each true or false response.
1. The majority of my friends drink alcohol.
(If answer is true, give yourself 1 point.)
(If answer is false, give yourself 0 points.)
2. I am able to enjoy parties or social events where alcohol is not served.
(If answer is true, give yourself 0 points.)
(If answer is false, give yourself 3 points.)
3. I have never been arrested for drunk driving.
(If answer is true, give yourself 0 points.)
(If answer is false, give yourself 3 points.)
4. I have had unprotected sex because I was intoxicated.
(If answer is true, give yourself 2 points.)
(If answer is false, give yourself 0 points.)
5. On more than one occasion I have said, “I don’t drink more than anyone else.”
(If answer is true, give yourself 2 points.)
(If answer is false, give yourself 0 points.)
6. On more than one occasion I have missed work or school because of a hangover.
(If answer is true, give yourself 3 points.)
(If answer is false, give yourself 0 points.)
7. I have a family history of alcoholism.
(If answer is true, give yourself 2 points.)
(If answer is false, give yourself 0 points.)
8. I can drink more than most of my peers.
(If answer is true, give yourself 3 points.)
(If answer is false, give yourself 0 points.)
9. It takes much more alcohol for me to “catch a buzz” now than when I started drinking.
(If answer is true, give yourself 3 points.)
(If answer is false, give yourself 0 points.
10. I have tried to cut down on my drinking but it didn’t last very long.
(If answer is true, give yourself 3 points.)
(If answer is false, give yourself 0 points.)
Results
Total your score. If your score is:
20 to 25 points: Your responses to the questionnaire are consistent with symptoms associated with alcohol dependence. You should consult with your Employee Assistance Program (EAP) as soon as possible.
12 to 19 points: Your responses to the questionnaire are consistent with others who report problems with alcohol. Please consider contacting your Employee Assistance Program (EAP).
6 to 11 points: Based on your responses to the statements in the questionnaire, you have some of the risk factors that are consistent with alcohol abuse and/or dependence. Examine the items for which you scored points and determine if the issue is an isolated incident or recurring problem. Please consider contacting your Employee Assistance Program (EAP).
1 to 5 points: Based on your responses to the statements in the questionnaire, you may have one or two risk factors associated with alcohol abuse. You should examine the items for which you scored points and assess how alcohol affects you. Consulting with your Employee Assistance Program (EAP) could be beneficial.
0 points: Congratulations. Your score indicates that presently you have none of the common symptoms associated with alcohol abuse or dependence.
By Mark S. Gold, MD and Drew Edwards, MS
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