Are you worried about you or a loved one's drinking? If so, your
concern could indicate substance abuse. Please complete the short screening
below to assess further.
1. How often do you or a loved one have a
drink containing alcohol?
(0) Never (Skip to Questions 9-10)
(1) Monthly or less
(2) 2 to 4 times a month
(3) 2 to 3 times a week
(4) 4 or more times a week
2. How many drinks containing alcohol do you/they
have on a typical day while drinking?
(0) 1 or 2
(1) 3 or 4
(2) 5 or 6
(3) 7, 8, or 9
(4) 10 or more
3. How often do you/they have
six or more drinks on one occasion?
(0) Never
(1) Less than monthly
(2) Monthly
(3) Weekly
(4) Daily or almost daily
4. How often during the last year have you or a loved one drinking found that
you/they could not stop drinking once started?
(0) Never
(1) Less than monthly
(2) Monthly
(3) Weekly
(4) Daily or almost daily
5. How often during the last year have you or a loved one failed to
do what was normally expected because of drinking?
(0) Never
(1) Less than monthly
(2) Monthly
(3) Weekly
(4) Daily or almost daily
6. How often during the last year have you/they been unable to
remember what happened the night before because of drinking?
(0) Never
(1) Less than monthly
(2) Monthly
(3) Weekly
(4) Daily or almost daily
7. How often during the last year have you or loved one
needed an alcoholic drink first thing in the morning to get going after a night
of heavy drinking?
(0) Never
(1) Less than monthly
(2) Monthly
(3) Weekly
(4) Daily or almost daily
8. How often during the last
year have you/they had feelings of guilt or remorse after drinking?
(0) Never
(1) Less than monthly
(2) Monthly
(3) Weekly
(4) Daily or almost daily
9. Have you or someone else been injured as a result of
your or a loved one's drinking?
(0) No
(2) Yes, but not in the last year
(4) Yes, during the last year
10. Has a relative, friend,
doctor, or another health professional expressed concern about your or a loved
one's drinking or suggested you/they cut down?
(0)No
(2) Yes, but not in the last year
(4) Yes, during the last year
Total points:
If the points add up to
8 or more, this indicates a harmful drinking behavior that requires immediate
professional attention. Unhealthy drinking leads to health and family problems,
loss of control, jobs, and relationships, and often progresses to serious injury
and/or other personal crisis.
Farnham Family Services has helped many
recover from addiction and substance abuse. Contact
us today to learn how we can help you.
Make an Appointment