The following questions assess your use of drugs (not including alcoholic beverages) during the past 12 months. Please read each statement and decide if your answer is “Yes” or “No”.

In the statements below, “drug abuse” could refer to the following:

1.

Have you used a prescription drug for reasons other than its intended use?

 

2.

Have you ever used a prescription drug not prescribed for you?

 

3.

Do you ever feel bad or guilty about your drug use?

 

4.

Have you unsuccessfully attempted to stop using drugs?

 

5.

Has there been a time when you couldn’t remember what happened after using drugs?

 

6.

Has anyone close to you ever complained about your use of drugs?

 

7.

Has your drug use interfered with your work or school performance?

 

8.

Have you engaged in illegal activities in order to obtain drugs?

 

9.

Have you increased your use of drugs to get the same effect?

 

10.

Have you ever experienced withdrawal symptoms (felt sick) when you stopped taking drugs?

 

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