Do you lose time from work or school due to drinking or drug use?

Is drinking or drug use making your home life unhappy?

Do you drink or use drugs because you are shy with other people?

Is drinking or drug use affecting your reputation?

Have you gotten into financial difficulties as a result of drinking or drug use?

Do you turn to lower companions and an inferior environment when drinking or using drugs?

Does your drinking or drug use make you careless of your family's welfare?

Has your ambition decreased since drinking or using drugs?

Do you crave a drink or drugs at a definite time daily?

Do you want a drink or drugs the next morning?

Does drinking or using drugs cause you to have difficulty in sleeping?

Has your efficiency decreased since drinking or using drugs?

Is drinking or using drugs jeopardizing your job or business?

Do you drink or use drugs to escape from worries or trouble?

Do you drink or use drugs alone?

Have you ever had a complete loss of memory as a result of drinking or drug use?

Has your physician ever treated you for drinking or drug use?

Do you drink or use drugs to build up your self-confidence?

Have you ever been to a hospital or institution because of drinking or drug use?

A Yes to three or more questions indicate abuse or addiction is present and corrective steps need to be taken.