Questionnaire for Alcohol Consumption

Take the first 25 questions as a test, then score the results at the bottom of this questionnaire.

Self Test

1. Do you feel you are a normal drinker?   Yes   No

2. Have you ever awakened the morning after some drinking the night before and found that you could not remember a part of the evening before?   Yes   No 

3. Does your spouse (or parents) ever worry or complain about your drinking?   Yes   No

4. Can you stop drinking without a struggle after one or two drinks?   Yes   No

5. Do you ever feel bad about your drinking?   Yes   No 

6. Do friends or relatives think you are a normal drinker?   Yes   No 

7. Do you ever try to limit your drinking to certain times of the day or to certain places?   Yes   No 

8. Are you always able to stop drinking when you want to?   Yes   No 

9. Have you ever voluntarily attended a meeting of Alcoholics Anonymous (AA)?   Yes   No

10. Have you gotten into fights when drinking?   Yes   No

11. Has drinking ever created problems with you and your spouse?   Yes   No 

12. Has your spouse (or other family members) ever gone to anyone for help about your drinking?  after drinking?   Yes   No 

13. Have you ever lost friends or girlfriends/boyfriends because of drinking?   Yes   No 

14. Have you ever gotten into trouble at work because of drinking?   Yes   No 

15. Have you ever lost a job because of drinking?   Yes   No 

16. Have you ever neglected your obligations, your family, or your work for 2 or more days in a row because you were drinking?   Yes   No 

17. Do you ever drink before noon?   Yes   No 

18. Have you ever been told you have liver trouble? Cirrhosis?   Yes   No 

19. Have you ever had delirium tremens (DT's), severe shaking, heard voices, or seen things that were not there after heavy drinking?   Yes   No 

20. Have you ever gone to anyone for help with drinking?   Yes   No 

21. Have you ever been in a hospital because of your drinking?   Yes   No 

22. Have you ever been a patient in a psychiatric hospital or on a psychiatric ward of a general hospital where drinking was part of the problem?   Yes   No

23. Have you ever been seen at a psychiatric or mental health clinic, or gone to a doctor, social worker, or clergyman for help with an emotional problem in which drinking had played a part?   Yes   No

24. 24. Have you ever been arrested, even for a few hours, because of drunk behavior?   Yes   No

25. Have you ever been arrested for drunk driving or driving?   Yes   No

Score Sheet

Add up the total points.  Interpret with your physician or family.

1. Do you feel you are a normal drinker?  Yes: 0  No: 2

2. Have you ever awakened the morning after some drinking the night before and found that you could not remember a part of the evening before?  Yes: 2  No: 0

3. Does your spouse (or parents) ever worry or complain about your drinking?  Yes: 1  No: 0

4. Can you stop drinking without a struggle after one or two drinks?  Yes: 0  No: 2

5. Do you ever feel bad about your drinking?  Yes: 1  No: 0

6. Do friends or relatives think you are a normal drinker?  Yes: 0  No: 2

7. Do you ever try to limit your drinking to certain times of the day or to certain places?  Yes: 1  No: 0

8. Are you always able to stop drinking when you want to?  Yes: 0  No: 2

9. Have you ever attended a meeting of Alcoholics Anonymous (AA)?  Yes: 5  No: 0

10. Have you gotten into fights when drinking?  Yes: 1  No: 0

11. Has drinking ever created problems with you and your spouse?  Yes: 2  No: 0

12. Has your spouse (or other family members) ever gone to anyone for help about your drinking? Yes: 2  No: 0

13. Have you ever lost friends or girlfriends/boyfriends because of drinking?  Yes: 2  No: 0

14. Have you ever gotten into trouble at work because of drinking?  Yes: 2  No: 0

15. Have you ever lost a job because of drinking? 
     Yes: 2  No: 0

16. Have you ever neglected your obligations, your family, or your work for 2 or more days in a row because you were drinking?  Yes: 2  No: 0

17. Do you ever drink before noon?  Yes: 1  No: 0

18. Have you ever been told you have liver trouble? Cirrhosis?  Yes: 2  No: 0

19. Have you ever had delirium tremens (DT's), severe shaking, heard voices, or seen things that were not there after heavy drinking?  Yes: 2  No: 0

20. Have you ever gone to anyone for help?  Yes: 2  No: 0

21. Have you ever been in a hospital because of your drinking?  Yes: 5  No: 0

22. Have you ever been a patient in a psychiatric hospital or on a psychiatric ward of a general hospital where drinking was part of the problem?  Yes: 2  No: 0

23. Have you ever been seen at a psychiatric or mental health clinic, or gone to a doctor, social worker, or clergyman for help with an emotional problem in which drinking had played a part?  Yes: 2  No: 0

24. Have you ever been arrested, even for a few hours, because of drunk behavior?  Yes: 2  No: 0

25. Have you ever been arrested for drunk driving or driving after drinking?  Yes: 2  No: 0

Basically, any score indicates a problem.  The more points you run up, the more of a real-world problem you have.  If needed, get some help, and learn to protect and repair the damage this addiction does to your body.  Many people have beaten this killer, but never very easily without learning to appreciate themselves for who they can be.

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