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CONFIDENTIAL ADDICTION ASSESSMENT

Want to Know if you might have a Problem?
Take our Self Assessments and see for Yourself

Please take any or all of these tests at your convenience and for your own assessment. The results of these assessments are not recorded or retained in any way. No identifying information is gathered or used by 1Recovery Center or any other facility or organization.

The assessments are only effective if you are truthfull and you answer ALL of the questions. The resulting score will give you an objective analysis of your current condition. For a more decisive diagnosis, contact us or a professional for an appointment today.

Scoring Review (Number of YES answers)

0-3       No sign of abnormal use. Taking this test indicates there may be a problem.
4-7       At-Risk Use
8-15     Probable Abuse
16-25   Probable Dependence

Your Score:   

Drug Questionnaire

 
Yes No
1. Have you ever taken drugs when you wake up?
2. Do you prefer to hang around with people who "party" with either alcohol or drugs?
3. Have you ever taken a drug without knowing what it is, or what it will do for you?
4. Is purchasing drugs more important than your financial security?
5. Are you ever having trouble going to sleep or waking up while using drugs?
6. Have you ever been arrested for drug possession?
7. Have you ever taken a drug to overcome the effects of a different drug?
8. Are you having difficulty keeping your scheduled daily affairs, work, school, etc.?
9. Have you tried switching from drugs to alcohol to reduce your drug use?
10. Do you ever bring drugs to an event to enhance the event?
11. Do you ever feel that life without your drugs would be boring?
12. Do you experience anxiety when anticipating the use of drugs, or guilt after the use?
13. Have you often used more of the drugs than you intended to on the occasion?
14. Have you ever taken drugs as a manner of dealing with an emotional disturbance?
15. Do you find it difficult to stop using when you swear it off?
16. Have you ever been hospitalized as a result of using drugs?
17. Do you hide the truth when family, or friends ask you about your drug use?
18. Have some of your old friends disassociated with you because of your drug use?
19. Have you ever taken drugs when you wake up?
20. Have you ever taken drugs for medical conditions you do NOT currently have?
21. Do you ever have withdrawal symptoms when you stop using the drugs, nervousness, sweating?
22. Are you having trouble focusing at work due to your drug use or sleep patterns?
23. Do you use drugs alone?
24. Is your reputation suffering as a result of your drug use with fellow workers, or friends?
25. Are you hanging around with people that you once considered less than your kind of friends?

Prescription Questionnaire

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Yes No
1. Are you receiving prescription medications from more than one doctor?
2. Have you "lost" or "misplaced" two or more scripts in the last year?
3. Do you fill your scripts faster than what is indicated on the bottle?
4. Have you continued to take the script even after the pain you were prescribed for, has gone?
5. In the past year have you taken any controlled scripts that were not prescribed to you?
6. Do you feel that you have a higher than normal tollerance for certain prescriptions? Do you find that you need more to receive the same effect?
7. Has your alcohol comsumption increased noticeably in the last year?
8. Do you order medications from the internet?
9. Have you visited a pain management clinic in the last year?
10. Are you adverse to treatment options other than prescription drugs for your condition? Diet, physical therapy?
11. Have you ever crushed a prescription pill before taking it?
12. Do you use more than one "controlled" script for the same condition? Two different pain suppressants?
13. Do you feel anxiety when you miss taking your scheduled script?
14. Does it get anxious when you run out of certain scripts for a day or more?
15. Have you experienced any noticeable weight loss or gain recently?
16. Have you ever been turned down for a script refill on a controlled script?
17. Has your job performance suffered as a result of your script use?
18. Do you use more than one pharmacy?
19. Have you ever purchased scripts in another country?
20. Do you often loose track of time as a result of taking controlled scripts?
21. Do your friends or family ever complain about your use of the scripts?
22. Do you ever feel guilty after taking more of the script than prescribed?
23. Do you sometimes dismiss the warnings on the bottle, "Do not take Alcohol" with this script?
24. Have you ever taken controlled scripts in dangerous circumstances? Driving, when the instructions say NOT to.
25. Do you hang around a different set of friends when you are using controlled scripts?

Alcohol Questionnaire

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Yes No
1. Are people annoyed or critical of your drinking?
2. Would you describe yourself as a normal drinker? (you drink about the same as most people)
3. Have you ever woken up and discovered you had forgotten parts of the previous evening?
4. Can you go to an event and easily consume two drinks and no more?
5. Have you ever noticed your behavior becoming more aggressive, or able to fit in when drinking?
6. Have you ever been confronted by a police officer because of your behavior while drinking? Driving, in public?
7. In the last year, have you found that you had more drinks than you had planned to? (4 or more times)
8. In the last year, have you found yourself oversleeping more often?
9. Have you had a feeling of sadness or guilt because of something you did while drinking?
10. Do your feel personality changes (loosens, or tighten up) after you had several drinks? (3 or more)
11. Do you enjoy having a drink before you head out to an event, party, or bar/restaurant?
12. After drinking do you ever forget when you went to bed the previous night?
13. Is your drinking making the people you live with unhappy?
14. Do you ever drink because you feel shy or awkward around people?
15. When drinking, do you seek a different group of friends to fit in?
16. Have you noticed that you are not as ambitious in the mornings, after nights of heavier drinking?
17. When filling out medical forms, do you ever underestimate the amount you drink?
18. Do you drink alcohol to increase your confidence?
19. Do you look forward to having a drink at a certain time of day, each day? Do you have more than one?
20. Have you ever stopped drinking for a period of time to prove to someone (or yourself) that you don't have a drinking problem?
21. Would it be a little uncomfortable if you attended a party where you found no alcohol was being served?
22. Do you find yourself being attracted to restaurants that serve alcohol?
23. Do you find that most of your friends are daily drinkers?
24. Has anyone ever commented that you smell like alcohol after a night of drinking?
25. Do you have a reputation of being able to handle your liquor?
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Our Mission Statement

To provide a comprehensive and accurate match for the best treatment for any client that seeks our help.

To attempt to ensure that multiple options are offered all clients so they may choose the best fit for themselves considering treatment, location, amenities, and budget, including NO Charge.

To guide all our clients to an aftercare program, social or otherwise, for life-long sustainability of sobriety and sanity.

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