Drug Use Questionnaire

 

 

1. Do you lose time from work due to drug use?

2. Is drug use making your home life unhappy?

3. Do you use drugs because you are shy with other people?

4. Is drug use affecting your reputation?

5. Have you ever felt remorse after drug use?

6. Have you gotten into financial difficulties as a result of your drug use?

7. Do you turn to lower companions and an inferior environment when using drugs?

8. Does your drug use make you careless of your family’s welfare?

9. Has your ambition decreased since using drugs?

10. Do you crave a drug at a definite time daily?

11. Do you want a drug the next morning?

12. Does your drug use cause you to have difficulties in sleeping?

13. Has your efficiency decreased since using drugs?

14. Is your drug use jeopardizing your job or business?

15. Do you use drugs to escape from worries or troubles?

16. Do you use drugs alone?

17. Have you ever had a complete loss of memory?

18. Has your physician ever treated you for drug use?

19. Do you use drugs to build your self-confidence?

20. Have you ever been in a hospital or institution on account of drug use?

 

 

If you answered “yes” to 3 questions, it suggests you probably have a drug problem.

 

If you answered “yes” to 4-7 questions, it suggests you may be in an early stage of drug addiction.

 

If you answered “yes” to 7-10 questions, it suggests you may be in the second stage of drug addiction.

 

If you answered “yes” to more than 10 questions, it suggests you may be in end-stage drug addiction.

 

Developed from the Johns Hopkins University addiction self-test

 

 

Contact us

You can reach us on:

(044) 0845 467 0612

 

or:

Emegancy mobile

(044) 07593809574

 

You can also use our contact form.

Visit or Write to us

Head Office:

Ayurva Ltd

18 St Georges Road

St Annes

Lancashire

United Kingdom

FY8 2AE

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