 | 1. Do you feel you are a normal drinker? |
| 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?
|
| 3. Does your spouse (or parents) ever worry or complain about your
drinking? |
| 4. Can you stop drinking without a struggle after one or two drinks?
|
| 5. Do you ever feel bad about your drinking?
|
| 6. Do friends or relatives think you are a normal drinker?
|
| 7. Do you ever try to limit your drinking to certain times of the day
or to certain places? |
| 8. Are you always able to stop drinking when you want to?
|
| 9. Have you ever heard about alcoholics Anonymous?
|
| 10. Have you gotten into fights when drinking?
|
| 11. Has drinking ever created problems with you and your spouse?
|
| 12. Has your spouse (or any other family member) ever gone to anyone
for help about your drinking? |
| 13. Have you ever lost friends or girlfriends/boyfriends because of
your drinking? |
| 14. Have you ever gotten into trouble at work because of drinking?
|
| 15. Have you ever lost a job because of drinking?
|
| 16. Have you ever neglected your obligations, your family, or your
work for two or more days in a row because you were drinking? |
| 17. Do you ever drink before noon? |
| 18. Have you ever been told you have liver trouble?
|
| 19. Have you ever had delirium tremens, severe shaking, heard voices,
or seen things that weren't there after heavy drinking? |
| 20. Have you ever gone to anyone for help about your drinking?
|
| 21. Have you ever been in a hospital because of drinking?
|
| 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?
|
| 23. Have you ever been arrested because of drunken behavior?
|
| 24. Have you ever been arrested for drunken driving or driving after
drinking? |
