These Questions Refer to the Past 12 Months

Has the use of drugs or alcohol ever resulted in legal problems, such as driving infractions? Yes | No

♦ Has the use of drugs or alcohol ever harmed your relationship(s)? Yes | No

♦ Has the use of alcohol ever affected your job performance, i.e. tardiness, sick days, hangovers? Yes | No

♦ Are you unable to stop using drugs or alcohol when you want to? Yes | No

♦ Have you ever had blackouts or flashbacks as a result of drug or alcohol use? Yes | No

♦ Do you ever feel bad or guilty about your drugs or alcohol use? Yes | No

♦ Do your friends or loved ones ever complain about your involvement with drugs or alcohol? Yes | No

♦ Have you neglected your family because of your use of drugs or alcohol? Yes| No

♦ Have you engaged in illegal activities in order to obtain drugs or alcohol? Yes | No

♦ Have you ever experienced withdrawal symptoms (felt sick) when you stopped taking drugs ? Yes | No

♦ Have you had medical problems as a result of your drug or alcohol use (e.g. nausea, memory loss, .......hepatitis, convulsion, bleeding)? Yes | No

If you have answered yes to one or more of the above questions, you would need to talk with a professional for a confidential evaluation of your use of drugs or alcohol. Help from the Recovery Center of AADP is just a phone call away.