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Griffin Hospital's Programs for Alcohol and Drug dependence

A Screening Questionnaire for Alcohol Dependence

Here is a quick and easy questionnaire that can help to determine if you or a loved one have a drinking problem. Answer each question and add up the points next to your answers.

1. How often do you have a drink containing alcohol?

  • (0.0) Never
  • (0.5) Monthly or less
  • (1.0) Two to four times a month
  • (1.5) Two to three times a week
  • (2.0) Four or more times a week

2. How many drinks containing alcohol do you have on a typical day when you are drinking?

  • (0.0) 1 or 2
  • (0.5) 3 or 4
  • (1.0) 5 or 6
  • (1.5) 7 to 9
  • (2.0) 10 or more

3. Have people annoyed you by criticizing your drinking?

  • (0.0) No
  • (1.0) Yes

4. Have you ever felt bad or guilty about your drinking?

  • (0.0) No
  • (1.0) Yes

5. Have you ever had a drink first thing in the morning to steady your nerves or get rid of a hang-over?

  • (0.0) No
  • (1.0) Yes

A score of 2.5 or greater indicates possible alcohol misuse and the need for further evaluation. We encourage you to contact Griffin Hospital's Outpatient Chemical Dependency Program.

For an additional alcohol dependency evaluation tool, click here for a questionnaire developed by Office of Health Care Programs at Johns Hopkins University Hospital.