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1. How often do you have a drink containing alcohol? |
Never* |
Monthly or less |
2 to 4 times a month |
2 to 3 times a week |
4 or more times a week |
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* If answer if never, skip to questions 9-10 |
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2. How many drinks containing alcohol do you have on a typical day when you are drinking? |
1 or 2 |
3 or 4 |
5 or 6 |
7, 8, or 9 |
10 or More |
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3. How often do you have six or more drinks on one occasion? |
Never* |
Less than monthly |
Monthly |
Weekly |
Daily or almost daily |
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* If your answers to 2 and 3 are "1 or 2" and "Never" skip to questions 9-10 |
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4. How often during the lest year have you found that you were unable to stop drinking once you had started? |
Never* |
Less than monthly |
Monthly |
Weekly |
Daily or almost daily |
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5. How often during the lest year have you failed to do what was normally expected of you because of drinking? |
Never* |
Less than monthly |
Monthly |
Weekly |
Daily or almost daily |
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6. How often in the last year have you needed a first drink in the morning to get yourself going after a heavy drinking session? |
Never* |
Less than monthly |
Monthly |
Weekly |
Daily or almost daily |
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7. How often in the last year have you had a feeling of guilt or remorse after drinking? |
Never* |
Less than monthly |
Monthly |
Weekly |
Daily or almost daily |
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8. How often during the last year have you been unable to remember what happened the night before because you had been drinking? |
Never* |
Less than monthly |
Monthly |
Weekly |
Daily or almost daily |
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9. Have you or someone else been injured as a result of your drinking? |
No |
Yes, but not in the last year |
Yes, in the last |
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10. Has a relative, friend, doctor or other health worker been concerned with your drinking or suggested you cut down? |
No |
Yes, but not in the last year |
Yes, in the last |
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Total Score: |
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