
Do you have a drinking problem? To answer this, ask yourself the following questions and answer them as honestly as you can
YES |
NO |
||
1 |
Do you lose time from work due to drinking? | ||
| 2 | Is drinking making your home life unhappy? | ||
| 3 | Do you drink because you are shy with other people? | ||
| 4 | Is drinking affecting your reputation? | ||
| 5 | Have you ever felt remorse after drinking? | ||
| 6 | Have you gotten into financial difficulties as a result of drinking? | ||
| 7 | Do you turn to lower companions and an inferior environment when drinking? | ||
| 8 | Does your drinking make you careless of your family's welfare? | ||
| 9 | Has your ambition decreased since drinking? | ||
| 10 | Do you crave a drink at a definite time daily? | ||
| 11 | Do you want a drink the next morning? | ||
| 12 | Does drinking cause you to have difficulty in sleeping? | ||
| 13 | Has your efficiency decreased since drinking? | ||
| 14 | Is drinking jeopardizing your job or business? | ||
| 15 | Do you drink to escape from worries or trouble? | ||
| 16 | Do you drink alone? | ||
| 17 | Have you ever had a complete loss of memory as a result of drinking? | ||
| 18 | Has your physician ever treated you for drinking? | ||
| 19 | Do you drink to build up your self-confidence? | ||
| 20 | Have you ever been to a hospital or institution on account of drinking? |