The following questions cover a wide
range of topics having to do with drinking. Please read each question
carefully, but do not think too much about its exact meaning. Think
about your most recent drinking habits and answer each question by using
the criteria listed below. Use a sheet of paper and write numbers from 1
through 15 and write your answer next to the number of the question.
1. Do you find difficulty in getting the thought of drinking out of
your mind?
Never Sometimes
Often Nearly
Always
2. Is getting drunk more important than your next meal?
Never Sometimes
Often Nearly
Always
3. Do you plan your day around when and where you can drink?
Never Sometimes
Often Nearly
Always
4. Do you drink in the morning, afternoon, and evening?
Never Sometimes
Often Nearly
Always
5. Do you drink for the effect of alcohol without caring what the drink
is?
Never Sometimes
Often Nearly
Always
6. Do you drink as much as you want irrespective of what you are doing
the next day?
Never Sometimes
Often Nearly
Always
7. Given that many problems might be caused by alcohol, do you still
drink too much?
Never Sometimes
Often Nearly
Always
8. Do you know that you won't be able to stop drinking once you start?
Never Sometimes
Often Nearly
Always
9. Do you try to control your drinking by giving it up completely for
days or weeks at a time?
Never Sometimes
Often Nearly
Always
10. The morning after a heavy drinking session do you need your first
drink to get yourself going?
Never
Sometimes Often
Nearly Always
11. The morning after a heavy drinking session do you wake up with
a definite shakiness of your hands?
Never Sometimes
Often Nearly
Always
12. After a heavy drinking session do you wake up and retch or vomit?
Never Sometimes
Often Nearly
Always
13. The morning after a heavy drinking session do you go out of your
way to avoid people?
Never Sometimes
Often Nearly
Always
14. After a heavy drinking session do you see frightening things that
later you realize were imaginary?
Never Sometimes
Often Nearly
Always
15. Do you go drinking and the next day and find that you have forgotten
what happened the night before?
Never Sometimes
Often Nearly
Always
Scoring:
To figure out your score, give yourself zero points for each "never" answer;
one point for "sometimes," two points for "often," and three points for "nearly
always." Out of a possible total of 45, the guidelines for interpretation
are as follows: 1-9 is considered low dependence; 10-19, medium dependence;
and 20 (or greater) high dependence.
