Print the full checklist here!
Alcohol Dependence Checklist:
| Question | Yes? | No? |
|---|---|---|
| 1. Has a friend or relative ever told you that you drink too much alcohol? | ||
| 2. Is it hard for you to stop drinking alcohol after you have had one or two drinks? | ||
| 3. Have you ever been unable to remember what you did while you were drinking alcohol? | ||
| 4. Do you ever feel bad about how much alcohol you drink? | ||
| 5. Do you ever get into arguments or physical fights when you have been drinking alcohol? | ||
| 6. Have you ever been arrested or hospitalized because of your drinking? | ||
| 7. Have you ever thought about getting help to control or stop your drinking? | ||
| 8. Have you ever felt like you needed a drink of alcohol first thing in the morning? | ||
| 9. Do you ever drink alcohol in secret or drink alone? |
*If you answered yes to one or more of these questions, you should talk to a support provider or to your doctor or nurse about whether or not you may have a dependence on alcohol.
| Attachment | Size |
|---|---|
 TOOLAlcoholDependenceChecklist.pdf |
19.01 KB |