Do you wonder whether your problem with alcohol or other drugs warrants seeking help?
If so, here is your own personal self assessment survey.

Am I an Addict?

1. Ask yourself the following questions and answer them as honestly as you can:

1. Do you avoid people or places that do not approve of you using drugs? Yes No
 
2. Do you continue to use despite negative consequences? Yes No
 
3. Do you ever use alone? Yes No
 
4. Do you put the purchase of drugs ahead of your financial responsibilities? Yes No
 
5. Do you regularly use a drug when you wake up or when you go to bed? Yes No
 
6. Do you think a lot about drugs? Yes No
 
7. Do you think you might have a drug problem? Yes No
 
8. Does the thought of running out of drugs terrify you? Yes No
 
9. Does using interfere with your sleeping or eating? Yes No
 
10. Has your job or school performance ever suffered from the effects of your drug use? Yes No
 
11. Have you ever been in a jail, hospital, or drug rehabilitation center because of your using? Yes No
 
12. Have you ever felt defensive, guilty, or ashamed about your using? Yes No
 
13. Have you ever lied about what or how much you use? Yes No
 
14. Have you ever manipulated or lied to a doctor to obtain prescription drugs? Yes No
 
15. Have you ever overdosed on any drugs? Yes No
 
16. Have you ever stolen drugs or stolen to obtain drugs? Yes No
 
17. Have you ever substituted one drug for another, thinking that one particular drug was the problem? Yes No
 
18. Have you ever thought you couldn´t fit in or have a good time without drugs? Yes No
 
19. Have you ever tried to stop or control your using? Yes No
 
20. Is your drug use making life at home unhappy? Yes No

 

If you have answered YES to any one of these questions, there is a definite warning that you may be an addict.

If you have answered YES to any two, the chances are that you are an addict.

YES answers to three or more, is definitely consistent with being an addict.

 

2. Congratulations on completing these questions.

If you wish for one of our A Home Away counsellors to contact you for a free, personal consultation, please complete your contact information for how you wish to be reached.

NB: Your confidentiality is strictly respected; your information will not be provided to any outside person or agency.

 

Name:
 
Email:
 
Phone Number:
   
Address:
 
City/Town:
 
Province/State:
 
Postal Code/ZIP:

3. You deserve to get the type of help you need.
Are you ready to consider treatment at A Home Away?

Yes

No

What is the best time to call you?

4. What is your preferred method of contact?

Telephone

E-Mail

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