Geauga Mental Health Association
Geauga Mental Health Association
Geauga Mental Health Association
Geauga Mental Health Association
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  Substance Abuse Survey  
 

This survey has been provided by the National Institute on Drug Abuse (NIDA). The NIDA's mission is to lead the nation in bringing the power of science to bear on drug abuse and addiction. This charge has two critical components: The first is the strategic support and conduct of research across a broad range of disciplines. The second is to ensure the rapid and effective dissemination and use of the results of that research to significantly improve drug abuse and addiction prevention, treatment and policy. 

National Institute on Drug Abuse National Institute of Health
6001 Executive Boulevard, Room 5213
Bethesda, MD 20892 U.S.A.
301.443.1124
www.nida.nih.gov

This survey is not meant to be a substitute for professional treatment. The purpose of the survey is to educate site users about the potential dangers of their own alcohol use.

1) How often do you have a drink containing alcohol?
Never
Monthly or less
2-4 times a month
2-3 times a week
4 or more times a week

2) How many drink containing alcohol do you have on a typical day when you are drinking?
0 - 2
3 - 4
5 - 6
7 - 9
10 or more
3) How often do you have four or more drinks on one occasion?
Never
Monthly or less
2-4 times a month
2-3 times a week
4 or more times a week
4) How often during the past year have you found that you were not able to stop drinking once you started?
Never
Monthly or less
2-4 times a month
2-3 times a week
4 or more times a week
5) How often during the last year have you failed to do what was normally expected from you because of drinking?
Never
Monthly or less
2-4 times a month
2-3 times a week
4 or more times a week
6) How often do you need a first drink in the morning to get yourself going after a heavy drinking session?
Never
Monthly or less
2-4 times a month
2-3 times a week
4 or more times a week
7) How often during the last year have you had a feeling of guilt or remorse after drinking?
Never
Monthly or less
2-4 times a month
2-3 times a week
4 or more times a week
8) How often during the last year have you been unable to remember what happened the night before because you had been drinking?
Never
Monthly or less
2-4 times a month
2-3 times a week
4 or more times a week
9) Have you or someone else been injured as a result of your drinking?
No
Yes, but not in the last year.
Yes, during the last year.
10) Has a relative, friend, doctor, or other health care worker been concerned about your drinking or suggested that you cut down?
No
Yes, but not in the last year.
Yes, during the last year.