Alcohol Questionnaire

Ask yourself the following test questions. Answer them as honestly as you can. (If the answers are 'No' to all the questions, re-answer them with the help of your spouse or the closest member the your family).

'It is a highly relapse -prone disease. A rigorous maintenance schedule is essential in order to stay sober'.

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

Analysis of questionnaire

If you have answered YES to any one of the questions, there is a definite warning that you may be an alcoholic.
If you have answered YES to any two, the chances are that you're an alcoholic.
If you have answered YES to three or more, you are definitely an alcoholic.
(John Hopkins University, Baltimore, USA uses the above test questions, in deciding whether or not a person is an alcoholic).

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