Alcohol Questionnaire

			Tulasi Home - A Half Way Home for Mental Disorders and Substance Abuse Seperate Female Patient De Addiction Programme

Schizophrenia often starts slowly. When the symptoms first appear, usually in adolescence or early adulthood, they may seem more bewildering than serious

A Half Way Home, as the name implies, is a stepping stone for a person with major mental illness and substance abuse who has received medical treatment and has recovered from an acute stage, but needs interventions to develop skills of daily living, interpersonal interactive skills and vocational skills.

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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