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It may be difficult to know if your alcohol or other substance use is putting you at risk for a substance use disorder. However, readily available screening instruments can help you determine if your alcohol or substance use may be harmful.

If you suspect you may have a problem with alcohol use, you might want to print out this section and ask yourself the following questions:

Alcohol Use Disorders Identification Test (AUDIT)

Please circle the answer that is correct for you:

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 drinks containing alcohol do you have on a typical day when you are drinking?
   • 1 or 2
   • 3 or 4
   • 5 or 6
   • 7 to 9
   • 10 or more
3. How often do you have six or more drinks on one occasion?
   • Never
   • Less than monthly
   • Monthly
   • Weekly
   • Daily or almost daily
4. How often during the last year have you found it difficult to get the thought of alcohol out of your mind?
   • Never
   • Less than monthly
   • Monthly
   • Weekly
   • Daily or almost daily
5. How often during the last year have you found that you were not able to stop drinking once you had started?
   • Never
   • Less than monthly
   • Monthly
   • Weekly
   • Daily or almost daily
6. How often during the last year have you been unable to remember what happened the night before because you had been drinking?
   • Never
   • Less than monthly
   • Monthly
   • Weekly
   • Daily or almost daily
7. How often during the last year have you needed a first drink in the morning to get yourself going after a heavy drinking session?
   • Never
   • Less than monthly
   • Monthly
   • Weekly
   • Daily or almost daily
8. How often during the last year have you had a feeling of guilt or remorse after drinking?
   • Never
   • Less than monthly
   • Monthly
   • Weekly
   • Daily or almost daily
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 any other health worker been concerned about your drinking or suggested you cut down?
    • No
    • Yes, but not in the last year
    • Yes, during the last year

Scoring AUDIT

For questions 1 through 8, you get zero points if you circled the first answer, one point if you circled the second answer, two points for the third, three points for the fourth and four points for the fifth.

For questions nine through 10, you get zero points for the first answer, two for the second and four for the third.

Add up your scores from questions 1 to 10. The maximum score is 40.

Questions 1 to 3:

A combined score of four or more for women or five or more for men suggests a hazardous level of drinking.

Questions 4 to 5:

A combined score of four or more suggests a person may be psychologically or physically dependent on alcohol.

Questions 7 to 10:

A combined score of four or more suggests significant problems with alcohol already exist.

A total score of seven or more on the questionnaire suggests that you have a pattern of hazardous or harmful alcohol consumption.

The Drug Abuse Screening Test (DAST)

The Drug Abuse Screening Test (DAST) is one of the two standard screening tools that health care providers use to screen a person for a possible drug use disorder.

Answer YES or NO to the following questions:

1. Have you used drugs other than those required for medical reasons?

2. Have you abused prescription drugs?

3. Do you abuse more than one drug at a time?

4. Can you get through the week without using drugs (other than those required for medical reasons)?

5. Are you always able to stop using drugs when you want to?

6. Do you abuse drugs on a continuous basis?

7. Do you try to limit your drug use to certain situations?

8. Have you had "blackouts" or "flashbacks" as a result of drug use?

9. Do you ever feel bad about your drug abuse?

10. Does your spouse (or parents) ever complain about your involvement with drugs?

11. Do your friends or relatives know or suspect you abuse drugs?

12. Has drug abuse ever created problems between you and your spouse?

13. Has any family member ever sought help for problems related to drug use?

14. Have you ever lost friends because of your use of drugs?

15. Have you ever neglected your family or missed work because of your use of drugs?

16. Have you ever been in trouble at work because of drug abuse?

17. Have you ever lost a job because of drug abuse?

18. Have you gotten into fights when under the influence of drugs?

19. Have you ever been arrested because of unusual behavior while under the influence of drugs?

20. Have you ever been arrested for driving while under the influence of drugs?

21. Have you engaged in illegal activities in order to obtain drugs?

22. Have you been arrested for possession of dangerous drugs?

23. Have you ever experienced withdrawal symptoms as a result of heavy drug intake?

24. Have you had medical problems as a result of your drug use (e.g., memory loss, hepatitis, convulsions, bleeding, etc.)?

25. Have you ever gone to anyone for help for a drug problem?

26. Have you ever been in a hospital for medical problems related to drug use?

27. Have you ever been involved in a treatment program specifically related to drug care?

28. Have you been treated as an out-patient for problems related to drug use?

Your score is equal to the number of questions you answered YES.

A score of five or less indicates a normal score.

A score of six or more indicates a problem with drugs.

Brief intervention

If you meet the criteria for hazardous drinking but are not actually dependent on alcohol, you should seek advice that is focused on the reduction of hazardous drinking. Depending on how severe your drinking is, brief counseling and continued monitoring may be all you need. If you don't respond to advice or counseling, or seem to be exhibiting signs of alcohol dependence, you need more evaluation and treatment.

Assessment, diagnosis and treatment

For women who screen positive for a substance abuse disorder, it is important to see a health care professional for further assessment. If you receive a diagnosis of alcohol or drug dependence, it is important that you seek treatment.

Since substance use disorders are chronic illnesses, treatment includes not only the initial therapy aimed at achieving abstinence from the substance, but long-term management to promote health and prevent further consequences. If you are diagnosed with substance use dependence, you are at risk for relapse throughout your life.

But substance dependence can be treated and the risk of relapse reduced using tested interventions. Researchers find that treatment issues differ between women and men, however. At one time, treatment programs were designed to address only the patterns and reasons behind men's substance dependency issues, since men comprised the majority of any treatment group. Women's issues, such as emotional, psychological or physical abuse, lack of self-esteem and family responsibilities, tended to slip through the cracks.

Yet depression and anxiety disorders are more common in women than men and are also risk factors for alcohol and drug abuse, including cigarette smoking. Thus, treating depression and anxiety disorders in women can be key to their recovery. Also, women are often reluctant to admit they have a problem and to seek or enter treatment, fearing they will lose their children or won't be able to take care of them.

Given these differences, single-sex programs are becoming more available. Although evidence is still inconclusive as to whether women-only treatment programs are more effective than mixed-gender programs, many women prefer them. Some programs offer child care, parenting classes and therapy for children of substance users.