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Self-Assessment
Repeat: weekly

A self-diagnosis to gain insights into your current situation and relationship with substances.

"Knowing yourself is the beginning of all wisdom." -  Aristotle

Self-assessment is the process of introspection and evaluation you can use to understand your behaviors, thoughts, emotions and triggers related to substance use. 

For a more detailed diagnosis, information and potential consequences please see "Take a test".

Rate your current interaction with mind altering substances.

5
=  Strongly Agree
4
=  Agree
3
=  Sometimes
2
=  Disagree
1
=  Strongly Disagree

I find myself thinking about drugs frequently, even when I'm not using them.

Notes:

I have tried to cut down or stop using drugs but found that I couldn’t.

Notes:

I use drugs to cope with stress, anxiety or other emotional problems.

Notes:

I have used drugs alone or in secret.

Notes:

I need to use more of the drug over time to achieve the same effects.

Notes:

I have experienced withdrawal symptoms (anxiety, sweating, nausea) when I haven’t used drugs for a while.

Notes:

I find it difficult to enjoy activities or social situations without using drugs.

Notes:

My relationships with family, friends or coworkers have been negatively affected by my drug use.

Notes:

I have neglected responsibilities at work, school or home because of my drug use.

Notes:

I continue to use drugs despite knowing they are causing problems in my life.

Notes:

I spend a significant amount of time obtaining, using or recovering from the effects of drugs.

Notes:

I have lied to others about my drug use or tried to hide it.

Notes:

I have experienced legal problems (arrests, fines) due to my drug use.

Notes:

I feel guilty or ashamed about my drug use.

Notes:

I have lost interest in hobbies, sports or other activities that I once enjoyed.

Notes:

I have put myself in dangerous situations (driving under the influence, using dirty needles) while using drugs.

Notes:

I continue to use drugs even though it causes health problems or makes existing conditions worse.

Notes:

I have experienced memory lapses, blackouts or other cognitive issues related to my drug use.

Notes:

I feel anxious, irritable and or depressed when I am not using drugs.

Notes:

I have tried to stop using drugs but relapsed, even after a period of abstinence.

Notes:

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