Click in this frame, print frame, and total your score.
Add up the points for each question you answered with a yes.
| Points | ||
| 2 | l. | Do you feel that you are a normal drinker? |
| 2 | 2. | Have you ever awakened the morning after some drinking the night before and found that you could not remember part of the evening before? |
| 1 | 3. | Does your spouse (or parent) ever worry or complain about your drinking? |
| 2 | 4. | Can you stop drinking without a struggle after one or two drinks? |
| 1 | 5. | Do you ever feel bad about your drinking? |
| 2 | 6. | Do friends or relatives think you are a normal drinker? |
| 0 | 7. | Do you ever try to limit your drinking to certain times of the day or to certain places? |
| 2 | 8. | Are you always able to stop drinking when you want to? |
| 5 | 9. | Have you ever attended a meeting of Alcoholics Anonymous(AA)? |
| 1 | 10. | Have you gotten into fights when drinking? |
| 2 | 11. | Has drinking ever created problems with you and your spouse? |
| 2 | 12. | Has your spouse (or other family members) ever gone to anyone for help about your drinking? |
| 2 | 13. | Have you ever lost friends, girlfriends, or boyfriends boyfriends because of your drinking? |
| 2 | 14. | Have you ever gotten into trouble at work because of drinking? |
| 2 | 15. | Have you ever lost a job because of drinking? |
| 2 | 16. | Have you ever neglected your obligations, your family, or your work for 2 or more days in a row because you were drinking? |
| 1 | 17. | Do you ever drink before noon? |
| 2 | 18. | Have you ever been told you have cirrhosis (liver trouble)? |
| 2 | 19. | Have you ever had delirium tremens (DT’s) severe shaking, heard voices, or seen things that weren’t really there after heavy drinking? |
| 5 | 20. | Have you ever gone to anyone for help about your drinking? |
| 5 | 21. | Have you ever been hospitalized because of drinking? |
| 2 | 22. | Have you ever been a patient in a psychiatric hospital or on a psychiatric ward of a general hospital where drinking was part of the problem? |
| 2 | 23. | Have you ever been seen at a psychiatric or mental health clinic, or gone to a doctor, social worker, or clergyman for help with an emotional problem in which drinking has played a part? |
| 2 | 24. | Have you ever been arrested, even for a few hours, because of drunken behavior? |
Total Points: ____
Scoring: A score of three points or less is considered nonalcoholic, four points is suggestive of alcoholism, a score of five points or more indicates alcoholism.
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