World Health Organisation ALCOHOL USE Self Screen.
The following questions will give you a picture of your recent alcohol use.
Please acknowledge the response that best describes your drinking.
If you haven’t been drinking alcohol you don’t need to answer the questions.
Have you drunk any alcohol in the last year?
How often do you have a drink containing alcohol?
Monthly or less
2-4 times a month
2-3 times a week
4 or more times a week
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
How often do you have six or more drinks on one occasion?
Less than monthly
Daily or almost daily
How often during the last year have you found that you were not able to stop drinking once you had started?
How often during the last year have you failed to do what was expected of you because of drinking?
How often during the last year have you needed a rst drink in the morning to get yourself going after a heavy drinking session?
How often during the last year have you had a feeling of guilt or remorse after drinking?
How often during the last year have you been unable to remember what happened the night before because of your drinking?
Have you or someone else been injured because of your drinking?
Yes, but not in the last year
Yes, during the last year
Has a relative, friend, doctor, or other health care worker been concerned about your drinking or suggested you cut down?
World Health Organisation USE OF DRUGS OTHER THAN ALCOHOL Self Screen.
The next questions will help you to understand whether use of all drugs other than alcohol is a problem for you.
This includes illicit drugs & pharmaceutical medications (e.g. sleeping pills, painkillers).
It does not include medication that you take as prescribed by your doctor.
Please acknowledge the response that best describes your use of all drugs (other than alcohol).
If you haven’t been using any, then you don’t need to answer the questions.
Have you used drugs other than alcohol in the last year?
How often do you use drugs other than alcohol?
How often do you use more than one drug on the same occasion?
How many times do you take drugs on a typical day when you use drugs?
7 or more
How often are you in uenced heavily by drugs?
Over the past year, have you felt your longing for drugs was so strong that you could not resist it?
Has it happened, over the past year, that you have not been able to stop taking drugs once you started?
How often over the past year have you taken drugs and then neglected to do something you should have done?
How often over the past year have you needed to take a drug the morning after heavy drug use the day before?
How often over the past year have you had guilt feelings or a bad conscience because you used drugs?
Have you or anyone else been hurt (mentally or physically) because you used drugs?
Has a relative or a friend, a doctor or a nurse, or anyone else been worried about your drug use or said to you that you should stop using drugs?
Have you injected drugs in the past four weeks? Yes/No