Do you ever use drugs for something other than a medical reason?
Yes
No
Do you use drugs more than once per week?
Yes
No
Have you ever tried to stop using drugs but couldn’t stay stopped?
Yes
No
Do you ever feel ashamed or guilty after using drugs?
Yes
No
Have you ever lost a job due to drug use?
Yes
No
Do you find it challenging to control or reduce your drug use?
Yes
No
Have you experienced cravings or strong urges?
Yes
No
Does your drug use interfere with responsibilities at work, school, or home?
Yes
No
Do you spend a significant amount of time obtaining, using, or recovering from drugs?
Yes
No
Have you given up activities you once enjoyed because of drug use?
Yes
No
Do you experience withdrawal symptoms when not using the substance?
Yes
No
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