John Muir Health
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Are you or others concerned about your use of alcohol or other chemicals?

Your answers to the following questions may assist you in that awareness.

    Yes No
1. Have you lost time from work due to drinking or other chemical usage?
2. Does drinking or chemical use cause your home life to be unhappy?
3. Has your drinking or using caused money problems?
4. Do you or have you associated with people you didn't respect, or hung out in places you didn't want to be in when drinking or using?
5. Does your drinking or using cause you to be careless about your family's welfare?
6. Do you need a drink or use a chemical "the morning after"?
7. Do you drink or use chemicals to escape from problems or worries?
8. Have you ever experienced a complete loss of memory following drinking or using chemicals?
9. Have you ever been arrested or hospitalized due to drinking or using chemicals?
10. Have you ever felt guilty after drinking or using chemicals?

If you have answered "yes" to any of the above questions, you may have a problem with alcohol and/or other chemicals.