Self Assessment - Foundation House

The following questions are only to be used as a tool to see if there are concerns that you might have either a substance abuse problem and or an emotional illness:

SELF-ASSESSMENT: CHEMICAL DEPENDENCY
Take a moment to ask yourself the following questions. Be sure to read through them all and be honest about your answers.

Are you unhappy?

Do you find yourself focusing on drugs/alcohol to the exclusion of work and family responsibilities?

Do you feel that you are different? That you are not an addict - that if it weren't for your spouse, job stresses, money problems, etc. that you would not be using?

Does the thought of living without drugs and alcohol seem impossible, too painful?

Do you ever feel trapped - that you can't stop using and you can't go on the way you're living?

Do you switch from vodka to beer to wine, from one drug to another, thinking that a particular type of substance is the problem?

Are you in jeopardy of losing your job or family because of your drinking/drug use?

Do you use or drink alone?

Do you refuse to go places where you cannot use or drink?

Do you hide your use or lie about the amount you drink or use?

Do you have any legal problems, like a DUI, felony arrests or other "brushes with the law" where your drug/alcohol use was present?

Have you ever used cocaine, crack, and heroin, pot? Ecstasy, blue ice, PCP, acid or any other designer drugs?

In the past, have you stopped, cut down, or decided to use/drink "only on weekends," only to find your use back in full swing after a short time?

Do you ever feel like you are going crazy, that your life is out of control?

Is it getting harder to keep it all "under control" - hiding your use, showing up for work, looking and acting "normal," pretending to be ok?

Do you use to manage feelings of anger, loss, loneliness and other emotional pain?

Has anyone commented about your use being excessive?

Do you feel that no one can help you or that you are beyond help?

Do you continue to use despite negative consequences?

SELF ASSESSMENT - PSYCHIATRIC / DUAL DIAGNOSIS

Do I have feelings of sadness and/or irritability?

Have I been feeling a loss of interest or pleasure in activities or my work that I once enjoyed?

Have I been experiencing changes in my weight and appetite?

Am I sleeping more or am I having trouble with falling asleep or waking up during the night or early in the morning?

Have I been feeling overwhelming guilt, hopelessness or worthlessness?

Is the ability to concentrate, remember things or make decisions becoming more difficult for me?

Have I been more fatigued and have less energy than I’ve had in the past even though my workload and normal daily stressors haven’t changed?

Have my colleagues, family or friends commented on my behavior, restlessness or decreased activity?

Have I recently had thoughts of suicide or death?

Do I seem to have more energy and require less sleep in recent weeks/months?

Have I had periods recently of feeling overly excited and irritable?

Have I recently engaged in impulsive behavior and used poor judgment – examples: gambling, sexual promiscuity?

If you answered "yes" to any of these questions, please call us at 207.767.1717.
Or you can E-mail us at recovery@foundationhouse.net
If you answered "yes" to three or more questions, please don't wait to call us.

Use of Self Assessment courtesy of Harmony Place