| Question |
Yes |
No |
| 1. |
Are my peers, friends
or family alleging that my drinking or drug use is interfering with my
work? |
( ) |
( ) |
| 2. |
Do I plan my day
around my drinking/drug use? |
( ) |
( ) |
| 3. |
Do I ever feel I
need a drink/drug to face certain situations? |
( ) |
( ) |
| 4. |
Do I frequently drink/use drugs alone? |
( ) |
( ) |
| 5. |
Have I ever had a loss of memory when apparently functioning because
of my drinking/drug use? |
( ) |
( ) |
| 6. |
Do I ever drink/use
drugs before a meeting or court appearance to calm my nerves, gain courage,
or improve my performance? |
( ) |
( ) |
| 7. |
Do I want a drink
or take a drug the morning after a hard night drinking/drugging? |
( ) |
( ) |
| 8. |
Have I missed deadlines
or appointments because of my drinking/drug use or because of a hangover? |
( ) |
( ) |
| 9. |
After drinking/drug use, have I ever felt any of the following: fear,
remorse, guilt, loneliness, depression, severe anxiety, terror, or impending
doom? |
( ) |
( ) |
| 10. |
Is my drinking/drug
use making me careless about my finances, health or other responsibilities? |
( ) |
( ) |
| 11. |
While drinking/drugging, have I ended up in places I would not normally
frequent or with people I would not normally socialize with? |
( ) |
( ) |
| 12. |
Do I need or desire a drink/drug to steady my nerves at a particular
time of day or week? |
( ) |
( ) |
| 13. |
Have I ever lied,
cheated or stolen to support or cover up my drinking/drug use? |
( ) |
( ) |
| 14. |
Have I ever tried unsuccessfully to quit drinking/drugging for any
length of time? |
( ) |
( ) |
| 15. |
Have I made attempts
to control my drinking/drug use by limiting it to special occasions,
special times of the day, or certain days of the week, certain number
or types of drinks/drugs? |
( ) |
( ) |
| 16. |
Do I avoid people
in order to hide the effects of my drinking/drug use? |
( ) |
( ) |
| 17. |
Have I ever been
hospitalized or treated by a doctor directly or indirectly as a result
of my drinking/drugging? |
( ) |
( ) |
| 18. |
Is there anyone
in any generation of my family who has been diagnosed, treated for, or
sought help for an alcohol, drug or other addiction problem? |
( ) |
( ) |
| If you answered YES to one or more of these questions,
you owe it to yourself, your family, your clients and your profession
to contact a lawyer assistance program. See the links on this site. |
