Quiz FormHiddenQuiz Typealcoholism-quizco-dependent-quizdual-diagnosis-co-occurring-disorder-quizenabling-family-member-quizfamily-addiction-quizheroin-addiction-quizprescription-drug-addiction-quizquiz-addictionquiz-outpatientAlcoholism QuizWhen you are feeling sad, do you have a few drinks to ease the pain?Do you notice that you can handle a lot more alcohol now than you could when you first started?Have you had blackouts after drinking?Is drinking a big highlight of your day?Do you plan your social life according to the events that will include alcohol?Let's say that you drank a lot at a party last night. You didn't pass out or black out. The next day your friends tell you that you said certain things you don't recall saying at all. Does this happen to you?Do your family members and/or friends tell you that you drink too much?Have you lost friendships because of your drinking?Do you ever have an alcoholic drink in the morning?Have you ever had a DUI or DWI?Do you have other family members that drink large amounts of alcohol or always include drinking alcohol in their daytime activities?Do you ever feel guilty about drinking?Are there days where you stay drunk for more than 24 hours?When you try to drink less, do you find that you get to the point where you feel so bad - but a drink pulls you out of it?Do you have any of these: fatigue, worsening memory, wake up with abdominal discomfort, episodes where your body shakes, or nausea?Do you feel socially inept whenever there's no alcohol at a party?Is it rare for you to eat three meals in a day?Have you been told by a doctor that you have a fatty liver or that you need an alcohol rehab center?Have you ever been to a rehab center for alcohol abuse?Do you try to keep your drinking a secret from your family or coworkers?Have you had arguments with family and friends about your drinking habits?Are you afraid to go without alcohol during the day?Do you try to hide your consumption of alcohol from coworkers?Do you find yourself calling in sick to work more often since you started drinking larger quantities of alcohol?Have you ever done anything illegal to get more alcohol or while under the influence?Have you had any blackouts recently?After going without a drink, do you get tremors and/or start sweating?Do you ever get withdrawal headaches, feel depressed, or feel suicidal on days when you don't drink?Do you rearrange your budget to insure that alcohol is always in the house and may even replace some foods?Since you started drinking, do you feel more guilt or hopelessness?Am I A Co-Dependent?Are you currently in a relationship with one or more needy people that allow you to take care of them?When another person acts negatively towards you, does it affect you a lot emotionally?When your friend does something negative that directly affects you, do you start taking it personally?When your friend does something that doesn't make a lot of sense to other people, do you try to step in and rescue him?When your friend's mood is bad, does it affect your mood?Do you struggle with perfectionism?Do you worry excessively?Do family members tell you that you do way too much to help someone you know that is addicted to alcohol or drugs, or actually call you codependent?After you compromise and give your friend what he wants, do you feel a lot of anger and resentment?Do you spend a significant portion of your time worrying about what your addicted friend or family member should do?Do you always make sure that your needy friend's needs are taken care of and then realize that your needs really are never addressed in the relationship?Do you believe you are totally dedicated to the welfare of the person you know who has the addiction problem?When looking back at your relationship within the last year, is it true that you can't remember many happy moments?Is it difficult to determine how you feel about something and express it?Do you frequently hear excuses from the other person about fulfilling their own responsibilities?Do you feel that you should be responsible for how others act?Is it difficult for you to say no when another person asks for help?When you try to change a situation that your friend is involved in, do you feel remorse later?Have you ever tried to orchestrate finances, even through borrowing money, to help someone else pay their debts or continue his drug problem?Do you notice that your time is spent more on another person than taking care of your own goals in life?Do you lose time at work due to another person's drug or alcohol problem?Have close friends or family members asked you why you are still friends with another person?Do you have difficulty sleeping due to the problems with another person?Have you ever wondered why you are still having a relationship with a certain friend?Have you ever had a strong feeling that you are or were in a codependent relationship?Do You Have a Dual Diagnosis or Co-Occurring Disorder?Has a medical doctor given you a diagnosis for anxiety in the last 6-12 months?Have you been taking medications of anxiety, depression, bipolar disorder, or Post Traumatic Stress Disorder?Have you been given a diagnosis of depression recently or been taking anti-depressants?Has a medical doctor ever diagnosed you with bipolar disorder or Post Traumatic Stress Disorder?Do you sleep more than 9 hours a night because there's no real reason to get up in the morning?Is it difficult for you to focus on whatever you have to do at work or at home?Are you an excessive worrier?Are you afraid you will have a panic attack suddenly or plan your schedule to avoid situations where it would be embarrassing if you had a panic attack?Have you ever been sexually abused, or witnessed violence or death of someone close to you?Does your mind often flashback to a very stressful incident you had in life?Are there times when you vomit after eating a large meal?Are there 'rituals' you have to do every day; otherwise, things are not right in life?Do you entertain thoughts of committing suicide?Do you have a phobia such as a fear of leaving your house, people, crowds, flying, animals, snakes, bridges, or other things, which prevent you from doing certain activities or going places?Do you feel it's important to wash your hands more than 5 times a day?Do you have huge mood swings during the day?Have you ever been diagnosed with anorexia or bulimia?Have you been told by family, friends or doctors you are too skinny and need to put weight on?Am I Enabling My Family Member to Continue Using Drugs or Alcohol?When your family member acts badly because he has been using drugs, do you step in and make excuses for him?Have you loaned the family member money?Are there times where you want to confront him about his drug or alcohol use but back down because of what you think his response might be?Do you try to keep the family peace and avoid conflict with her?Have there been times where you had to step in and pay for her legal fees?Have things progressed to a point in the past where you asked him to leave?Have there been times where you made a threat and said you would walk out but then changed your mind?Have you spent money bailing her out of jail or paying legal fees?In your mind, have you given your loved one another chance to straighten up or to do the right thing?Do you still wrestle with the idea that your family member may not be using drugs or drinking alcohol?Are there times where you see that your family member may go through a lot of pain from the consequences of using drugs or alcohol - and you step in to rescue him?Have you called upon your virtue of patience or waiting on God to get through this drug/alcohol problem?Have you ever used drugs or alcohol with your loved one?Are there times where you are covering for the family member's responsibilities?Is Your Family Member Addicted?Has your family member been acting more secretive in the last few months?Do you notice he is a lot more withdrawn lately?Has she stopped contributing to groceries, rent, or other family costs, or stopped offering to help around the house or with yard work lately?Is your family member gone for long periods of time with no rational explanation for where he was?You had a scheduled lunch or meeting with your family member. He doesn't show up. You find out later that he drank alcohol or used drugs instead of meeting you. Is this a common scenario in your life?Have you felt uncomfortable about the character of your family member's friends but can't really pinpoint why?Do you see a decline in personal hygiene in your family member?Has she been avoiding eye contact with you?Have your or other family members noticed that personal belongings have disappeared recently?Has your family member been to rehab in the past, but is now avoiding you, and even lying to you about what he's doing during the day?Do you feel heartbroken that your family member appears to be slipping away from you - and off into another world, the world of addiction?Has your family member been fired from a job recently - and said it wasn't his fault?Has your family member started asking for loans but won't seem to tell you what the money is for?Is she acting differently, such as showing signs of depression, anxiety or bizarre anger outbursts?Do you find your loved one really isn't interested in things that he used to love doing?Do you notice that your family member is in need of more health care now than say a few months ago?Does your family member appear to be concerned only with her own social events, not those of the family?Have you noticed a shift in the sleeping hours your family member is keeping, such as staying up to the early morning hours and sleeping in late?Have you noticed that at holiday parties, your family member volunteers to get the beverages and brings home alcoholic beverages?Have you noticed your loved one is more aggressive and/or appears to have little concern for other people's feelings?Have you seen your loved one stagger or stumble while walking for no apparent reason at all?Has your loved one changed the type of foods he eats - and is now eating more junk food rather than real meals?Has your loved one been diagnosed with illnesses that are not usually seen in someone who is his age, such as heart disease, liver disease, lung disease or kidney disease?Does your loved one act suspicious about other family members; for example, he suspects you are taking his belongings?Is she adamant about privacy and everyone staying out of her room?Have you noticed that your family member is calling in sick to work more often?Are there times when he raids the refrigerator, eating everything in sight?Has your loved one had a recent DUI or DWI?Do you notice big mood swings in your loved one?Heroin AddictionDo you base your daily schedule on your heroin habit?Do you have friends that are heroin or drug users?Have any of your family members or friends asked you to stop using heroin?Do you notice you need higher amounts of heroin to get the same effect?When you try to cut back on your heroin use, are you unsuccessful?Do you have cravings to use heroin?At a party, do you find you end up using more heroin than you planned and stay longer so you can use more heroin?Have you done anything illegal to obtain heroin or while using heroin?Have you ever been arrested for drug possession?Do you spend a big part of your budget on heroin and/or other drugs?Do you borrow money from family and friends to purchase heroin?In the past few months, have you noticed a decline in your physical or mental health?Has your doctor said you need to spend time in a rehab center?Do you notice physical withdrawal symptoms wen you don't use the drug for a period of time?Are there things you should do at home but don't do them because of your use of heroin?Have you ever checked in at a rehab facility for painkiller or opiate addiction?Have you been told recently you have lung problems?Are you forgetting appointments, names, phone numbers, and why you walk into a room in your house?Have you been on opioid pain medications in the past year or two?Have you been told by your doctor you have kidney or heart problems?Do you have long periods of time where you don't eat meals?Do you often wear long-sleeved shirts during the summer months?Has your personal hygiene gone downhill in the last few months?Have you noticed you fudge the truth when others ask about what you've been doing?Have you had more problems with relationships at home, school, and work since you started using?Do you often experience nausea, vomiting or itching?Are your sleep cycles out of sync - you're up at night but sleep during the day?Have you noticed that a lot of the things you liked doing in the past are no longer important to you?Have you recently lost your job or an important relationship because of using heroin?Do you wish you could stop using heroin?Prescription Drug AddictionAre you using prescription drugs that your doctor did not prescribe for your health condition?Are you taking a dosage of your prescription drugs that is greater than the serving size or the amount your doctor prescribed?Do you set up doctor appointments with several doctors to get more medication and have extra ‘just in case'?Have you noticed that the regular dosage of your prescription medication isn't anywhere near what you need to handle your pain anymore?Does your personality change negatively if you miss a dose of medication?Are you afraid to go without your prescription medications when you travel?Do you find yourself calling in sick to work more often since you started taking your prescription medications?Have you ever spent time in a drug rehab center?Have you ever done anything illegal to get more prescription drugs?Do you take pain medication as a precaution to prevent pain later in the day?Have you had arguments with a family member or friend about your prescription drug use?When you tried reducing the dosage of your prescription pain medication, did you find that your pain increased so much that you had to get back on them?When you try stopping prescription medications, do you notice you have bouts of anxiety, tremors, headaches, or sweating?Do you get depressed if you miss a dose of your medication?Have you withdrawn from social interactions in the last few months, preferring to be alone?While you are on your medication, do you find yourself acting out of anger without cause or at the drop of a hat?Has your health declined since you started taking prescription drugs?Do you rearrange your finances to insure that you have enough money for prescription drugs?Have you seen multiple physicians to fill your prescriptions?Do you make up fake prescriptions to fill at the pharmacy?Do you often think of what life used to be like before you started taking prescription medications?Do you often have constipation? (Constipation is less than two bowel movements a day according to natural healing experts.)Has anyone ever told you that there are times when your words are slurred, even though you have never had a stroke?Addiction Rehab QuizHave you ever used any type of drug that was not prescribed by a doctor?When you have gotten prescriptions filled, have you ever used an amount that was more than what was prescribed?Do you use more than one substance at a time?Is it impossible for you to go extended periods of time without using drugs or alcohol? (For example, more than a week)Have you ever stopped using drugs or alcohol because you wanted to and found that you were not able to be successful?Have you ever experienced a blackout because of your drug or alcohol use?Does using drugs or alcohol ever make you feel guilty, or like you should try to stop?Have the people you love ever complained or expressed their concern about your drug or alcohol use?Have you lost important relationships in your life because of your substance use?Has your family ever expressed feeling neglected because of your dependence on drugs or alcohol?Have you experienced problems in your professional life because of your drug or alcohol use?Have you experienced financial hardships because of your drug or alcohol use?Have you ever been arrested because you were in possession of illegal drugs?Have you ever attempted to obtain prescription drugs illegally?Are you experiencing medical problems that could be linked to your use of drugs and/or alcohol?Have you ever considered getting help for an addiction in the past?Have you been a part of an addiction treatment program in Boise, Idaho or elsewhere in the country in the past?When you stop using drugs or alcohol for a period of time, do you experience withdrawal symptoms?Have you ever been in a fight with someone while you were under the influence of drugs and/or alcohol?Have you ever regretted drinking alcohol or using drugs because of circumstances that resulted from your use?Outpatient Rehab QuizDo you have a family with small children at home that relies on you to care for them each day?Do you have a part-time or a full-time job that makes it difficult for you to take extended periods of time off from work in order to go to addiction treatment at an inpatient facility?Do you attend school and want to continue with your education while you get addiction treatment?Do you feel that taking the time to go to an inpatient facility would be a hardship on you that would cause you a lot of stress?Do you have pets at home and no one else to care for them?Are you a caregiver for an elderly family member in the final stages of his/her life?Do you feel as though you have a solid support system that will help you get through each stage of your addiction recovery?Would you prefer to live at home while you get outpatient addiction treatment?Do you feel that you're highly motivated to get the help you need to stop using drugs and alcohol?Are you able to stop using drugs or alcohol for a period of up to three days at a time on your own?Can you take the time for several evenings a week to attend an outpatient treatment program?Are you interested in attending other types of groups such as AA or 12 Step Programs to supplement the information you learn during outpatient treatment in Boise, Idaho?Do you feel you're in the earlier stages of your addiction to drugs and alcohol?Will your health insurance company cover outpatient addiction treatment in full, but only partially cover inpatient treatment?Do you have any other personal situations that would create hardships for you if you were to choose inpatient addiction treatment?EmailNameFirst NameΔ
