JOHNS HOPKINS Questionnaire

Do You Have an Alcohol Use Disorder?

This test was developed by Dr. Robert Seliger of Johns Hopkins in the 1930s to help people self-assess whether or not they have a drinking problem. This is not a professional screening tool, nor has it been validated and judged reliable. It is, however, a useful tool to help determine if your alcohol use is becoming problematic. Ask yourself the following questions, and answer them as honestly as you can.

1. Do you lose time from work due to drinking?

 

Yes_____    No_____

2. Is drinking making your home life unhappy?

 

Yes_____    No_____

3. Do you drink because you are shy with other people?

 

Yes_____    No_____

4. Is drinking affecting your reputation?

 

Yes_____    No_____

5. Have you ever felt remorse after drinking?

 

Yes_____    No_____

6. Have you gotten into financial difficulties as a result of drinking?

 

Yes_____    No_____

7. Do you turn to lower companions/inferior environments when drinking?

 

Yes_____    No_____

8. Does your drinking make you careless of your family’s welfare?

 

Yes_____    No_____

9. Has your ambition decreased since you started drinking?

 

Yes_____    No_____

10. Do you crave a drink at a definite time daily?

 

Yes_____    No_____

11. Do you want a drink the next morning?

 

Yes_____    No_____

12. Does drinking cause you to have difficulty in sleeping?

 

Yes_____    No_____

13. Has your efficiency decreased since you started drinking?

 

Yes_____    No_____

14. Is drinking jeopardizing your job or business?

 

Yes_____    No_____

15. Do you drink to escape from worries or trouble?

 

Yes_____    No_____

16. Do you drink alone?

 

Yes_____    No_____

17. Have you ever had a loss of memory (blackout) as a result of drinking?

 

Yes_____    No_____

18. Has your physician ever treated you for drinking?

 

Yes_____    No_____

19. Do you drink to build up your self-confidence?

 

Yes_____    No_____

20. Have you ever been to a hospital or institution on account of drinking?

 

Yes_____    No_____

If you answered YES to any one of the questions, this indicates you MAY have a problem with alcohol.

If you answered YES to any two, CHANCES are you have a problem with alcohol.

If you answered YES to three or more, you should seek additional evaluation of your use of alcohol.