Self Questionnaire

Questionnaire Interpretation:

• If you checked any of the boxes in Section 1, you may have an alcohol/other drug problem.

• If you checked any of the boxes in Section 2, your spouse may need help handling your drinking/using problem in a way that protects both of you.

• Please consider getting help by talking with a substance abuse or health professional today or getting a referral to speak with a professional at a later date. To receive a referral please contact:

What to do if you think you may have an alcohol or other drug problem:

• Seek out resources locally such as the Addiction Resource Council as well as local treatment providers, mental health clinics, therapists, clergy, doctors, and social workers who are knowledgeable about substance abuse problems to arrange for a confidential assessment of your use. Don’t let pride or fear block your efforts to get help for yourself.

• Use the resources but you are under no obligation to follow through with any recommendations made if you are not ready to do so.

• Seek out the people and resources that can support you in your decision to make changes related to your drinking/other drug use (see below). Keep in mind that you are not alone. There is hope and help and healing available in your local community.