SAVERA

Addiction Self-Assessment Screening Tool

Important Health and Medical References

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<span class="glossary-tooltip glossary-term-12613" tabindex="0"><span class="glossary-link"><a href="https://meenuvaidmd.com/glossary/addiction/" target="_blank" class="glossary-only-link">Addiction</a></span><span class="hidden glossary-tooltip-content clearfix"><span class="glossary-tooltip-text">Chronic disorder with compulsive use despite harm; brain changes. <a href="https://meenuvaidmd.com/glossary/addiction/">More</a></span></span></span> Self-Assessment Screening Tool

Addiction Self-Assessment Screening Tool

Important Notice

This screening tool is for educational purposes only and does not constitute a medical diagnosis.

These questionnaires use validated screening instruments to help identify potential substance use or behavioral addiction concerns. Results should be discussed with a qualified healthcare professional for proper evaluation and treatment recommendations.

Confidentiality: Your responses are not stored or transmitted. This assessment is completely anonymous.

If you are in crisis or need immediate help, please contact:

  • SAMHSA National Helpline: 1-800-662-HELP (4357)
  • Crisis Text Line: Text HOME to 741741
  • National Suicide Prevention Lifeline: 988

Select a Screening Assessment

Alcohol Use Disorders Identification Test (AUDIT)

Please answer the following questions about your alcohol consumption over the past year.

1. How often do you have a drink containing alcohol?
2. How many drinks containing alcohol do you have on a typical day when you are drinking?
3. How often do you have six or more drinks on one occasion?
4. How often during the last year have you found that you were not able to stop drinking once you had started?
5. How often during the last year have you failed to do what was normally expected of you because of drinking?
6. How often during the last year have you needed a first drink in the morning to get yourself going after a heavy drinking session?
7. How often during the last year have you had a feeling of guilt or remorse after drinking?
8. How often during the last year have you been unable to remember what happened the night before because of your drinking?
9. Have you or someone else been injured because of your drinking?
10. Has a relative, friend, doctor, or other health care worker been concerned about your drinking or suggested you cut down?

Drug Abuse Screening Test (DAST-10)

The following questions concern information about your possible involvement with drugs not including alcoholic beverages during the past 12 months. When the words "drug abuse" are used, they mean the use of prescribed or over-the-counter medications/drugs in excess of the directions and any non-medical use of drugs.

1. Have you used drugs other than those required for medical reasons?
2. Do you abuse more than one drug at a time?
3. Are you unable to stop using drugs when you want to?
4. Have you ever had blackouts or flashbacks as a result of drug use?
5. Do you ever feel bad or guilty about your drug use?
6. Does your spouse (or parents) ever complain about your involvement with drugs?
7. Have you neglected your family because of your use of drugs?
8. Have you engaged in illegal activities in order to obtain drugs?
9. Have you ever experienced withdrawal symptoms (felt sick) when you stopped taking drugs?
10. Have you had medical problems as a result of your drug use (e.g., memory loss, hepatitis, convulsions, bleeding)?

Fagerström Test for Nicotine Dependence

Please answer the following questions about your smoking habits.

1. How soon after you wake up do you smoke your first cigarette?
2. Do you find it difficult to refrain from smoking in places where it is forbidden?
3. Which cigarette would you hate most to give up?
4. How many cigarettes per day do you smoke?
5. Do you smoke more frequently during the first hours after waking than during the rest of the day?
6. Do you smoke if you are so ill that you are in bed most of the day?

Internet Gaming Disorder Scale - Short Form (IGDS9-SF)

Please answer the following questions about your gaming activities over the past 12 months.

1. Do you feel preoccupied with your gaming behavior?
2. Do you feel irritable, anxious or sad when you try to reduce or stop gaming?
3. Do you feel the need to spend increasing amounts of time engaged in gaming?
4. Do you fail when trying to control or reduce your gaming activity?
5. Have you lost interests in previous hobbies and other activities as a result of gaming?
6. Have you continued gaming despite knowing it was causing problems between you and other people?
7. Have you deceived any of your family members, therapists or others because of the amount of gaming?
8. Do you use gaming to escape or relieve a negative mood?
9. Have you jeopardized or lost a significant relationship, job or educational opportunity because of gaming?

Problem Gambling Severity Index (PGSI)

Thinking about the last 12 months, please answer the following questions about your gambling activities.

1. Have you bet more than you could really afford to lose?
2. Have you needed to gamble with larger amounts of money to get the same feeling of excitement?
3. Have you gone back another day to try to win back the money you lost?
4. Have you borrowed money or sold anything to get money to gamble?
5. Have you felt that you might have a problem with gambling?
6. Has gambling caused you any health problems, including stress or anxiety?
7. Have people criticized your betting or told you that you had a gambling problem?
8. Has your gambling caused any financial problems for you or your household?
9. Have you felt guilty about the way you gamble or what happens when you gamble?

Bergen Social Media Addiction Scale (BSMAS)

Below you find six statements about your relationship with social media. For each statement, please indicate how often during the last year this has occurred.

1. You spend a lot of time thinking about social media or planning how to use it
2. You feel an urge to use social media more and more
3. You use social media in order to forget about personal problems
4. You have tried to cut down on the use of social media without success
5. You become restless or troubled if you are prohibited from using social media
6. You use social media so much that it has had a negative impact on your job/studies

Resources and Support

  • SAMHSA National Helpline: 1-800-662-HELP (4357) - Free, confidential, 24/7 treatment referral service
  • Alcoholics Anonymous: www.aa.org
  • Narcotics Anonymous: www.na.org
  • SMART Recovery: www.smartrecovery.org
  • National Council on Problem Gambling: 1-800-522-4700
  • Find an Addiction Medicine Specialist: ASAM Provider Directory

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