Chances of Success

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WHAT IS MODERATE DRINKING?

CHANCES OF SUCCESS

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Chances of success

What are your chances of success? If you take the questionnaire below, you'll get feedback about how likely you could be to succeed with moderating your drinking. If you'd rather skip this questionnaire then this is the end of the overview. If you wish to register to use the program, click here.

Do you feel you are a normal drinker? (By normal we mean you drink less than or as much as most other people.)	Yes No
Have you ever awakened the morning after some drinking the night before and found that you could not remember a part of the evening?	Yes No
Does your wife, husband, a parent, or other near relative ever worry or complain about your drinking?	Yes No
Can you stop drinking without a struggle after one or two drinks?	Yes No
Do you ever feel guilty about your drinking?	Yes No
Do friends or relatives think you are a normal drinker?	Yes No
Are you always able to stop drinking when you want?	Yes No
Have you ever attended a meeting of Alcoholics Anonymous (AA)?	Yes No
Have you gotten into physical fights when drinking?	Yes No
Has your drinking ever created problems between you and your wife, husband, a parent, or other relative?	Yes No
Has your wife, husband, (or other family members) ever gone to anyone for help about your drinking?	Yes No
Have you ever lost friends because of your drinking?	Yes No
Have you ever gotten into trouble at work or school because of drinking?	Yes No
Have you ever lost a job because of drinking?	Yes No
Have you ever neglected your obligations, your family, or your work for two or more days in a row because you were drinking?	Yes No
Do you drink before noon often?	Yes No
Have you ever been told you have liver trouble? Cirrhosis?	Yes No
After heavy drinking, have you ever had Delirium Tremens (D.T.'s) or severe shaking or heard voices or seen things that really weren't there?	Yes No
Have you ever gone to anyone for help about your drinking?	Yes No
Have you ever been in a hospital because of drinking?	Yes No
Have you ever been a patient in a psychiatric hospital or on a psychiatric ward of a general hospital when drinking was part of the problem that resulted in hospitalization?	Yes No
Have you ever been seen at a psychiatric or mental health clinic, or gone to any doctor, social worker; or clergyman for help with any emotional problem, where drinking was part of the problem?	Yes No
Have you ever been arrested for drunk driving, driving while intoxicated, or driving under the influence of alcoholic beverages? If yes, how many times	Yes No
Have you ever been arrested, or taken into custody, even for a few hours, because of other drunk behavior? If yes, how many times	Yes No