Age
When did you leave school?
What is the highest level of education you have achieved?
Education level
What is your marital status?
Do you have any children?
Do you have a profession or trade?
Psychiatric disorder other than SUD
Depression
Anxiety Disorders
Obsessive Compulsive Disorder
Post Traumatic Stress Disorder
Bipolar Disorder
Eating Disorder
Schizophrenia
Personality Disorder
How often do you use drugs other than alcohol?
Do you use more than one type of drug on the same occasion?
How many times do you take drugs on a typical day when you use drugs?
How often are you influenced heavily by drugs?
Over the past year, have you felt that your longing for drugs was so strong that you could not resist it?
Has it happened, over the past year,that you have not been able to stop taking drugs once you started?
How often over the past year have you taken drugs and then neglected to do something you should have done?
How often over the past year have you needed to take a drug the morning after heavy drug use the day before?
How often over the past year have you had guilt feelings or a bad conscience because you used drugs?
Have you or anyone else been hurt (mentally or physically) because you used drugs?