(Scores for response categories are given in parentheses. Scores range from 0 to 40, with a cutoff score of 5 or more indicating hazardous drinking, harmful drinking, or alcohol dependence.) |
1. How often do you have a drink containing alcohol? |
(0) Never | (1) Monthly or less | (2) Two to four times a month | (3) Two or three times a week | (4) Four or more times a week |
2. How many drinks containing alcohol do you have on a typical day when you are drinking? |
(0) 1 or 2 | (1) 3 or 4 | (2) 5 or 6 | (3) 7 to 9 | (4) 10 or more |
3. How often do you have six or more drinks on one occasion? |
(0) Never | (1) Less than monthly | (2) Monthly | (3) Weekly | (4) Daily or almost daily |
4. How often during the past year have you found that you were not able to stop drinking once you had started? |
(0) Never | (1) Less than monthly | (2) Monthly | (3) Weekly | (4) Daily or almost daily |
5. How often during the past year have you failed to do what was normally expected of you because of drinking? |
(0) Never | (1) Less than monthly | (2) Monthly | (3) Weekly | (4) Daily or almost daily |
6. How often during the past year have you needed a first drink in the morning to get yourself going after a heavy drinking session? |
(0) Never | (1) Less than monthly | (2) Monthly | (3) Weekly | (4) Daily or almost daily |
7. How often during the past year have you had a feeling of guilt or remorse after drinking? |
(0) Never | (1) Less than monthly | (2) Monthly | (3) Weekly | (4) Daily or almost daily |
8. How often during the past year have you been unable to remember what happened the night before because you had been drinking? |
(0) Never | (1) Less than monthly | (2) Monthly | (3) Weekly | (4) Daily or almost daily |
9. Have you or has someone else been injured as a result of your drinking? |
(0) No | | (2) Yes, but not in the past year | | (4) Yes, during the past year |
10. Has a relative or friend or a doctor or other health worker been concerned about your drinking or suggested you cut down? |
(0) No | | (2) Yes, but not in the past year | | (4) Yes, during the past year |