Name

Do you ever use/drink (or engage in other addictive behavior) more than intended?

(examples:  Tell yourself you're only going to drink a few beers, but end up drinking way more, Tell yourself you're just going to look at porn for a few minutes, but then end up spending way too much time looking at it, tell yourself you would leave the party at midnight but end up staying out all night using cocaine). 

Do you have failed attempts to stop, cut back, or control it? 

Do you spend a lot of time in activities necessary to obtain, use, or recover from the effects of your addictive behavior?  (ie: going to different stores to buy alcohol because you feel embarrassed about the cashier seeing you so frequently; sitting in  parking lots for long periods of time waiting for your dealer to show up; spending a lot of time in casinos; etc...) 

Do you get cravings (strong desires) to drink/use (or engage in addictive behaviors)? 

Does your substance use (or addictive behavior) negatively impact your ability to keep up with your responsibilities (at school, work, or home)

Is your drug/alcohol use (or other addictive behavior) negatively impact your family relationships, friendships, work relationships, or social life? 

Do you drink/use (or engage in other addictive behavior) in situations where it is physically hazardous?  (examples; drinking/driving; history of overdose; putting yourself in dangerous situations; using heavy equipment while intoxicated; etc...) 

Have you reduced your participation in important hobbies, work, or social activities? (example: do you avoid doing things that don't involve the substance/addictive behavior)  

Do you continue to do it, even though it's causing or worsening a physical or mental problem?  (examples: blood pressure, anxiety, depression, liver problems, STD's) 

Have you built up a tolerance to the substance/behavior? (do you need more or stronger to get the same effect) 

Do you feel bad when you can't (or don't) do it?