ADS (Alchohol Use)

Alcohol Use Questionnaire - ADS

© CAMH

The questions below are about your use of alcohol in the past 12 months.

1. Carefully read each question and the possible answers provided. Answer each question by choosing the ONE choice that is MOST true for you.

2. The word "drinking" in a question refers to "drinking of alcoholic beverages".

Upon completion, the system will tell you where you stand with regards to having a problem with alcohol based on the answers you provided.

If you received an ID number from your Therapist, please enter it here

How much did you drink the last time you drank?

Enough to get high or less Enough to get drunk Enough to pass out

Do you often have a hangover on Sunday or Monday morning?

Yes No

Have you had the "shakes" when sobering up (hands tremble, shake inside)?

No Sometimes Almost every time I drink

Do you get physically sick (e.g. vomit, stomach cramps) as a result of drinking?

No Yes Almost every time I drink

Have you had the "DTs" (delirium tremens) -that is, seen, felt or heard things not really there; felt very anxious, restless and overexcited?

No Once Several Times

When you drink, do you stumble about, stagger and weave?

No Sometimes Often

As a result of drinking, have you felt overly hot and sweaty (feverish)?

No Once Sometimes

As a result of drinking, have you seen things that were not really there?

No Once Several Times

Do you panic because you fear you may not have a drink when you need it?

Yes No

10.

Have you had blackouts ("loss of memory" without passing out) as a result of drinking?

No, never Sometimes Often Almost every time I drink

11.

Do you carry a bottle with you or keep one close at hand?

No Some of the time Most of the time

12.

After a period of abstinence (not drinking), do you end up drinking heavily again?

No Sometimes Almost every time I drink

13.

In the past 12 months, have you passed out as a result of drinking?

No Once More than once

14.

Have you had a convulsion (fit) following a period of drinking?

No Once Several Times

15.

Do you drink throughout the day?

Yes No

16.

After drinking heavily, has your thinking been fuzzy or unclear?

No Yes, but only for a few hours Yes, for one or two days Yes, for many days

17.

As a result of drinking, have you felt your heart beating rapidly?

No Yes Several times

18.

Do you almost constantly think about drinking and alcohol?

Yes No

19.

As a result of drinking, have you heard "things" that were not really there?

No Once Several times

20.

Have you had weird and frightening sensations when drinking?

No Once Often

Alcohol Use Questionnaire - ADS

© CAMH

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