Addictions
Addiction to a substance or behavior is complex affecting the addictive person and everyone around them. We help every individual at their unique state of development, motivation, and readiness for treatment and recovery
DUAL DIAGNOSIS SCREEN FOR PARENT/ CAREGIVER, SPOUSE
Questions to Screen for Alcohol and/or Other Drug Problems
Are others concerned about her/his use of alcohol and/or drugs? * Yes * No If yes, who/how/when:_____________________________________________________________
Have any attempts been made to stop or cut down on her/his drinking and/or drug use? * Yes * No If yes, how/when:_________________________________________________
Has s/he had prior treatment for alcohol and/or drug use? * Yes * No If yes, where/when:
Does s/he have problems with school, family, law enforcement or others due to his/her use of alcohol or drugs? * Yes * No If yes, who/how/when:____________________________
Has s/he experienced sadness/depression, nervousness, worry, mood changes or disturbing thoughts? * Yes * No If yes, how/when:________________________________
Has s/he had any thoughts, plans or attempts to harm her/himself, others or property? * Yes * No If yes, how/when:________________________________________________
[if yes, must connect individual with counselor or clinician immediately upon completion of screening tool]
Has s/he received professional help or medication for an emotional problem? * Yes * No If yes, how/when:___________________________________________________________
Has her/his family, friends or others been concerned about her/his emotional well-being? * Yes * No If yes, who/how/when:_____________________________________________
Are you concerned about her/his safety? * Yes * No If yes, how/when:________________
If there is a YES response to questions 7, 10 or both, immediately connect with a clinician or call the Access and Crisis Line at 1-800-439-3339.
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