Michigan Alcohol Screening Test

Assessment

1. Do you feel you are a normal drinker? ("normal" - drink as much or less than most other people)

Yes
No

2. Have you ever awakened the morning after some drinking the night before and found that you could not remember a part of the evening?

Yes
No

3. Does any near relative or close friend ever worry or complain about your drinking?

Yes
No

4. Can you stop drinking without difficulty after one or two drinks?

Yes
No

5. Do you ever feel guilty about your drinking?

Yes
No

6. Have you ever attended a meeting of Alcoholics Anonymous (AA)?

Yes
No

7. Have you ever gotten into physical fights when drinking?

Yes
No

8. Has drinking ever created problems between you and a near relative or close friend?

Yes
No

9. Has any family member or close friend gone to anyone for help about your drinking?

Yes
No

10. Have you ever lost friends because of your drinking?

Yes
No

11. Have you ever gotten into trouble at work because of drinking?

Yes
No

12. Have you ever lost a job because of drinking?

Yes
No

13. Have you ever neglected your obligations, your family, or your work for two or more days in a row because you were drinking?

Yes
No

14. Do you drink before noon fairly often?

Yes
No

15. Have you ever been told you have liver trouble such as cirrhosis?

Yes
No

16. After heavy drinking have you ever had delirium tremens (D.T.'s), severe shaking, visual or auditory (hearing) hallucinations?

Yes
No

17. Have you ever gone to anyone for help about your drinking?

Yes
No

18. Have you ever been hospitalized because of drinking?

Yes
No

19. Has your drinking ever resulted in your being hospitalized in a psychiatric ward?

Yes
No

20. Have you ever gone to any doctor, social worker, clergyman or mental health clinic for help with any emotional problem in which drinking was part of the problem?

Yes
No

21. Have you been arrested more than once for driving under the influence of alcohol?

Yes
No

22. Have you ever been arrested, even for a few hours because of other behavior while drinking?

Yes
No

Comments

This field is for validation purposes and should be left unchanged.

Instructions

Assessment

Ready to Talk?