Here is a basic checklist frequently used by counselors to see if alcohol and other drug abuse may be an issue in someone's life.
- Does the person report or appear to be frequently high or intoxicated?
- Do recreational activities center around drinking or other drug use, including getting, using, and recovery from use?
Atypical Social Settings
- Does the immediate peer group of the individual suggest that substance abuse may be encouraged?
- Is the person socially isolated from others and is substance abuse occurring alone?
- Is the person reluctant to attend social events where chemicals won't be available?
Intentional Heavy Use
- Does the person use "social drugs" with prescribed medications?
- Does the person use more than is safe in light of other medications they may be using, or because of compromised tolerance due to illness or disability?
- Does the person have an elevated tolerance as evidenced by the use of large quantities of alcohol or other drugs without appearing intoxicated?
- Are there predictable patterns of use which are well known to others?
- Is there a reliance on chemicals to cope with stress?
- Has the person made lifestyle changes yet the drug use has stayed the same or increased? (eg. changed friends or moved to another area)
- Does the person rely on drugs as a means of coping with negative emotions?
- Does the person believe that pain can't be coped with without medication?
- Does the person obviously feel guilty about some aspect of their use of alcohol or other drugs?
- Are there medical conditions which decrease tolerance or increase the risk of substance abuse problems?
- Are there medical situations which are aggravated by repeated alcohol or other drug use?
- Did the person ever suffer an accident or disability while under the influence, even if it is denied by the person?
- Is the person underemployed or unemployed?
- Has the person missed work or gone to work late due to use of alcohol or other drugs?
- Does the person blame the drinking on work related problems?
Problems with Significant Others
- Has a family member or friend expressed concern about the person's use?
- Have important relationships been lost or impaired due to chemical use?
Problems with Law or Authority
- Has the person been in trouble with authorities or arrested for any alcohol or drug related offenses?
- Have there been instances when the person could have been arrested but wasn't?
- Does the person seem angry at "the system" and at authority figures in general?
- Is the person's spending money easily accounted for?
- Does the person frequently miss making payments when they are due?
- Does the person appear angry or defensive but doesn't know why?
- Is the person defensive or angry when confronted about chemical use?
- Does increasing isolation suggest heavier substance abuse?
- Is the person giving up or changing social and family activities in order to use?
Several methods have shown to work including quantity-frequency interview questions and questionnaires such as CAGE, the AUDIT, and the MAST. The CAGE is a well-established and simple method of screening for alcohol problems. It was designed (in 1970) for use by people such as doctors to quickly identify whether a patent may have a drink problem. The questions are designed to be put to anyone whose overall level of consumption is at a level considered risky or harmful. The Alcohol Use Disorder Identification Test (AUDIT) was developed by the World Health Organization to identify persons whose alcohol consumption has become hazardous or harmful to their health. Developed in 1971, the Michigan Alcohol Screening Test (MAST) is one of the oldest and most accurate alcohol screening tests available, effective in identifying dependent drinkers with up to 98% accuracy. Questions on the MAST test relate to the patient’s self-appraisal of social, vocational, and family problems frequently associated with heavy drinking.