If you are in a state of crisis or need immediate help for any reason, please refrain from filling out this assessment and call 911. If you feel that you are a danger to yourself, please refrain from filling out this assessment and contact the National Suicide Prevention Lifeline at 1-800-273-8255.

This online Substance Abuse assessment takes approximately five minutes and will provide general feedback when completed. Please note that this assessment is not a formal diagnostic tool and should not be interpreted as such. This assessment is free and can be taken anonymously, if you choose.

If you answer “yes” to any of the questions provided, it is highly recommended that you contact the staff at Cross Creek Hospital Together With Ascension Seton or another qualified healthcare provider. If you would prefer to be contacted by the staff at Cross Creek Hospital Together With Ascension Seton, please leave your contact information in the space provided at the end of this assessment. Please note that by leaving your information, you consent to allow Cross Creek Hospital Together With Ascension Seton to use this information to contact you. Any information provided will remain confidential. If you choose to not leave your information, the staff at Cross Creek Hospital Together With Ascension Seton will not contact you.

If you answer “no” to the questions provided, you are still encouraged to reach out to the staff at Cross Creek Hospital Together With Ascension Seton or another qualified healthcare provider for a detailed evaluation of your risk for Substance Abuse.

Free Confidential Substance Abuse Assessment

1. Have you ever abused substances while alone?

2. Have friends and/or family members expressed concern about your substance use?

3. Has your substance use been a source of conflict in your marriage or with your boyfriend/girlfriend?

4. Have you lied to friends or family members about the amount and frequency of your substance use?

5. Have you lied to a doctor in order to obtain prescription medications?

6. Has your substance use negatively impacted your performance at work or school?

7. Have you stolen substances, or stolen money or property in order to buy substances?

8. Have you awakened after using substances with no memory about what you did while you were high?

9. Have you used substances in order to wake up in the morning and/or to go to sleep at night?

10. Have you used one substance in order to intensify the high from another substance?

11. Have you used one substance in order to recover from using another substance?

12. Have you used substances as a way of dealing with stress, pressure, and other negative experiences?

13. Have you tried and failed to reduce the amount and/or frequency of your substance use?

14. When you try to stop using, or when you can’t use, do you start to feel sluggish, sick, agitated, or depressed?

15. Do you worry that you might have a substance abuse problem?

Thank you for taking Cross Creek Hospital Together With Ascension Seton's Addiction Screening.

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