1. Do you think a lot about drugs? 
 2. Do you ever use alone? 
 3. Have you ever thought you couldn't fit in or have a good time without drugs? 
 4. Have you ever used drugs because of emotional pain or stress? 
 5. Have you ever used a drug without knowing what it was or what it would do to you? 
 6. Have you ever taken one drug to overcome the effects of another? 
 7. Has your school or job performance ever suffered from the effects of your drug use? 
 8. Does the thought of running out of drugs terrify you? 
 9. Have you ever stolen drugs or stolen to obtain drugs? 
 10. Have you ever felt defensive, guilty, or ashamed about your using? 
 11. Have you ever overdosed on any drugs? 
 12. Has using affected your relationships?