Alcohol problems screening

Home
Pharm/Assist
Forms
Alcohol Problems Screening

The SMAST questionnaire (Short Michigan Alcoholism Screening Test) helps you evaluate your drinking habits. For each question, circle the value that matches your answer (Yes or No).

	Questions	Yes	No
1.	Do you feel you are a drinking more than the average?	1	0
2.	Does your wife, husband, a parent, or other near relative ever worry or complain about your drinking?	1	0
3.	Do you ever feel guilty about your drinking?	1	0
4.	Do friends or relatives think you are a normal drinker?	0	1
5.	Are you able to stop drinking when you want to?	0	1
6.	Have you ever attended a meeting of Alcoholics Anonymous (AA)?	1	0
7.	Has your drinking ever created problems between you and your wife, husband, a parent, or near relative?	1	0
8.	Have you ever gotten into trouble at work because of your drinking?	1	0
9.	Have you ever neglected your obligations, your family, or your work for 2 or more days in a row because you were drinking?	1	0
10.	Have you ever gone to anyone for help about your drinking?	1	0
11.	Have you ever been in a hospital because of drinking?	1	0
12.	Have you ever been arrested for drunken driving, driving while intoxicated, or driving under the influence of alcoholic beverages?	1	0
13.	Have you ever been arrested, even for a few hours, because of other drunken behaviour?	1	0

Compile your total score. If you have a score of 4 or more, you seem to have an alcohol dependence problem and should seek help.

© Copyright Vigilance Santé

The patient information leaflets are provided by Vigilance Santé Inc. This content is for information purposes only and does not in any manner whatsoever replace the opinion or advice of your health care professional. Always consult a health care professional before making a decision about your medication or treatment.

Alcohol Problems Screening

Find a Pharmacy