Tests (MAST & DAST)

Alcohol Screening Test

The following questions are about your alcohol use during the past 12 months. Please circle your response.

1. Do you feel that you are normal drinker?
   YES (0)  NO (2)
2. Have you attended a meeting of Alcoholics Anonymous (AA)?
   YES (5)  NO (0)
3. Have you gotten into trouble at work because of your drinking?
   YES (2)  NO (0)
4. Have you had delirium tremens (DT), severe shaking, heard voices or seen things that were not there after heavy drinking?
   YES (2)  NO (0)
5. Have you been in a hospital because drinking?
   YES (5)  NO (0)
6. Do friends or relatives think you are a normal drinker?
   YES (0)  NO (2)
7. Have you lost friends or girlfriends/boyfriends because of your drinking?
   YES (2)  NO (0)
8. Have you neglected your obligations, your family or your work for two or more days in a row because of drinking?
   YES (2)  NO (0)
9. Have you gone to anyone for help about your drinking?
   YES (5)  NO (0)
10. Have you received a 24-hour road side suspension or have you been charged for impaired driving?
    YES (2)  NO (0)

TOTAL SCORE  = 

Total Scores May Range from 0 to 29. (Scores of 6 or greater are considered to reflect serious problems with alcohol)

Drug Screening Test

The following questions concern information about your potential involvement with drugs not including alcoholic beverages during the past 12 months.

1. Have you used drugs other than those required for medical reasons?
   YES (1) NO (0)
2. Do you abuse more than one drug at a time?
   YES (1) NO (0)
3. Are you always able to stop using drugs when you want to?
   YES (0) NO (1)
4. Do you ever feel bad or guilty about your drug use?
   YES (1) NO (0)
5. Has drug abuse created problems between you and your spouse or parents?
   YES (1) NO (0)
6. Have you neglected your family because of your use of drugs?
   YES (1) NO (0)
7. Have you lost a job because of drug use?
   YES (1) NO (0)
8. Have you engaged in illegal activities in order to obtain drugs?
   YES (1) NO (0)
9. Have you experienced withdrawal symptoms (feel sick) when you stopped using drugs?
   YES (1) NO (0)
10. Have you gone to anyone for help for drugs problems?
    YES (1) NO (0)
11. Have you abused prescription drugs?
    YES (1) NO (0)
12. Can you get through a week without using drugs?
    YES (0) NO (1)
13. Have you had blackouts or flashbacks as a result of drug use?
    YES (1) NO (0)
14. Does your spouse (or parents) ever complain about your involvement with drugs?
    YES (1) NO (0)
15. Have you lost friends because of your use of drugs?
    YES (1) NO (0)
16. Have you been in trouble at work because of drug abuse?
    YES (1) NO (0)
17. Have you gotten into fights when under the influence of drugs?
    YES (1) NO (0)
18. Have you been arrested for possession of illegal drugs?
    YES (1) NO (0)
19. Have you had medical problems as a result of your drug use (e.g. memory loss, hepatitis, convulsions, bleeding)?
    YES (1) NO (0)
20. Have you been involved in a treatment program specifically related to drug use?
    YES (1) NO (0)

Total Score

Score: 0 No Problems, 1 -5 Low, 6 – 10 Moderate, 11 – 15 Substantial Level, 16 – 20 Severe Level