Drug Abuse Questionnaire

Am I A Drug Addict?
The simple definition for a drug addict is a person
whose life is controlled by drugs. Some think of an
addict as the junkie in the alley who sticks a dirty
needle in his arm. This misconception keeps many
addicts from getting the help they need. Drug addicts
come from all walks of life and social strata. Many begin
their habit with prescription drugs obtained from well
meaning family doctors. Most do not intend to become drug addicts. Whether
the drug use comes from legal medications or illegal substances such as crack
cocaine, heroin, methamphetamines and marijuana, the consequences of
drug addiction can be devastating and just as deadly. Recognizing that there
is a problem is the first step of recovery.
If you think you may have a drug problem but are not sure that it is a drug
addiction, try answering the following questions as honestly as you can.
These questions were proposed by recovering drug addicts in Narcotics
Anonymous as a tool of discovery. Once the signs of addiction are clear to
you, the path to recovery is attainable.

1. Do you ever use drugs alone?

2. Have you ever switched drugs, thinking one was the problem?
3. Have you ever lied to a doctor to obtain prescription drugs?
4. Have you stolen drugs or stolen to buy drugs?
5. Have you ever used one drug to relieve the effects of another drug?
6. Do you avoid people who would disapprove of your drug use?
7. Have you ever used a drug without knowing what it was?
8. Has your job or school performance suffered from your drug use?
9. Have you ever been arrested as a result of using drugs?
10.Have you ever lied about what or how much you use?
11.Does the purchase of drugs affect your financial stability?
12.Have you ever tried to stop or control your drug use
13.Have you ever been in a jail, hospital, or treatment center due to
using?
14.Does drug use interfere with your sleeping or eating?
15.Does the thought of running out of drugs terrify you?
16.Does it seem impossible to live without drugs?
17.Is your drug use disrupting your family life or relationships?
18.Do drugs seem necessary to have a good time and fit in?
19.Have you ever felt guilty or ashamed about your using?
20.Do you think a lot about drugs?
21.Have you ever used drugs to mask your emotional pain?
22.Have you ever overdosed on any drugs?
23.Do you continue to use drugs despite negative consequences?
24.Do you feel that you may have a drug problem?

If you are a drug addict or have a chemical dependency or substance abuse

problem, you must first admit the problem before any progress can be made
toward recovery. These questions, may help to show you how using drugs
has made your life unmanageable. Drug addiction is a disease which, without
recovery, ends in jails, mental institutions, and even death.
Narcotics Anonymous which uses the same 12 step program as Alcoholics
Anonymous is one path of recovery from substance abuse, chemical
dependency and drug addiction. NA provides a lifetime program of recovery.
If you feel you need an intensive inpatient or outpatient program, there are
many fine treatment centers based on the 12 step model used by NA. At A
Friend of Bill's, we offer a transitional living program based on the 12 steps of
recovery. If you would like additional information about A Friend of Bill's or if
you have questions about your personal path to recovery, please call (615)
449-9514 or send email to [email protected].

SUBSTANCE ABUSE QUESTIONNAIRE

NAME: _______________________________________________ DATE:

___________________

Please carefully read through the list below of different types of drugs/chemicals.
Please put an X by any of the substances that you have used, even if only one time.
Please be honest. Thank you.

___Alcohol ___Anabolic Steroids

___Nicotine ___Cannabinoids
__Cigarettes __Marijuana
__Smokeless Tobacco __Hashish
__Cigar
___Inhalants/Whippets/Huffing
___Antidepressants __Nitrites: Amyl, Butyl,
Rush/Poppers
__Paxil __Solvents: Glue,
Gasoline
__Prozac __Gases: Nitrous Oxide, Paint
__Zoloft __Other: ______________
__Effexor
__Celexa ___Sedative, Hypnotic, or Anxiolytic

__Remeron __Barbiturates: Phenobarbital,

Nembutal
__Other: ______________ __Benzodiazepines: Ativan,
Valium
Klonopin, Xanax,
Librium
___Dissociative Anesthetics __Rohypnol/Roofies
__Ketamine __GHB
__PCP/Angel Dust __Methaqualone/Quaalude
__Ambien, Sonata
___Hallucinogens __Other: ______________
__LSD/Acid
__Mescaline/Peyote ___Opioids & Derivatives

__Psilocybin/Magic Mushrooms __Codeine

 __Morphine
___Antipsychotics/Anticonvulsants __Opium
__Haldol __Heroin
__Tegretol __Fentanyl
__Depakote __Oxycodone
__Topomax __Hydrocodone: Lortab,
Vicodin
__Lithium __Propoxyphene: Darvon,
Darvocet
__Zyprexa __Methadone
__Other: ______________ __Other: ______________

___Over-The-Counter Medications ___Stimulants

__Aspirin, Tylenol __Amphetamines: Ritalin,
Adderall, Dexedrine
__Ephedrine/Psuedoephedrine __Cyalert
__Antihistamines: Benadryl __MDMA/Ecstasy
__Cough Medicines: Robitussin, Nyquil __Cocaine/Crack
__Cold Medicines: Sudafed
__Methamphetamine/ICE/Crank
__Other: ______________ __Other: ______________

Please list any other substances that you have used that are not listed above:
___________

______________________________________________________________
____________

INSTRUCTIONS: Answer the following questions for the last 12 months of your
drinking or drug use.

1. When I drink, I often drink more that the 1-2-3 guidelines.

YES NO

2. Occasionally, I use illegal drugs or use a prescription drug to

YES NO
get high.

3. It now takes more drugs or alcohol for me to get high or

YES NO
intoxicated than when I first started.

4. I function best in groups when I am making high-risk drinking

YES NO
or drug choices.

5. Have you wanted or needed to cut down on your drinking or

YES NO
drug use in the last year?
 6. In the last year, have you ever drunk or used drugs more than
YES NO
you meant to?

7. Have you had a feeling of guilt or remorse after drinking or

YES NO drug use?

8. Have you failed to do what was normally expected from you

YES NO
because of drinking or drug use?

9. Have you been unable to remember what happened the night

YES NO
before because you had been drinking or using?

10. Have you needed a drink (or drug) in the morning to get
YES NO yourself going after a heavy drinking (or drug using) episode?

11. Have you tried to cut back on your drinking or drug use but
YES NO could not?

12. Sometimes when I start drinking or using drugs, it is like

YES NO
something takes over and I get drunk or high without meaning to.

* RAPS4 and TICS

Hypoism Hypoics are born, not

Home Page of made.
Hypoism, The Disease Hypoism
of Addictions Dan F. Umanoff, M.D.
The Overriding 941-926-5209
Principle 8779 Misty Creek Dr.
The reason for this web Sarasota, Florida 34241
site
[email protected]
IMAGINE
send me a message
Discussion Page

Buy the book

ADDICTION QUESTIONNAIRE
Buy the Book

Hypoism Issues Feel free to copy this questionnaire, answer the

Role of Dopamine in questions, and send me your answers. I would be
Addiction Causation
Theory of Addiction - very interested in your answers.
Hypoism Hypothesis
Why drug use is
unconscious and
This questionnaire is designed to determine the
against one's prevailing attitudes, beliefs, knowledge, and
willfulness - not definitions concerning the general area of addictions
volitional
of a random sample of ordinary people. The present
Misuse of the word
choice in addictions questionnaire will present general queries into
THE INESCAPABLE attitudes, biases about addictions, and several other
LOGIC OF ANY VALID medical diseases more widely accepted as
ADDICTION
ETIOLOGICAL biologically caused. When I use the word addiction, I
PARADIGM mean any addiction to drugs, alcohol, beliefs, and
WHAT OTHER behaviors. This questionnaire will remain totally
DISEASE....?
confidential. A second follow-up questionnaire will
What Am I Angry
About? - Don't Ask Me later seek to determine the responders' more
This Again specific personal experiences in the area of
Disease Concept - A addictions.
Perspective
HYPOISM IN A NUT
SHELL The purpose of this study is to discover the
Page Directory of this prevailing attitudes of ordinary people to common
Site with Explanations addiction situations. The questions will include
and Links
addictions probably not considered as such by most
The History of the Proof
of Hypoism in the Wake of the participants and will help to clarify what
of the P/R Paradigm behaviors people think are addictions, what is their
page 1.
concept of an addiction, and a little about what they
History page 2
think determines addictions and what makes
Why Addiction Experts
and Other People Are someone into an addict. General personal
Ignoring Hypoism socioeconomic, religious, racial, and political
Strange Brew questions will be added in order to characterize the
AIMING AT AN diversity of the participants in these areas and to
UNDERSTANDING OF
ADDICTIONS reveal other particular attitudes which have a
The Paradigm Vacuum "spiritual" bearing on their attitudes about disease.
in Addictions Today All questions will be optional. The purpose of the
THE ADDICTION questionnaires will be described as studying
PROBLEM AND THE
SOLUTION
"attitudes and beliefs concerning diseases,
What Does An
behaviors and addictions." Each participant will be
Addiction Expert Know? given a code number for documentation purposes
The Hypoism Addiction and to maintain confidentiality. All information will
Hypothesis - An
Evolutionary
be coded under your ID Number listed on top of
Psychology Perspective page. Name is optional. Please take your time
Addiction Questionnaire answering these questions; there is no rush.
 Misconceptions of Complete the questionnaire as thoroughly as
addictions and addicts possible. Something like this has never been done
What's Hypoism?
What's an Addiction?
and will be invaluable for future generations. Thank
WHY WE DON'T NEED
you. If you have any questions, please e-mail them
HYPOISM. and I will answer them as soon as possible.
Why We Need
Hypoism: A
Comparison of the
Before we get going I'd like to inform
Principles and
Consequences
you about this one very special rehab.
between the two
Paradigms
For those interested in "rehabs" and
Entitled to Your finding a suitable one, specifically for
Opinion? Not Anymore.
HYPOICMAN: A non-
marijuana as well as all other
recovering,
unimpressed Hypoic
addictions, please click and read the
The Field of following underlined blue ad link----
Addictionology: A
Golfing Analogy Few marijuana abusers go to marijuana
NEW YEAR
PREDICTIONS
rehab, because most of them believe
Contact Information the drug does them no harm physically.
Hypoism Treatment Questionnaire I
Research
The Addiction General personal identification questions (optional) -
Treatment Fraud Finally
Exposed write in or circle correct answer. Use separate
Hypoism Treatment page(s) to explain your answers more fully if needed.
Research Proposal Answer as thoroughly as desired. We want to know
N4A
exactly what you think about all questions. Please
I KEPT QUIET
answer as many as you can or will. Do not go
The National backwards to change answers you have already
Association for the answered. You will be asked about how your
Advancement and attitudes and beliefs have changed at the end of the
Advocacy of Addicts
Make A Contribution To
questionnaire.
The N4A
Addict Discrimination Age:
Documentation Sex:
Social Innovations
Award 2000 for The
Race:
N4A Occupation:
Third Millennium N4A Income:
Conference Keynote Religion:
Address on Hypoism -
Pathophysiology in
 Addictions vs. Level of education:
Superstition
N4A Goes on the
Offensive - Suggesting Political party or leaning (Republican, Democratic,
Real Action other)
The Verdict
Blind Faith?

Learn More About the Do you consider yourself radical left, liberal,
Book conservative, radical right, middle of the road, etc.?
Letters from book
readers
Title Page of Book
Do you think you presently have a good
Book Blurb
understanding of addictions? 0 (low) -100 (excellent)
Book Cover
Back Cover
Table of Contents Do you think anyone has a good understanding of
Foreword addictions? Who?
Preface
Opening Statement
Chapter 1 Are you religious? (fundamentalist, very, moderate,
Vision For The Future mildly, not at all)
Outcomes of Hypoic's
Handbook
Bibliography Do you believe in some sort of god (or higher
Book Corrections power)?
Harm reduction
prototype: Swiss
PROVE program
Are you superstitious?
Book Reviews
The Phoenix Magazine
Do you believe in creationism?
Hypoics Not-Anonymous
Hypoics Not-
Anonymous
Do you believe in evolution?

Things You Can Do

What you can do---
Do you believe in the scientific method?
My Kids

Special Links Do you believe that the Bible is literally true,

Special Links to historically true, a nice story to learn from, or
important web sites nonsense?
Addiction Links on the
Web
Do you believe that God (anytime I mention God in a
Addiction Genetics
Recent Genetic Studies question, I also mean a higher power) exerts control
on Various Addictions over events in the past, present, and future?
from a Large Twin
Registry
Genetic Studies page
2. Do you believe that God intervenes in human
Gateway theory finally outcomes?
disproven
Celera Discovers
Millions of Tiny Genetic Do you believe that God treats humans the same or
Differences in People
differently from other animals?
Interesting Addiction
Science
Do you believe that man is created in God's image?
Clinically Important
Neurotransmitter What does this mean to you?
Deficiencies

Hypoism Magazine- Do you believe that psychology and/or psychiatry

Articles by and for
Hypoics
understand human nature?
EMBRYONIC
HYPOISM CIRCA 1968
Do you believe that your religion's authorities
#1 Hatred, #2 The
Words: Opinion, Belief, understand human nature?
and Knowledge, #3
Hate Addiction
#4 The Drug War War, Does anyone understand human nature?
#5 Evolution vs.
Creationism Revisited
for Addictions
Does God treat you differently from any other
#6 American Society for
Addiction Medicine person?
Statement for
Recovering Physicians
#7 Issues Peculiar to Does God treat your religion differently from any
the Disease of other religion?
Addictions
#8 Critique of Alan
Lechner's (NIH), "The
Hijacked Brain Does God treat your country differently from any
Hypothesis." other country?
#8a. Update!! Dr.
Leshner recently makes
a change Does God treat your race differently from any other
#9 MY STORY - The
race?
Doctor Drug War -
Wrong and Wasteful
p.1, 1/6/00
The Doctor Drug War If you are a recovering addict of any kind, does God
p.2
Doctor Drug War p.3 keep you sober?
Doctor Drug War p.4
Doctor Drug War p.5
Affidavit for judicial This is the information age, right? Let's see how you
review of NYS Dept. of use information.
Ed.
#10 The Superstition
Instinct 3/1/00
What do the following words mean to you in terms of
#11-Conflict of Interest
in Addiction Research
level of certainty for using them to make a decision,
#12 - Controlled and what information (actual documented knowledge
Drinking Lands On Its in some published literature or verbal
Ass
communication from somebody) criteria do you use
#13 - The Kennedy
Curse or Kennedy
to define:
Hypoism?
#14 - The Lord's Prayer
for Hypoics I know (what does the word knowledge mean to
#15 - Replacing Alan you?):
Leshner is the only way
to end the Drug War
#16 - The Brain I believe (what does the word belief mean to you?):
Addiction Mechanism
and the COGA Study
#17 - Letter to the
I think (what does the word thought mean to you?):
director of the National
Academy of Medicine's
Board on Neurobiology
and Behavior Health on I feel (what does the word feel mean to you?):
Addictions
#18 - Is Addiction
Voluntary, A Choice, as It's my opinion (what does the word opinion mean to
Leshner and NIDA
Insist? you?):
#19 - Bush's Alcoholism
and Lies
#20 - A P/R Paradigm Put the phrase number in the sentences below
Addict - "Cured?" concerning the level of certainty you personally need
#21 - Congress Misled for deciding it's the right thing to do in the following
and Lied to by NIAAA
circumstances, 1) I know it's right, 2) I believe it's
#22 - Special Letter to
the Times on Addiction right, 3) I think it's right, 4) I feel that it's right, 5) It is
Genetics my opinion that it's right, when making a decision
#23 - JAMA Editor about:
Publishes According to
His Beliefs, Not
Science
Sending your child to war____, to jail for using
#24 - Smoking as
Gateway Drug. I Don't drugs____, to a religious school____, to a mental
Think So!
#24B - IS COCAINE hospital____, to a medical hospital____.
ADDICTION CAUSED
BY COCAINE?
#25 - One Less Heroin Sending someone else's child to war____, to jail for
Addict. But At What
Cost? using drugs____, to a religious school____, to a
#26 - An Open Letter to mental hospital____, to a medical hospital____.
the Judge who
Sentences Robert
Downey, Jr.
If you use someone else's judgment to make these
#27 - Letter To Schools
About The Pride
decisions, whose (pick as many different experts as
Program Against Drugs you deem appropriate) would you use, and which of
#28 - A Letter To Bill the above five words do you need them to use when
Moyers, Close To
making their decision for your child or someone
Home, and PBS
#29 - HYPOISM IS
else's child:
ACTUALLY A
DISEASE OF THE
"WILL"
#30 - Brookhaven Labs Please give your answers on a scale of 0-10 with 0
Provide More Evidence being "never" and 10 "always correct." You may
For Hypoism
explain further if you wish.
#31 - Addiction
Prevention Revisited
#32 - DRUG WAR
EVALUATION BY THE Do you believe that scientific "experts" are correct?
NATIONAL ACADEMY
OF SCIENCE
#33 - NIDA Is Close But Do you believe that psychology "experts" are
No Cigar correct?
#34 - Bush's Addict
Discrimination and
Hypocricy Begins
Do you believe that religious "experts" are correct?
#35 - Maya Angelou's,
"Still I Rise."
#36 - Leshner Lies To
Congress
Do you believe that psychic "experts" are correct?
#37 - Addiction
Combos
#38 Brain tumor proves
Do you believe that medical "experts" are correct?
Hypoism hypothesis
#39: So-called
Availability Debunked Do you believe that psychiatric "experts" are
as Contributor of correct?
Addictions
#40 - Hypoism
Reproduced By A Pill
Do you believe that TV and/or newspaper "experts"
PIMMPAL Complex
 Cartoons
are correct?
The Hypoism Blog - The
Addiction Blog
Current Letters to Do you believe that political "experts" are correct?
Editors 9/14/10 -
Current letters to
editors 11/12/09 - Can any of the above experts predict future human
9/14/10
Current Letters to
behavior better than you can ahead of time?
Editors 7/23/09 -
11/09/09
Current Letters to Which one(s) and how?
Editors 5/16/09 -
7/22/09
Current letters to Can any of the above experts predict past or future
editors 3/3/09 - 5/13/09 behavior(s) in an accused person better than you
Current Letters to
Editors 8/3/08 - 3/3/09
can in a criminal court proceeding? Which one(s)
Current Letters to
and how?
editors 4/1/07 - 8/3/08

old letters Apportion the blame in terms of percentage for the

My NY Times Letters to person's problem or behavior listed below.
the Editor page 1.
My NY Times Letters to
the Editor page 2. On a scale from 0-100 with 0 being never responsible
My NY Times Letters to and 100 always responsible, rate the level
the Editor page 3.
My NY Times Letters to
of direct personal responsibility for these particular
the Editor page 4. human occurrences?
My NY Times Letters to
the Editor page 5.
My New York Times 1. A stroke___2. A heart attack___3. Woman with
Letters to the Editor black eye___4. An automobile accident___ 5. High
page 6.
blood pressure___6. Leukemia___7. AIDS___8.
My Letters to the editor
of the NY Times page Tuberculosis___9. Diabetes___10. Drinks a quart of
7. booze a day___11. Depression___12.
My Letters to the Editor Pregnancy___13. Survivor of drowning___14.
of the NY Times page
8. Homosexuality___15. Arthritis___16. Strep.
NY Times Letters Page Throat___17. Uses heroin every day___18. Broken
9. leg___19. Suicide___20. Getting divorced___21.
New York Times Homelessness___22. Bankruptcy___23. Punches
Letters Page 10
wife___24. Colon cancer___25. Survivor of plane
My NYT Letters page
11 crash___26. Food poisoning___27. Commits
NY Times Letters page murder___28. Illegal drug overdose___ 29. Uses
 12.
NY Times letters p. 13 Valium every day___30. Checking account
Letters to the NY Times overdraft___31. Foreclosure of house due to
page 14.
gambling___32. Adultery___33. Lung cancer___34.
Letters to Newsday
Nervous breakdown___35. Joins a gang___36. Steals
Letters To The Los
Angeles Times something from work___37. Caught watching
Creationism/Evolution someone undress in their home___38. Loses their
Letter to BAM 11-25-05 wallet___39. Forgets to pay taxes___40. Lies about
Speeches
adultery___41. Lies about drug use___42. Lies on
Committee for
income taxes___43. Lies about age___44. Weighs
Physician Health 431 pounds___45. Headache___46. Uses Prozac
Speech every day___47. Gets undressed in front of open
The Future of
Addictions
window___48. Stabs boyfriend___49. Has sex with
20 different people at work___50. Eats a quart of ice-
Addict Discrimination in cream every night___51. 24-year-old takes a
the News
cathartic every day___52. Laughs so hard he wets
Mandated Treatment
for Welfare Recipients
his pants___53. Boss pinches job applicant's
Anorectic Murdered by
behind___54. Goes to bar every night for a beer with
Doctors out of the guys___ 55. Addiction to sleeping pills___56.
Ignorance and Drinks 10 cups of coffee per day___57. Forgets
"Desperation"(10/20/99)
Six Dead Heroin
wedding anniversary___58. Kidney dialysis___59.
Addicts-Enough? Lies about not being married___ 60. Masturbates in
10/31/99 school___61. Has sex with daughter___62.
American Society of Schizophrenic___63. Skin rash___64. Fights in
Addiction Medicine
Discrimination bar___65. Feels anxious___66. Leprosy___67. Fired
Darryl Strawberry from job___68.Smokes 2 packs of cigarettes per
Punished Again day___69. Spends 3 or 4 hours a day on Internet chat
South Carolina Forces sites___70. Shoots ex-lover___71. 21 year old
Pregnant Women to
Take Drug Tests college graduate weighs 65 pounds___72. Illegal
When it comes to drugs in random urine at work___
drugs, the constitution
doesn't apply
Parents of Overweight Which of the above is definitely an addiction (list the
Girl Will Sue New
Mexico
numbers)?
Scrapbook

Downloads Which of the above might be an addiction?

Download Files
huffington post
Which may be associated with an addiction?
Custom HTML
Sitemap Here's a list of some possible addictions. Use these
to answer the following questions. Use their
numbers as the answers. 1-alcohol, 2-heroin, 3-
marijuana, 4-cocaine and crack, 5-cigarettes, 6-
addictive, prescription, mood-altering drugs such as
barbiturates, sleeping pills, Quaaludes, Valium,
Librium, etc. (I refer to 1-6 as mood-altering drugs in
future questions), 7-sex (including voyeurism,
exhibitionism, unwanted sexual touching or assault,
etc.), 8-workaholism, 9-people (codependency), 10-
gambling, 11-food, 12-bulimia, 13-anorexia, 14-
exercise, 15-racism, 16-self-mutilation, 17-money, 18-
membership in cult, 19-religious fanaticism, 20-sky
diving, mountain climbing, race car driving, and
other risky activities, 21-compulsive shopping, 22-
superstition, 23-spouse abuse by either gender, 24-
violence, 25-theft, 26-lying, 27-gangs, 28-power over
people (guru, dictator, police officers, politician).

Which [list numbers] of the above behaviors is

grounds for:
1. Divorce
2. Firing from job despite doing good work as:
Doctor
Garbage Hauler
President of the USA
Lawyer
Policeman
Accountant
Gardener
Teacher
Traveling Salesperson
Nurse
Professional Baseball Player
Airplane Pilot
Air Force Pilot
School Crossing Guard
Politician
Pharmacist
Stock Broker
3. Criminal charges and/or arrest

4. Boss turning over to police

5. Public humiliation

6. TV show

7. Loss of driver's license

8. Irrevocable loss of professional (medical, dental,

airline pilot, therapist, teacher, broker) license or job.

Do you agree that when someone is addicted to

mood-altering drugs, he is automatically impaired?

What criteria do you use for proclaiming impairment

on the job for an addict?

List the numbers of the above possible addictions

for answers to the following questions:

Which of the above situations deserves punishment

of some kind?

Which of the above shows bad choices?

Which are learned?

Which of the above show loss of control?

Which of the above are inevitable and beyond ones'

control?

Which of the above are purely genetic?

Which of the above do you definitely consider

addictions?

Which of the above may be addictions?

Which deserve criminal punishment?

In your opinion, what causes addictions?

Apportion (in terms of percentage-for a total of

100%) the percentage responsible for the causation
of addictions in any particular person. May be one,
all, or none of the below. Just put in what you
believe. Add any I may have left out under the
category of "other."

Environment:
Parental influence ___%
Sibling influence ___%
Peer pressure or influence ___%
Religious or spiritual influence ___%
Media influence ___%
Neighborhood environmental influence ___%
Socioeconomic influences ___%
Teachers, coaches, religious leaders, counselors ___
%
Other: ___%
Total Environmental Influence ___%
Genetic-Biological Influence ___%
Total % influence = 100%
Are some addictions worse than others?___ Of the
ones you think are addictions from the above 28
possible addictions, rank the order (use the number),
from worst to least worse:

Which mood-altering drugs are the most and second

most damaging on a medical-physical basis?

Which mood-altering drugs are the most and second

most damaging to the most number of people?

Which mood-altering drugs are associated with the

most and second most amounts of crime?

Which mood-altering drugs are associated with the

most and second most amount of violence?

Which mood-altering drug is associated with the

most amount of
fatal automobile accidents? Suicides? Child abuse?
Sexual abuse?

Which mood-altering drug is associated with the

most amount of incarcerations?

Which mood-altering drugs are associated with the

most and second most amount of lost time and
productivity at work?

Which mood-altering drug is by far associated with

the most amount of domestic violence?
In terms of percentage of the total amount of damage
done by all mood-altering drugs to all people,
including economic, medical, broken families,
violence, crime, incarceration, etc., allot a
percentage to the following mood-altering drugs:
Alcohol___%, Heroin___%, Marijuana___%,
Cocaine___%, Sleeping pills___%, Prescription
tranquilizers___%, Crack___%, Speed
(methamphetamine)___%, Cigarettes___%.

Which of these mood-altering drugs are legally

purchased by their users?

*In your opinion, which is the most damaging of

these mood-altering drugs?

*Which of these mood-altering drugs is publicly

promoted to be the worst by the government, media,
and drug abuse experts?
Second ?________ Third?
________Forth________Fifth?_________

If there is a difference, why do you think there is a

difference in your answers to the above two
questions with an asterisk (*)?

Are drugs bad?

Are other addictions bad?

Are addicts bad? Immoral?

What makes a drug bad?

What makes an addiction immoral?

What makes an addict bad?

What makes an addict immoral?

Which addictions should be legal?

Which addictions should be illegal?

How do you define disease?

How do you define choice?

How do you define addiction?

How do you define superstition?

How do you define racism?

How do you define instinct?

How do you define spirituality?

How do you define genetic?

Do you think a belief in God (or other supernatural

higher power) is necessary for recovery from
addictions?

Rate the following from 0-10, with 0=never and

10=always.

How much of a role does self-control have on the

treatment or recovery from addictions (0-10)?

Are (all, most, many, some, few, none) addicts

irresponsible in their personal and professional life?

Are (all, most, many, some, few, none) addicts

dangerous to the public?

Are (all, most, many, some, few, none) addicts

mentally ill?
Are (all, most, many, some, few, none) addicts
antisocial?

Are (all, most, many, some, few, none) addicts

immature?

Is addiction learned?

Is addiction taught by example?

Is addiction a choice?

Are addicts born or made?

In your opinion, what causes addictions and how do

you know this?

Do you think our society has a good handle on

addictions?

Do you think we understand all there is to know

about addictions?
If not, what do you think we don't understand?

Do you think our current understanding of

addictions produces good results for addicts and
society?

Do you see addiction as a disease?

Do you see addiction as a disease like diabetes or

arteriosclerosis (hardening of the arteries) are
diseases or is there a difference?

If so, what is the difference?

Is there a difference between the effect that being an

addict has on family, job, or society from the effect a
non-addict's heart attack, stroke, or kidney failure
has on his family, job,
or society?

If yes, what?

What would you guess is the present rate of success

(sobriety) in our current methods of treating
addicts? [I define sobriety in the context of this
questionnaire as being completely free from the
addiction, whatever it is, for at least 3 years.]
What is a good success rate for any medical disease
that a person might have?

What is a good success rate for a disease you might

have?

What would be an acceptable success (sober) rate

among all addicts?

Do you think that the rate of success has anything to

do with how well we understand diseases and
addictions?

Do you think there may be something we don't

understand about addicts and their addictions which
makes them addicts and makes non-addicts, non-
addicts? What?

Is there something inherently different about addicts

that makes them addicts? What?

Can anyone be an addict?

Do you agree that addicts should be held criminally

liable for victimless crimes such as purchasing and
using mood-altering drugs?
In the societal, occupational, relationship, or criminal
judgment of an addict, which is more important: the
presence of the addiction or the specific behavior(s)
that the addict actually does?

Should the mere presence of an addiction be the

focus of these above judgments?

Should addicts be judged on their addictions or on

their specific behaviors?

How is it possible for a person to be a drug addict in

the absence of the drug?

On what criteria should addicts be judged?

On what criteria should addicts be judged at work?

On what criteria should addicts be judged at home?

On what criteria should addicts be judged

criminally?

On what criteria should addicts be judged

concerning a professional license?
Should a drug addict be judged for obtaining and
using the drug in the absence of any other criminal
behavior? If so, how?

Should there be laws and criminal prosecution for

addicts obtaining drugs? If so, what?

Should addicts be judged in the absence of

interpersonal or property damage and crimes? If so,
how?

Should addicts be judged only for interpersonal or

property damage and crimes? If so, how?

Should addicts be sentenced differently than non-

addicts for these interpersonal or property crimes?

In the absence of interpersonal or business crimes

or damage, should addicts be fired from jobs, forced
to stop their addictions, penalized, convicted, or
punished for just being addicts?

What makes some addictions different from others in

the absence of criminal or damaging behavior?

Should any addictions be handled by the criminal

justice system in the absence of interpersonal
criminal behavior?

Should a diabetic who fails to stick to his diet and

medication regimen be punished by his family? His
boss?
Criminal justice system?

Should a current smoker who gets lung cancer be

punished by his family? His boss?

Criminal justice system?

What is the difference, if any, between the above

three situations?

If you think addiction is a disease, how does it differ,

if at all, from any other disease?

Should drug addicts be allowed to legally obtain

their drugs and sterile needles and syringes (if
used)?

If so, how should this be accomplished?

Should this be run at the federal or state level, by the

Health Department, or by private M.D.s through
prescriptions and pharmacies?
Rate from 0-10 to the following "experts" or
"methods" in terms of their knowledge and ability to
understand and successfully (produce long-term
sobriety) treat addictions. 0=none, 10=excellent. I
define sober in the context of this questionnaire as
being completely free from the addiction, whatever it
is, for at least 3 years. If you assign a number of 8 or
above (what I would callusually effective in most
addicts), please tell how you know this and what that
knowledge or ability might be. "I don't know, I just
believe it" is a valid answer. Make any comments
you wish.

Psychiatrist

Psychologist

Priest

12 Step programs

Other types of self-help programs:

Rational Recovery

SOS

Women for Recovery

Other:
Boot camp

Religious conversion

A decision by the addict to stop

Self-help books and tapes

Affirmations and spiritual readings

Methadone (for heroin addiction)

Other addiction drug substitutes

Opioid blocking drugs

Antabuse

Prozac (or other antidepressants)

Group therapy

Jail

"Just Say No"

Self-control

Valium or other tranquilizers

Aromatherapy

Exorcism

Prayer

Therapeutic community

Acupuncture

Voodoo

Education

Meditation

Diet

Vitamins

Rehabilitation center

Other (list other treatments you believe are

successful and why):

How do you know these (8 or above) are effective?

Which of these have you seen documented in a

reputable peer reviewed publication and shown to be
scientifically proven by a double blind, controlled
study using accepted scientific method techniques?

Have you ever read or studied any articles of this

type?
If you have, please site the reference here.

Do you think such studies are necessary to prove

efficacy of medical treatment in general?

Do you think such studies are necessary to prove

efficacy of addiction treatment?

Do you take the word of experts, newspaper

journalists, magazines or TV? If so, which one(s)?

Who qualifies as an expert in the field of addictions?

What qualifies them?

Is there such a thing as a qualified expert in

addictions?

Can addictions be prevented and how?

Do you think our current political (drug war,

education and prevention programs) and criminal
justice policies on addictions are correct?

If not, how would you change them?

Do current policies reflect a clear or unclear

understanding of addictions?

Should a better understanding of addictions lead to

a change of our current policies and laws?

How?

Have your attitudes or beliefs changed in any way by

doing this questionnaire?

How?

Do you think you know more or less about

addictions now than when you started?

In what ways?

Are you as confident about your opinions and beliefs

about addictions as when you started?

Rate your understanding about addictions now from

0 (none)-100 (everything):

Explain why and how has this changed?

Rate how valuable this questionnaire experience has

been for you:
0-100; please explain.

Would you participate in a follow up questionnaire

that attempts to discover the role addiction plays in
yourself and your family (family tree)?

How should we address the next questionnaire for

mailing purposes?

back to preface

You can take the addiction out of the hypoic, but you
can't take the Hypoism out of the addict.