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Over 80 percent of people 18 and over drink alcohol and millions of these people become alcoholics.  Alcoholism is a disease of addiction that has physical manifestations that can eventually lead to death.  In the United States, for example, alcoholism is the third leading preventable cause of death.

The good news is that many people seek treatment for alcohol and when successfully completed become sober and remain sober for the rest of their lives with the proper aftercare.  

Alcohol questionnaires facilitate people who come in for treatment and are a primary tool to get the process started.

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Alcohol Consumption & Intake Questionnaire

An intake alcohol questionnaire asks the basic questions as well as a focus on alcohol consumption.  These kinds of questions as part of alcohol questionnaires are essential to gain an understanding of the individual and the individual’s history before intake.

Questions to Identify the Subject

  1. What is your age?
  2. What is your gender?
  3. What is your ethnicity?
  4. Are you pregnant?

Questions About the Subject’s History Regarding Alcohol Consumption

  1. At what age did you begin drinking alcohol?
  2. Is there a history of drinking in your family?
  3. Have you blacked out during drinking?
  4. Have you been arrested for driving under the influence?
  5. Have you been arrested for public intoxication or an altercation in public due to drinking?
  6. Have you lost a job because of drinking?
  7. Have you ended up in a hospital due to drinking?

Questions About the Subject’s Habits During Alcohol Consumption

  1. How often do you drink?
  2. Do you drink before noon?
  3. Why do you drink?
  4. How many drinks do you have at one sitting?
  5. How many drinks do you have in one day?
  6. Do you combine your drinks with recreational drugs?
  7. Do you combine your drinks with prescription drugs?
  8. When you drink, do you get drunk?
  9. If you have children, do you drink in front of your children?
  10. Do you get drunk in front of your children?
  11. Do you drive drunk?
  12. Do you get violent when you drink?
  13. Do you drink at work?

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Lifestyle Questions: Health and Habits Concerning Alcohol Use

Lifestyle questions regarding alcohol and your health are another part of an intake questionnaire that helps a professional learn more about the subject and begins the process of allowing a subject to understand their problem.

  1. After you’ve been drinking, how do you feel physically?
  2. After you’ve been drinking, how do you feel emotionally?
  3. While you’re drinking, do you feel different about yourself, and if so, in what way?
  4. Is your goal to achieve something when you’re drinking?
  5. Do you drink to escape?
  6. Do you drink alone and if so, why?
  7. Do you drink with others and if so, what kind of people do you drink with?
  8. Do you attract people when you drink and if so, what kind of people do you draw?

Alcoholics Anonymous Quiz

Alcohol QuestionnairesAn Alcoholics Anonymous quiz are questions to help a person decide if they can benefit from Alcoholics Anonymous or AA.

If a person answers yes to any of the questions, it’s advised that the person seeks help through AA or some other avenue.

AA is an international, nonprofessional, multiracial, apolitical group of males and females who have or who have had a drinking problem.

It is a self-supporting organization that one can find across the globe. There are no age restrictions or education restrictions for the group. Anyone who wants help with their drinking can join.

  1. Are you drinking because of the existence of stressful problems?
  2. Do people tell you that you should stop drinking, but you don’t want to listen to them?
  3. When you get mad at family, parents, children, friends, associates or people in general, do you respond to that anger by drinking?
  4. Is there trouble at home because of your drinking, such as your finances, your relationship with your wife, or your relationship with your children?
  5. Are you a person who would rather drink alone than with others?
  6. Is your drinking starting to affect your work?
  7. Have you tried to drink less or to stop drinking, but you always fail?
  8. Do you find yourself drinking in the morning before you go to school or before you go to work?
  9. Do you gulp your drinks down?
  10. Do you switch from one drink to another in the hopes that it will prevent you from getting drunk?
  11. Have you experienced memory loss or blackouts while you’ve been drinking?
  12. Do you lie to people when you drink?
  13. Do you get in trouble when you’re drinking?
  14. Do you drink to get drunk?
  15. Are you jealous of people who don’t have a drinking problem?
  16. Do you believe you would have a better life if you didn’t drink?

Alcoholism Recovery Detox and Withdrawal Questions

Detoxing and withdrawing from alcohol is the goal of every person who enters an alcohol treatment facility or who joins an alcohol rehabilitation program.

It’s an integral part of the process, and arguably one of the most important because it is the beginning of an attempt to maintain sobriety.

There are certain questions that should be including on alcohol questionnaires to ask a person who is detoxing from alcohol to facilitate the process.

  1. There are physical manifestations that are part of detox such as headaches, shaking, clammy skin, sweating, rapid heartbeat, nervousness, insomnia, nightmares, etc.
  2. What did you experience during detox and how do you feel now that the alcohol is out of your system?
  3. Are you currently experience pain or nausea?
  4. Do you have any recurring concerns now that the alcohol is out of your system?
  5. What can we do to make you feel more comfortable at this moment?
  6. Are you able to drink water?
  7. Are you able to participate in light exercises, such as yoga?
  8. Is there any memento from home that will help you feel more comfortable?
  9. Have you had thoughts of drinking alcohol?
  10. Have you had any hallucinations during the last 24 hours?
  11. Are you fearful for the future?
  12. What triggers do you believe could be responsible for a relapse if that were to happen?
  13. What changes to your environment need to be made to avoid the possibility of a relapse?

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After the Interview: Having a Discussion and Ongoing Conversation

After a person has successfully completed detox, this is where the true work begins.  

You can’t simply put a person with a drinking problem back in society without having a discussion and an ongoing conversation about alcoholism and avoiding alcohol.  

One of the main things a person will be responsible for is to avoid drinking alcohol entirely for the rest of his or her life. The reason for this is if alcohol is reintroduced the person can easily return to a destructive life of drinking.   

To facilitate communication, it’s important to encourage a person to do everything in her or her power to commit to after-treatment.

Once a commitment is established, to keep a person sober, these questions should be included on alcohol questionnaires.  

  1. What situations were you in where alcohol consumption was most prevalent?  What steps can be done to reduce or change the situation to prevent the desire for alcohol?   For example, if you’ve always drunk with a particular group of people, what can be done to change who you hang around.  If you’ve always drunk by yourself, where did this typically happen and how can we change your routine?
  2. Were drinking due to loneliness, boredom or stress?  How can we explore the cause and nature of your feelings?  What can we do to encourage healthier ways to deal with loneliness, boredom or stress?
  3.  If your drinking is sparked by a work environment, for example, colleagues getting together after work to drink, what can be done to remove you from that activity?  Is that activity necessary to relate to co-workers? Is there pressure to participate in such activities?
  4. Did drinking make you feel more important and likable?  Did you become the “life of the party” when you drank? What can be done to nurture your self-esteem?  What can be done to remove alcohol has a way to feel better about yourself?
  5. What goals do you have for the next six months, the next year, and the next five years?  What will happen to those goals if you continue to drink? What steps can be taken to get you closer to those goals?

Alcohol questionnaires follow a particular template, but they are not set in stone as to what they can include.  A set of questions can and should be tailored for each individual circumstance. As long as the relevant subjects are covered, these questionnaires can help a person get off alcohol and stay off alcohol.

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