undefined

Substance Use Disorder Survey

The Substance Use Disorder Survey is a tool used to assess an individual's level of substance use and potential for substance abuse. It is made up of a series of questions about an individual's use of drugs and alcohol, as well as their attitudes and beliefs about substance use.

1 minute to complete

Eligibility

To be eligible to fill out the Substance Use Disorder Survey, an individual must be 18 years of age or older.

undefined

Questions for Substance Use Disorder Survey

Questions

1.

What is your current drug of choice?

The answer should be a text input.
2.

How often do you use drugs or alcohol?

The answer should be a text input.
3.

What are your thoughts on drug or alcohol use?

The answer should be a text input.
4.

Are you worried about your level of drug or alcohol use?

The answer should be a text input.
5.

Have you ever sought help for your drug or alcohol use?

The answer should be a single choice:
  1. Yes
  2. No
  3. Unsure

Tests Similar to Substance Use Disorder Survey

  • The CAGE questionnaire
  • The Michigan Alcohol Screening Test
  • The Short Inventory of Problems
  • The Drug Abuse Screening Test
  • The Alcohol Use Disorders Identification Test

Here are some FAQs and additional information
on
Substance Use Disorder Survey

What are the signs of substance use disorder?

-Bloodshot eyes, pupils larger or smaller than usual. -Changes in appetite or sleep patterns. -Deterioration of physical appearance, and personal grooming habits. -Runny nose or sniffling.

What is the main problem of substance abuse?

The effects of substance abuse are cumulative, significantly contributing to costly social, physical, mental, and public health problems.

What is the difference of drug abuse and substance abuse?

Drug abuse or substance abuse is when you use a drug, even when you know it is harmful to your health. It includes taking illegal drugs and using prescription medicine differently from how your doctor prescribes. Taking illicit drugs like heroin or cocaine is substance abuse.

Want to use this template?

Loved by people at home
and at work

undefined
“BlockSurvey is a simple, effective, and scalable tool for creating surveys for leadership and learning assessment. It's one of this year's best buying choices. Each month, it keeps improving and strives to serve its customers needs.”
Nelson Emilio
Personal Branding Strategist
undefined
“I use BlockSurvey to get feedback about all my activities and events. It is really easy to get started and create my first surveys! Then I could see how easy it was to share them. Now I am thinking to use BlockSurvey also within my creative process as an author in order to listen and engage with my audience, knowing that anonymity provides the most sincere and reliable answers.”
Georgina García-Mauriño
Author & Designer
BlockSurvey social proof
G2 Crowd
4.8 Star Rating
BlockSurvey social proof
Dapp.com
Editor's choice
BlockSurvey social proof
Capterra
4.9 Star Rating

What's next? Try out templates like
Substance Use Disorder Survey

1000+ Templates, 50+ Categories

Want to create secure online forms and surveys?

Join BlockSurvey.

SHARE