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Alcohol Problem Questionnaire
 
01. Do you feel that your drinking is getting out of control?
  YesNo
02. Have you ever tried to stop drinking but could only manage to stop for a day or so at a time?
  YesNo
03. Do you regularly need a drink “to get started” in a morning?
  YesNo
04. Are you afraid to leave the house?
  YesNo
05. When you wake up in a morning, have you noticed that you feel sweaty?
  YesNo
06. Have there been times of the day when you can’t remember what you have done?
  YesNo
07. If you don’t have a drink for 12 to 24 hrs, do your hands shake?
  YesNo
08. Is your drinking causing you problems within your own family?
  YesNo
09. Are you craving for a drink on a regular basis?
  YesNo
10. Once you start drinking, do you find that you are not able to stop? - that one is never enough!
  YesNo
 
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