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    BAHS Substance Abuse/Use Questionnaire  

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    This form is intended as a tool for students to evaluate concerns that they may have about themselves or a friend with regards to substance abuse.  We encourage our students to fill out this form and then talk to their guidance counselor, a teacher, or one of the building principals.

     

    HOW CAN I TELL IF MY FRIEND OR I HAVE A SUBSTANCE ABUSE PROBLEM?

     

    1) Do you or your friend ever lose time from school due to drinking alcohol or using drugs.
                 
    		 Y or N
    2) Do you or your friend use drugs to feel more comfortable, forget about worries or studies, or to build self-confidence?      
        
    		 Y or N
    3) Do you or your friend use substance alone?    
                                                           
    		 Y or N
    4) Do you or your friend ever feel guilty because of substance use?     
                                    
    		 Y or N
    5) Have you or your friend ever gotten in trouble at home or school for substance use?      
                
    		 Y or N
    6) Do you or your friend do without other things or borrow money in order to get the substance?    
     
    		Y or N
    7) Do you or your friend feel a sense of power when using substances?        
                               
    		 Y or N
    8) Have you or your friend lost friends since beginning to use the substance?        
                       
    		 Y or N
    9) Have you or your friend started hanging out with a heavy substance abusing crowd?
     
    		 Y or N
    10) Do you or your friend use the substance until it is all gone?               
                            
    		 Y or N
    11) Does your friend turn off studies or lectures about substance use?     
                                 
    		 Y or N
Last Modified on August 19, 2009