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    Drug Abuse Screening Test 105 PDF

    Uploaded by

    Anand Kirti

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    © All Rights Reserved
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    Drug Abuse Screening Test 105 PDF

    Uploaded by

    Anand Kirti
    321 views2 pages

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    drug_abuse_screening_test_105.pdf

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    321 views2 pages

    Drug Abuse Screening Test 105 PDF

    Uploaded by

    Anand Kirti

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    DRUG USE QUESTIONNAIRE (DAST-20)

    Name: _________________________ Date: __________________

    The following questions concern information about your potential involvement with drugs
    not including alcoholic beverages during the past 12 months. Carefully read each
    statement and decide if your answer is "Yes" or "No". Then, circle the appropriate
    response beside the question.

    In the statements "drug abuse" refers to (1) the use of prescribed or over the counter
    drugs in excess of the directions and (2) any non-medical use of drugs. The various
    classes of drugs may include: cannabis (e.g. marijuana, hash), solvents, tranquilizers (e.g.
    Valium), barbiturates, cocaine, stimulants (e.g. speed), hallucinogens (e.g. LSD) or
    narcotics (e.g. heroin). Remember that the questions do not include alcoholic beverages.

    Please answer every question. If you have difficulty with a statement, then choose the
    response that is mostly right.

    ©1982 by the Addiction Research Foundation. Author: Harvey A. Skinner Ph.D.

    For information on the DAST, contact Dr. Harvey Skinner at the Addiction Research
    Foundation, 33 Russell St., Toronto, Canada, M5S 2S1.
    These questions refer to the past 12 months.
    Circle your
    response

    1. Have you used drugs other than those required for medical reasons?................ Yes No

    2. Have you abused prescription drugs? ................................................................. Yes No

    3. Do you abuse more than one drug at a time? ..................................................... Yes No

    4. Can you get through the week without using drugs? .......................................... Yes No

    5. Are you always able to stop using drugs when you want to?............................... Yes No

    6. Have you had "blackouts" or "flashbacks" as a result of drug use? .................... Yes No

    7. Do you ever feel bad or guilty about your drug use? .......................................... Yes No

    8. Does your spouse (or parents) ever complain about your involvement
    with drugs? ......................................................................................................... Yes No

    9. Has drug abuse created problems between you and your spouse
    or your parents? .................................................................................................. Yes No

    10. Have you lost friends because of your use of drugs? ......................................... Yes No

    11. Have you neglected your family because of your use of drugs? ........................ Yes No

    12. Have you been in trouble at work because of drug abuse? ................................ Yes No

    13. Have you lost a job because of drug abuse? ...................................................... Yes No

    14. Have you gotten into fights when under the influence of drugs? ......................... Yes No

    15. Have you engaged in illegal activities in order to obtain drugs? .......................... Yes No

    16. Have you been arrested for possession of illegal drugs? .................................... Yes No

    17. Have you ever experienced withdrawal symptoms (felt sick) when you
    stopped taking drugs? ......................................................................................... Yes No

    18. Have you had medical problems as a result of your drug use
    (e.g. memory loss, hepatitis, convulsions, bleeding, etc.)?.................................. Yes No

    19. Have you gone to anyone for help for a drug problem? ..................................... Yes No

    20. Have you been involved in a treatment program specifically


    related to drug use? ............................................................................................. Yes No

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