Drug Abuse Screening Test (DAST-10)
Sign in to Google to save your progress. Learn more
Email *
Name
*
The following questions concern information about your possible involvement with drugs (not including alcoholic beverages) during the past 12 months.
 "Drug abuse" refers to (1) the use of prescribed or over-the-counter drugs in excess of the directions, and (2) any nonmedical use of drugs. 
The various classes of drugs may include cannabis (marijuana, hashish), solvents (e.g., paint thinner), 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.
In the past 12 months have you used drugs other than those required for medical reasons?
*
In the past 12 months have you abused more than one drug at a time?
*
In the past 12 months have you been unable to stop abusing drugs when you want to?
*
In the past 12 months have you had blackouts or flashbacks as a result of drug use?
*
 In the past 12 months have you ever felt bad or guilty about your drug use?
*
In the past 12 months has your spouse (or parents) ever complained about your involvement with drugs?
*
In the past 12 months have you neglected your family because of your use of drugs?
*
In the past 12 months have you engaged in illegal activities to obtain drugs?
*
In the past 12 months have you ever experienced withdrawal symptoms (felt sick) when you stopped taking drugs?
*
In the past 12 months have you had medical problems as a result of your drug use (e.g., memory loss, hepatitis, convulsions, bleeding)?
*
Response and Scores will be discussed during intake session(s).
Skinner HA (1982). The Drug Abuse Screening Test. Addict Behav 7(4):363-371. Yudko E, Lozhkina O, Fouts A (2007). A comprehensive review of the psychometric properties of the Drug Abuse Screening Test. J Subst Abuse Treatment 32:189-198.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy