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DAST-10

In the past 12 months (drug use = non-medical use of prescription drugs or use of illegal drugs). Answer Yes or No.

1. 1.Have you used drugs other than those required for medical reasons?

   • [1]Yes
   • [0]No

2. 2.Do you abuse more than one drug at a time?

   • [1]Yes
   • [0]No

3. 3.Are you always able to stop using drugs when you want to?

   • [1]Yes
   • [0]No

4. 4.Have you had "blackouts" or "flashbacks" as a result of drug use?

   • [1]Yes
   • [0]No

5. 5.Do you ever feel bad or guilty about your drug use?

   • [1]Yes
   • [0]No

6. 6.Does your spouse (or parents) ever complain about your involvement with drugs?

   • [1]Yes
   • [0]No

7. 7.Have you neglected your family because of your use of drugs?

   • [1]Yes
   • [0]No

8. 8.Have you engaged in illegal activities in order to obtain drugs?

   • [1]Yes
   • [0]No

9. 9.Have you ever experienced withdrawal symptoms (felt sick) when you stopped taking drugs?

   • [1]Yes
   • [0]No

10. 10.Have you had medical problems as a result of your drug use (memory loss, hepatitis, convulsions, bleeding, etc.)?

    • [1]Yes
    • [0]No