drug addiction

Drug Use Questionnaire - Planning to quit.

This drug use questionnaire is for you and is not intended for anyone else to see unless you want to share it. It will help you think about what triggers your use.

There will be many smells, sounds and sights that are part of your drug use that you may not even recognize. To be able to quit, you first need to see what part they play in your using.

  • Do you have one place you go to use, i.e. bathroom or garage?
  • What things trigger your use? i.e.
  1. Morning routine?
  2. Stress?
  3. Need a fix?
  4. Fatigue?
  5. Friends using?
  6. Other?
  • Who else knows about your habit?
  • Do they encourage you?
  • Are they neutral? Do they care?
  • Do they want you to stop?
  • Where do you get your supply from?
  1. Work?
  2. Family member
  3. Friends?
  4. Local dealer?

Pause here and think of the people who might help you in getting clean. Family members? Friends who are not users. What about an ex-user?

Now go to where you usually go to set up your drug fix. What do you see round you? For example; kitchen, bathroom, porch,(is it clean or dirty?). Notice and write down the smells and the sounds that you associate with using.

When you have finished this questionnaire and made a list of the things which are associated with your use, you are well on the way to getting them out of your life. Think about this list along with your Drug Abandonment Ritual.

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Copyright Vivienne Edwards/Angels on Wheels LLC; 2008 - 2009
This page updated 2013