5. Readiness to Change Questionnaire (Treatment Version) (RCQ-TV) (Revised)
6. Stages of Change Readiness and Treatment Eagerness Scale‒Alcohol (SOCRATES 8A) 7. Stages of Change Readiness and Treatment Eagerness Scale‒Drugs (SOCRATES 8D) 8. University of Rhode Island Change Assessment (URICA) Scale
9. Alcohol and Drug Consequences Questionnaire (ADCQ) 10. Alcohol Decisional Balance Scale
11. Drug Use Decisional Balance Scale
12. Brief Situational Confidence Questionnaire (BSCQ) 13. Alcohol Abstinence Self-Efficacy Scale (AASES) 14. Motivational Interviewing Knowledge Test
1. U.S. Alcohol Use Disorders Identification Test (AUDIT)
Instructions: Alcohol can affect your health and treatment. We ask all clients these questions. Your answers will remain confidential. Circle the best answer to each question. Think about your drinking in the past year. A drink means one beer, one small glass of wine (5 oz.), or one mixed drink containing one shot (1.5 oz.) of spirits. 1.How often do you have a drink containing alcohol?
(0) Never [Skip to Questions 9 and 10] (1) Less than monthly
(2) Monthly (3) Weekly
(4) 2 to 3 times a week (5) 4 to 6 times a week (6) Daily
6. How often during the last year have you needed an alcoholic drink first thing in the morning to get yourself going after a night of heavy drinking? (0) Never
(1) Less than monthly (2) Monthly
(3) Weekly
(4) Daily or almost daily 2.How many drinks containing alcohol do you have
on a typical day when you are drinking? (0) 1 (1) 2 (2) 3 (3) 4 (4) 5 to 6 (5) 7 to 9 (6) 10 or more
7. How often during the last year have you had a feeling of guilt or remorse after drinking? (0) Never
(1) Less than monthly (2) Monthly
(3) Weekly
(4) Daily or almost daily
3.How often do you have X (5 for men; 4 for women and men over age 65) or more drinks on one occasion?
(0) Never
(1) Less than monthly (2) Monthly
(3) Weekly
(4) 2-3 times a week (5) 4-6 times a week (6) Daily
[Skip to Questions 9 and 10 if total score for Questions 2 and 3 = 0]
8.How often during the last year have you been unable to remember what happened the night before because you had been drinking?
(0) Never
(1) Less than monthly (2) Monthly
(3) Weekly
(4) Daily or almost daily
4. How often during the last year have you found that you were not able to stop drinking once you had started?
(0) Never
(1) Less than monthly (2) Monthly
(3) Weekly
(4) Daily or almost daily
9. Have you or someone else been injured as a result of your drinking?
(0) No
(2) Yes, but not in the last year (4) Yes, during the last year
5.How often during the last year have you failed to do what was normally expected from you because of drinking?
(0) Never
(1) Less than monthly (2) Monthly
(3) Weekly
(4) Daily or almost daily
10. Has a relative, friend, doctor, or another health professional expressed concern about your drinking or suggested you cut down?
(0) No
(2) Yes, but not in the last year (4) Yes, during the last year
Scoring
Risk Level Intervention USAUDIT Score Possible AUD (DSM-5, ICD-10)
Zone I Feedback 0–6/7 (Women/Men) None
Zone II Feedback/brief intervention 7/8–15 (Women/Men) Mild AUD, hazardous use Zone III Feedback/monitoring/brief
outpatient treatment
16–24 Moderate AUD, harmful use
Zone IV Referral to evaluation and treatment
25+ Moderate/severe AUD, alcohol dependence
Note: Questions 1 to 3 of U.S. AUDIT have been modified to reflect standard drink size in the United States and differences for men, women, and older adults.
3. Drinker Inventory of Consequences (DrInC) (Lifetime)
Instructions: Here are a number of events that drinkers sometimes experience. Read each one carefully and circle the number that indicates whether this has EVER happened to you (0 = No, 1 = Yes). If an item does not apply to you, circle zero (0).
Has this EVER happened to you? Circle one answer for each item. No Yes
1. I have had a hangover or felt bad after drinking. 0 1
2. I have felt bad about myself because of my drinking. 0 1 3. I have missed days of work or school because of my drinking. 0 1 4. My family or friends have worried or complained about my drinking. 0 1
5. I have enjoyed the taste of beer, wine, or liquor. 0 1
6. The quality of my work has suffered because of my drinking. 0 1 7. My ability to be a good parent has been harmed by my drinking. 0 1 8. After drinking, I have had trouble with sleeping, staying asleep, or nightmares. 0 1 9. I have driven a motor vehicle after having three or more drinks. 0 1 10. My drinking has caused me to use other drugs more. 0 1
11. I have been sick and vomited after drinking. 0 1
12. I have been unhappy because of my drinking. 0 1
13. Because of my drinking, I have not eaten properly. 0 1 14. I have failed to do what is expected of me because of my drinking. 0 1
15. Drinking has helped me to relax. 0 1
16. I have felt guilty or ashamed because of my drinking. 0 1 17. While drinking, I have said or done embarrassing things. 0 1 18. When drinking, my personality has changed for the worse. 0 1 19. I have taken foolish risks when I have been drinking. 0 1
20. I have gotten into trouble because of drinking. 0 1
21. While drinking or using drugs, I have said harsh or cruel things to someone. 0 1 22. When drinking, I have done impulsive things that I regretted later. 0 1 23. I have gotten into a physical fight while drinking. 0 1 24. My physical health has been harmed by my drinking. 0 1 25. Drinking has helped me to have a more positive outlook on life. 0 1
26. I have had money problems because of my drinking. 0 1
27. My marriage or love relationship has been harmed by my drinking. 0 1
28. I have smoked tobacco more when I am drinking. 0 1
29. My physical appearance has been harmed by my drinking. 0 1
30. My family has been hurt by my drinking. 0 1
31. A friendship or close relationship has been damaged by my drinking. 0 1
32. I have been overweight because of my drinking. 0 1
33. My sex life has suffered because of my drinking. 0 1
34. I have lost interest in activities and hobbies because of my drinking. 0 1 35. When drinking, my social life has been more enjoyable. 0 1 36. My spiritual or moral life has been harmed by my drinking. 0 1 37. Because of my drinking, I have not had the kind of life that I want. 0 1 38. My drinking has gotten in the way of my growth as a person. 0 1
39. My drinking has damaged my social life, popularity, or reputation. 0 1 40. I have spent too much or lost a lot of money because of my drinking. 0 1 41. I have been arrested for driving under the influence of alcohol. 0 1 42. I have had trouble with the law (other than driving while intoxicated) because of drinking. 0 1 43. I have lost a marriage or a close love relationship because of my drinking. 0 1 44. I have been suspended/fired from or left a job or school because of drinking. 0 1
45. I drank alcohol normally, without any problems. 0 1
46. I have lost a friend because of my drinking. 0 1
47. I have had an accident while drinking or intoxicated. 0 1 48. While drinking or intoxicated, I have been physically hurt, injured, or burned. 0 1 49. While drinking or intoxicated, I have injured someone else. 0 1 50. I have broken things while drinking or intoxicated. 0 1
Scoring: For each item, copy the circled number from the answer sheet next to the item number above. Then sum each column to calculate scale totals. Sum these totals to calculate the Total DrInC Score.
*Zero scores on Control Scale items may indicate careless or dishonest responses. The Total DrInC Score reflects the overall number of alcohol problems that have occurred during the person’s lifetime.
*See the test manual for this instrument for more information about scoring and interpreting the score. It also provides the instruments and scoring information for other versions of DrInC including one for drug use and a short version (SIP) of the instrument for alcohol and drugs.
Source:Miller, Tonigan, & Longabaugh (1995). Adapted from material in the public domain. Available online at no cost (https://pubs.niaaa.nih.gov/publications/projectmatch/match04.pdf).