UNCOPE
Answer the questions to the right. In the last 12 months, have you:
Scoring:
Yes = 1 No = 0
2-3 indicates possible substance abuse
4 or more strongly indicate substance dependence
Scores of 2+ require a follow up
Score:
1. In the past year, have you ever drunk or used drugs more than you meant to? Or have you spent more time drinking or using than you intended?
Yes
No
2. Have you ever neglected some of your usual responsibilities because of using last year?
Yes
No
3. Have you felt you wanted or needed to cut down on your drinkin or drug use in the last year?
Yes
No
4. Has anyone objected to your drinking or drug use? Or has your family, friend, or anyone else told you they objected to your drug or alcohol use?
Yes
No
5. Have you ever found yourself preoccupied with wanting to use drugs or alcohol? Or have you found yourself thinking a lot about using or drinking?
Yes
No
6. Have you ever used alcohol or drugs to relieve emotional discomfort such as sadness, anger, or boredom?
Yes
No
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Date Completed