Online Assessment Form at The Cabin Chiang Mai

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Question 1 of 12
Has using your substance of choice – or engaging in your behaviour of choice – created personal problems for you, hurt your relationships with family or friends, or negatively affected your work or school performance?*
- Yes
- No
Note: This online assessment is not intended as a substitute for a professional assessment. If you have concerns about addiction, please seek professional advice from one of our admissions team. All of your responses are confidential.

Question 2 of 12
Have you noticed that you need progressively more of your substance or behaviour in order to achieve the same effect?*
- Yes
- No

Question 3 of 12
When you start using your substance or engaging in your behaviour, do you find it difficult to stop?*
- Yes
- No

Question 4 of 12
Do you spend less time doing activities you enjoy (e.g. hobbies, sports, spending time with your family and non-using friends) or neglect responsibilities (e.g., important events, appointments, sleep or eating) because of your use or behaviour?*
- Yes
- No

Question 5 of 12
Do you spend a lot of mental energy on your substance or behaviour, thinking about it when you’re not using or engaging in it?*
- Yes
- No

Question 6 of 12
Do you try to hide your use or behaviour from others, or lie about how much you use or engage in it?*
- Yes
- No

Question 7 of 12
Do you become uncomfortable, depressed, moody, nervous or irritable – or really bored – when you stop using or can’t get a ‘fix’ for a long period of time?*
- Yes
- No

Question 8 of 12
Do you go to extensive lengths to obtain your drug or activity of choice, when it’s not readily available? Do you feel anxious when you can’t get it?*
- Yes
- No

Question 9 of 12
Do you use or engage in your behaviour to cope with difficult emotions and/or memories – to escape personal problems or to seek relief from uncomfortable feelings such as guilt, anxiety, helplessness, or depression?*
- Yes
- No

Question 10 of 12
Do you feel that you are unable to enjoy certain activities or situations without your substance or behaviour of choice?*
- Yes
- No

Question 11 of 12
Have you ever felt defensive, guilty, or ashamed of your use or behaviour, or avoided people or places that don’t approve of it?*
- Yes
- No

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Free, Instant Online Assessment