Drug and alcohol printable worksheet
[DOC File]DRUG ABUSE WORKSHEET - Pottsgrove School District
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DRUG ABUSE WORKSHEET Name: _____ DEPRESSANTS VOLATILE SOLVENTS STIMULANTS DRUGS. CANNABIS NARCOTICS NICOTINE HALLUCINOGENS MORPHINE CAFFEINE. TRANQUILLIZERS SEDATIVES O.T.C. DRUGS. ALCOHOL DRUG ABUSE ANABOLIC STEROIDS Place the appropriate substances (other than food, air or water) that when taken into the body …
[DOC File]WRITING MY RECOVERY STORY WORKSHEET
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WRITING MY RECOVERY STORY WORKSHEET (Note: Be sure to save this document to your desktop before you start editing.) Thought-Starter Questions: What were some of the early indications that you were beginning to have difficulties? Briefly describe yourself …
[DOCX File]FULL ASAM ASSESSMENT - ADULT
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Amy has a 5 yr history of opioid use, beginning with prescription opioids and progressing to mixed prescription and heroin use. She has attempted multiple programs to try and manage her use and despite these attempts and escalating harmful consequences (loss of employment and independent housing), she continues to use.
[DOC File]Autobiography – My History of Substance Abuse
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The use of alcohol and drugs often stops your emotional development and is many times used to cope with feelings. In other words, when you start using drugs/alcohol you stop maturing emotionally. An emotionally immature person throws temper tantrums, has little/no impulse control, has no patience, requires immediate gratification, etc.
[DOCX File]TREATMENT PLAN GOALS & OBJECTIVES
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Alcohol/Drugs and Other Addictions. Goal: Be free of drug/alcohol use/abuse. Avoid people, places and situations where temptation might be overwhelming. Explore dynamics relating to being the [child/husband/wife] of an [alcoholic/addict] and discuss them each week at support group meetings. Learn five triggers for alcohol & drug use
[DOC File]RELAPSE PREVENTION PLAN WORKSHEET
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RELAPSE PREVENTION PLAN WORKSHEET. DRUGS. A relapse prevention plan is a tool to help you as you continue your life free from drugs. The following questions will help you examine your past behavior and how you overcame your dependence on drugs.
[DOC File]DRUG AND ALCOHOL QUESTIONNAIRE - clarkclipsonphd
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Part III: Consequences Related to Alcohol or Drug Use. Please circle any problems that have persisted following your use of drugs or alcohol: Hepatitis or liver problems Persistent cough Hallucinations Strange thoughts. Congestion or wheezing Heart problems Depression Mania Loss of sex drive. Please circle any social or relationship problems ...
[DOC File]DRUG/ALCOHOL FREE WORK PLACE POLICY
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Drug and Alcohol Prohibition Policy. REQUIREMENTS FOR USE OF THIS SAMPLE DOCUMENT: 245D license holders are responsible for modifying this sample for use in their program. At a minimum, you must fill in the blanks on this form. You may modify the format and content to meet standards used by your program. This sample meets compliance with ...
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