FREE Medication Abuse Screening Test

Welcome to your Free Medication Abuse Screening Test

Kindly complete the questionnaire so that we can evaluate your condition according to the options you select.

Name
Email
Country/ State

Please rate the CURRENT (i.e. LAST 2 WEEKS) SEVERITY of your insomnia problem(s).

Do you use more than one pharmacy to fill these medications?
Do you ever find yourself needing rapid increases of these meds to help you find relief of symptoms?
Are there times when medications are unsuccessful to control your pain, assist with sleep or calm your nerves?
Do you have an urge or a feeling to use the medications daily or even several times per day?
Have your medications created problems with your friends or family?
Do you feel sick or show unusual symptoms when you stop taking your medications?
Do you ever feel bad or guilty about taking these medications?
Have you ever been instructed to stop taking the medications but refused or were unable to stop?