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|
Name_______ |
|
|
Date_______ |
|
|
Score_______ |
1.A |
How many drinks does it take before you begin to feel the first effects of alcohol? |
______ |
|
OR |
|
1.B |
How many drinks does it take before the alcohol makes you fall asleep or pass out.
If you never pass out, what is the largest number of drinks that you have? |
______ |
|
|
Yes No |
2. |
Have your friends or relatives worried about your drinking in the past year? |
____ ____ |
3. |
Do you sometimes take a drink in the morning when you first get up? |
____ ____ |
4. |
Are there times when you drink and afterwards can't remember what you said or did? |
____ ____ |
5. |
Do you sometimes feel the need to cut down on your drinking? |
____ ____ |
Scoring: Three or more points is considered positive for alcoholism/heavy drinking.
Reference: Chan AWK; Pristach EA; Welte JW; Russell M. Use of the TWEAK test in screening for alcoholism/heavy drinking in three populations. Alcoholism: Clinical and Experimental Research 17(6): 1188-1192, 1993. (30 refs.)
Bibliography on TWEAK
Copy for Clinical Use
