Self Assessment for Methamphetamine Users

1. What are the most important reasons you use methamphetamine? Check below any reasons that apply to you.: *

It is fun, I feel happy/excited when I use

I feel more confident with friends and in groups

It makes listening to music and dancing more enjoyable

It helps me feel better when I am depressed

It keeps me going on a night out

It is a habit

There is nothing else to do

It makes sex better

To lose weight

To escape

My friends and sexual partners use meth

To get more work done

To concentrate and focus

2. How often do you use methamphetamine?: *

A few times a year

Once or twice a month

Once or twice a week (like every weekend)

Every day or almost every day

3. How much money do you spend on methamphetamine in an average week?: *

Less than $20.00

$20.00 - $60.00

$60.00 - $150.00

More than $150.00

4. Do you use methamphetamine in combination with other substances, like mixing ecstasy and methamphetamine? Please ignore cigarettes and tobacco when answering this question.: *

Yes, often

Yes, sometimes

No, never

5. When you use methamphetamine, what people do you usually use with?: *

Always with friends

Usually with friends, but sometimes alone

Sometimes with people who you only know through using methamphetamine

With sex partners

Always alone

6. Have you ever NOT done what was expected of you because of using methamphetamine or because of its after effects; for example missing work, or breaking promises to family and friends?: *

Never

Occasionally

All the time

7. Think about the times you have felt worried or concerned about using methamphetamine in the last year. Read the statements below and check the ones that feel most like you.: *

8. How often have you thought to yourself in the past year, ‘I should cut down or stop’?: *

9. Could you stop using methamphetamine whenever you want?: *

No, I couldn’t

Maybe, but it would take me a lot of effort

Probably, but not without some effort

Sure, I would have no trouble at all

10. Do you want to change the way you use methamphetamine?: *

Not at all

Maybe

Yes, but not stop

I want to stop using methamphetamine