Patient Questionnaire (DAST)
DAST – 10
No = 0Yes = 1 Have you used drugs other than those required for medical reasons
No = 0 Yes = 1 Do you abuse more than one drug at a time
No =1Yes = 0 Are you always able to stop using drugs when you want to? (If never used drugs, answer yes)
No = 0Yes = 1 Have you had “blackouts” or “flashbacks” as a result of drug use?
No = 0 Yes = 1 Do you ever feel bad or guilty about your drug use? If never used drugs, choose No
No = 0Yes = 1 Do your spouse (or parents) ever complain about your involvement with drugs?
No = 0Yes = 1 Have you neglected your family because of your use of drugs?
No = 0Yes = 1 Have you engaged in illegal activities in order to obtain drugs?
No = 0Yes = 1 Have you ever experienced withdrawal symptoms (felt sick) when you stopped taking drugs?
No = 0Yes = 1 Have you had medical problems as a result of your drug use (e.g., memory loss, hepatitis, convulsions, bleeding)?
DAST Score0 = None1-2 = Low 3-5 = Moderate 6-8 = Substantial9-10 = Severe
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Document Name: Patient Questionnaire (DAST)
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