Assessment #2:
What Price Do I Pay?

Rate how much your substance use is affecting each of the life areas listed below, using a scale of 1 to 10. The questions we’ve put under each category are there to help you think it through thoroughly. High scores mean the life area is greatly affected by your substance use. Score zero to mean no effect.

1. Physical Health

Score out of 10: _______

2. Financial and Legal

Score out of 10: _______

3. Relationship Issues

Score out of 10: _______

4. Job/Education

Score out of 10: _______

5. Internal Life

Score out of 10: _______

Total score out of 50: _______

This total score represents in a number rating the price you believe you are paying for your substance use. If you multiply that number by two, it will give you a percentage score, which is something we are more used to.

Even scores that look low may give you cause for concern. If you score 25%, that is saying you believe your life could be 25% better without the drugs or alcohol. Cutting back on the substance use would be a powerful performance enhancer.

Your next step is to take Assessment #3, which will help you decide which course of action is best suited to creating this positive change for you.