Nasha Mitra

Community Addiction Screening Inventory (CASI)

Take the CASI test below to know the impact of addiction on your health

Q1. Do you use any addictive substances?

Yes No

Q2. Have you used any of the following substance over last three-months period?

Alcohol	Daily	Weekly	Monthly	Never
Cough Syrup	Daily	Weekly	Monthly	Never
Opium	Daily	Weekly	Monthly	Never
Injectable Drugs	Daily	Weekly	Monthly	Never
Cannabis	Daily	Weekly	Monthly	Never
Cocaine	Daily	Weekly	Monthly	Never
Amphetamine like substances	Daily	Weekly	Monthly	Never
Inhalational substances	Daily	Weekly	Monthly	Never
Sleeping pills	Daily	Weekly	Monthly	Never
Tobacco	Daily	Weekly	Monthly	Never
Heroin	Daily	Weekly	Monthly	Never

Q3. Have you ever tried to reduce or stop using any substance over last three-months period?

Yes No

Q4. Have you experienced any of the following physical withdrawal symptoms when you tried to reduce or stop any substance over last three-months period?

Fast heartbeat	Yes	No
Breathing difficulties	Yes	No
Sweatiness	Yes	No
Headaches	Yes	No
Nausea	Yes	No
Vomiting	Yes	No
Diarrhoea	Yes	No
Running nose	Yes	No
Dizziness	Yes	No
Aches and pains	Yes	No
Convulsions	Yes	No

Q5. Have you ever experienced any of the following psychological withdrawal symptoms when you tried to reduce or stop any substance over last three-months period?

Irritable mood	Yes	No
Anxiety/Tension	Yes	No
Depression	Yes	No
Suicidal thoughts	Yes	No
Lack of sleep	Yes	No
Aggressive behaviour	Yes	No
Seeing unusual objects	Yes	No
Hearing of vices/noises	Yes	No
Agitation	Yes	No
Confusion/Disorientation	Yes	No

Q6. Have you ever experienced any psychological illnesses due to substance use over last one-year period?

Yes No

Q7. Have you ever experienced any legal problems due to substance use over last one-year period?

Yes No

Q8. Have you ever had any financial difficulties due to substance use over last one-year period?

Yes No

Q9. Have you ever experienced any physical health problems due to substance use over last one-year period?

Yes No

Q10. Have you ever tried to cut down or stop using any substance due to substance related complications over last one-year period?

Yes No

Q11. Have you ever experienced any problems at work due substance use over last three-months period?

Yes No

Q12. Have you ever failed to do your daily chores or daily duties due to substance use over last three-months period?

Yes No

Q13. Have you ever felt guilty about your substance use over last one-year period?

Yes No

Q14. Has your family member or friend expressed concerns about your substance use over last one-year-period?

Yes No

Q15. Have you ever seen any doctor for substance related problems over last one-year period?

Yes No

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