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Substance Use Patterns and Impact Inventory

A structured self-assessment of substance use history, frequency, and functional consequences

Addiction & RecoveryAssessmentFree ResourceLast reviewed April 2026

Substance Use Patterns and Impact Inventory

A structured self-assessment of substance use history, frequency, and functional consequences

Substance Use Patterns and Impact Inventory

A structured self-assessment of substance use history, frequency, and functional consequences

Understanding the full scope of substance use, including patterns, consequences, and warning signs, is a critical first step in treatment planning. The DSM-5-TR (American Psychiatric Association, 2022) defines substance use disorders along a severity continuum based on the number of diagnostic criteria met. This inventory draws on validated screening constructs from the AUDIT, DAST-10, and NIDA Quick Screen to help clinicians and clients collaboratively assess use patterns and their impact across major life domains. Honest self-report, even approximate, provides valuable clinical information. This is not a diagnostic instrument but a structured conversation starter.

1Not at all2Rarely3Sometimes

Loss of Control and Compulsive Use

123
I have used a substance in larger amounts or for longer than I originally intended
123
I have experienced persistent desire or repeated unsuccessful efforts to cut down or control use
123
I have spent a great deal of time obtaining, using, or recovering from substance use
123
I have experienced strong cravings or urges to use a substance
123
I have continued using despite knowing it was causing or worsening a physical or psychological problem

Functional Impairment

123
My substance use has interfered with fulfilling responsibilities at work, school, or home
123
I have continued using despite it causing or worsening interpersonal or relationship problems
123
I have given up or significantly reduced important social, occupational, or recreational activities because of use
123
I have used substances in situations where it was physically hazardous, such as driving or operating machinery
123
I have experienced legal, financial, or housing problems related to my substance use

Physiological Dependence and Escalation

123
I have developed tolerance, needing noticeably more of a substance to achieve the same effect
123
I have experienced withdrawal symptoms when reducing or stopping use of a substance
123
I have used a substance, or a similar one, to relieve or avoid withdrawal symptoms
123
My pattern of use has escalated in frequency, quantity, or risk level over time
123
I have used substances to cope with emotional pain, anxiety, depression, or trauma symptoms

Social and Relational Impact

123
Important relationships with family, friends, or a partner have been damaged by my substance use
123
I have been dishonest with others about the extent of my use
123
I have isolated myself from people who do not use substances
123
Others have expressed concern about my substance use on more than one occasion
123
I have engaged in risky sexual behavior or boundary violations while under the influence

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Common Questions

What is the Substance Use Patterns and Impact Inventory worksheet?

Understanding the full scope of substance use, including patterns, consequences, and warning signs, is a critical first step in treatment planning. The DSM-5-TR (American Psychiatric Association, 2022) defines substance use disorders along a severity continuum based on the number of diagnostic criteria met.

How do I use the Substance Use Patterns and Impact Inventory worksheet?

Rate each item honestly. This is a self-assessment tool, not a clinical diagnosis. Bring your results to your next therapy session for discussion.

Is the Substance Use Patterns and Impact Inventory worksheet free?

Yes. Like every worksheet on Therapy Resource, it is free to read, print, and download as a PDF — no account required. A Pro subscription adds online filling with saved progress, practice-branded PDF exports, and secure client sharing.

Can I fill out the Substance Use Patterns and Impact Inventory worksheet online?

Yes — switch the worksheet to "Type on Screen" mode to fill in the fields directly in your browser before printing. Pro members can also save their entries across sessions and export the completed worksheet as a branded PDF.

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