Free Substance Use Self-Assessment Worksheet
Substance Use Disorder Criteria (DSM-5 Based)**
Understanding the underlying patterns of substance use is essential for building insight and motivation. This free worksheet provides a clear, evidence-based overview of the 11 DSM-5 criteria for Substance Use Disorders, complete with everyday examples to help group members connect the material to real life.
What This Worksheet Covers
Participants review each DSM-5 symptom area, including:
Loss of control
Unsuccessful attempts to cut down
Craving
Impaired functioning at work, school, or home
Social and relationship impacts
Tolerance and withdrawal
Use despite negative consequences
Each criterion includes examples that make the content relatable and discussion-ready.
How to Use This in Group
This worksheet works well in:
Psychoeducation groups
Relapse prevention
Motivational interviewing sessions
Co-occurring disorder groups
Individual counseling
Suggested flow:
Participants check “Yes” or “No” for each criterion.
Facilitate discussion on patterns, insight, or surprises.
Explore how symptoms show up across daily life.
Close with a conversation about readiness, change, and goals.
This structure naturally supports insight, reduces shame, and encourages honest reflection.
Download the Worksheet
Source Acknowledgment
This worksheet comes from: Daley, D. C., & Douaihy, A. (2019). Managing Your Substance Use Disorder. Oxford University Press
Shared here exclusively for educational and clinical use.
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