Alcohol Dependence Scale (ADS)
Harvey A. Skinner‚ (1982)
These questions refer to the past 12 months
1. How much did you drink the last time you drank?
a. Enough to get high or less
b. Enough to get drunk
c. Enough to pass out
2. Do you often have hangovers on Sunday or Monday mornings?
a. No
b. Yes
3. Have you had the “shakes” when sobering up (hands tremble‚ shake inside)?
a. No
b. Sometimes
c. Often
4. Do you get physically sick (e.g.‚ vomit‚ stomach cramps) as a result of drinking?
a. No
b. Sometimes
c. Almost every time I drink
5. Have you had the “DTs” (delirium tremens) – that is‚ seen‚ felt or heard things not really there; felt very anxious‚ restless‚ and over excited?
a. No
b. Sometimes
c. Several times
6. When you drink‚ do you stumble about‚ stagger‚ and weave?
a. No
b. Sometimes
c. Often
7. As a result of drinking‚ have you felt overly hot and sweaty (feverish)
a. No
b. Once
c. Several times
8. As a result of drinking‚ have you seen things that were not really there?
a. No
b. Once
c. Several times
9. Do you panic because you fear you may not have a drink when you need it?
a. No
b. Yes
10. Have you had blackouts (“loss of memory” without passing out) as a result of drinking?
a. No‚ never
b. Sometimes
c. Often
d. Almost every time I drink
11. Do you carry a bottle with you or keep one close at hand?
a. No
b. Some of the time
c. Most of the time
12. After a period of abstinence (not drinking)‚ do you end up drinking heavily again?
a. No
b. Sometimes
c. Almost every time I drink
13. In the past 12 months‚ have you passed out as a result of drinking?
a. No
b. Once
c. More than once
14. Have you had a convulsion (fit) following a period of drinking?
a. No
b. Yes
c. Several times
15. Do you drink throughout the day?
a. No
b. Yes
16. After drinking heavily‚ has your thinking been fuzzy or unclear?
a. No
b. Yes‚ but only for a few hours
c. Yes‚ for one or two days
d. Yes‚ for many days
17. As a result of drinking‚ have you felt your heart beating rapidly?
a. No
b. Yes
c. Several times
18. Do you almost constantly think about drinking and alcohol?
a. No
b. Yes
19. As a result of drinking‚ have you heard “things” that were not really there?
a. No
b. Yes
c. Several times
20. Have you had weird and frightening sensations when drinking?
a. No
b. Once or twice
c. Often
21. As a result of drinking have you “felt things” crawling on you that were not really there (e.g.‚ bugs‚ spiders)?
a. No
b. Yes
c. Several times
22. With respect to blackouts (loss; of memory):
a. Have never had a blackout
b. Have had blackouts that last less than an hour
C. Have had blackouts that last for several hours
d. Have had blackouts that last a day or more
23. Have you tried to cut down on your drinking failed?
a. No
b. Once
c. Several times
24. Do you gulp drinks (drink quickly?)
a. No
b. Yes
25. After taking one or two drinks‚ can you usually stop?
a. Yes
b. No
This instrument can be found at: http://www.emcdda.europa.eu/html.cfm/index3583EN.html
Scoring: The 15 items summed for a total score than can range from 0 to 45. Scale totals are interpreted as follows: 1-9 low dependence‚ 10-19 medium dependence‚ and 20 or greater high dependence.
Scoring: Dichotomous items are scored 0‚ 1; three-choice items are scored 0‚ 1‚ 2; and four-choice items are scored 0‚ 1‚ 2‚ 3. In each case‚ the higher the value the greater the dependence. Total scores can range from 0 to 47.
ADS INTERPRETATION GUIDE
ADS Raw Score Interpretation* Suggested Care**
0 No evidence of alcohol dependence was reported. However‚ this does not Advice necessarily mean at the individual is free of dependence symptoms. Assess the validity of self-reports. 1-13 Low level of alcohol dependence. Brief (1st quartile) Symptoms are probably psychological‚Counselling rather than physical. Moderation (Level I) drinking strategies may be considered if there are no contradictions.
Score of 9 or more is highly indicative of a current diagnosis (DSM-III) of alcohol abuse or dependence.
14-21 Intermediate level of alcohol dependence. Out-Patient (2nd quartile) Psychological problems elated to (Level I or II) drinking are likely. Psychological dependence may still be characteristic‚ but look for signs of physical dependence and withdrawal symptoms.
22-30 Substantial level of alcohol dependence. Intensive (3rd quartile) Physical dependence is likely. dical Out-Patient/disorders‚ psychiatric symptoms and social Inpatient problems related to alcohol buse are (Level II or III) probable. Abstinence treatment goal should be recommended. Clients are more likely to recognize that abstinence is the only way to improve.
31-47 Severe level of alcohol dependence. Physical Intensive (4th quartile) dependence is highly likely. Serious psychiatric symptoms and medical disorders related (Level III or IV) to drinking – such as liver disease – are likely. Abstinence is recommended. Check for seriousness of intentions to comply with treatment.
*CAUTION: ADS Scores should always be checked with information from other sources before making a treatment plan. Attention must be given to age and gender‚ the number of years the individual has been drinking heavily‚ time since last drinking (and amount)‚ use of drugs other than alcohol‚ and other pertinent information. Also‚ assess the validity of self-reports.
**ASAM Placement Level.
Skinner HA‚ Allen BA. Alcohol Dependence Syndrome: Measurement and validation. J. Abnorm. Psychol. 1982;91:199–209. [PubMed]
Skinner HA‚ Horn JL. Alcohol Dependence Scale (ADS): User’s Guide. Toronto‚ Canada: Addiction Research Foundation; 1984.
Harvey A. Skinner‚ Ph.D.
Professor and Chair
Department of Public Health Sciences
Faculty of Medicine.
University of Toronto.
12 Queen’s Park Cres.
West‚ Toronto.
Ontario. Canada‚ M5S‚ 1A8.
Phone: (416) 978-8989.Fax: (416) 978-2087.