Place a checkmark next to activities, situations, or settings in which you frequently used substances; place a zero next to activities, situations, or settings in which you never have used substances.
□ Home alone
□ Home with friends
□ Friend’s home
□ Parties
□ Sporting events
□ Movies
□ Bars/clubs
□ Beach
□ Concerts
□ With friends who use drugs
□ When gaining weight
□ Vacations/holidays
□ When it’s raining
□ Before a date
□ During a date
□ Before sexual activities
□ During sexual activities
□ After sexual activities
□ Before work
□ When carrying money
□ After going past dealer’s residence
□ Driving
□ Liquor store
□ During work
□ Talking on the phone
□ Recovery groups
□ After payday
□ Before going out to dinner
□ Before breakfast
□ At lunch break
□ While at dinner
□ After work
□ After passing a particular street or exit
□ School
□ The park
□ In the neighborhood
□ Weekends
□ With family members
□ When in pain
List any other activities, situations, or settings where you frequently have used.
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List activities, situations, or settings in which you would not use.
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List people you could be with and not use.
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