Severity of Alcohol Dependence Questionnaire (SADQ)

The severity of Alcohol Dependence Questionnaire (SADQ, SAD-Q) was first published in the British Journal of Addiction.

The SADQ is sometimes used to to predict the levels of medication needed during alcohol detoxification.

The test is divided into 5 sections:

1. Physical withdrawal symptoms
2. Affective withdrawal symptoms
3. Craving and relief drinking
4. Typical daily consumption
5. Reinstatement of dependence after a period of abstinence.

Each item is scored on a 4-point scale, giving a possible range of 0 to 60.  A score of over 30 indicates severe alcohol dependence.

The SADQ Test

1. The day after drinking alcohol, do you wake up feeling sweaty?
   (1) Almost never
   (2) Sometimes
   (3) Often
   (4) Nearly always
2. The day after drinking alcohol, do your hands shake first thing in the morning?
   (1) Almost never
   (2) Sometimes
   (3) Often
   (4) Nearly always
3. The day after drinking alcohol, does your body shake violently first thing in the morning if you don't have a drink?
   (1) Almost never
   (2) Sometimes
   (3) Often
   (4) Nearly always
4. The day after drinking alcohol, do you wake up drenched in sweat?
   (1) Almost never
   (2) Sometimes
   (3) Often
   (4) Nearly always
5. The day after drinking alcohol, do you dread waking up?
   (1) Almost never
   (2) Sometimes
   (3) Often
   (4) Nearly always
6. The day after drinking alcohol, are you frightened of meeting people first thing in the morning?
   (1) Almost never
   (2) Sometimes
   (3) Often
   (4) Nearly always
7. The day after drinking alcohol, do you feel at the edge of despair when you wake up?
   (1) Almost never
   (2) Sometimes
   (3) Often
   (4) Nearly always
8. The day after drinking alcohol, do you feel frightened when you wake up?
   (1) Almost never
   (2) Sometimes
   (3) Often
   (4) Nearly always
9. The day after drinking alcohol, do you like a drink in the morning?
   (1) Almost never
   (2) Sometimes
   (3) Often
   (4) Nearly always
10. The day after drinking alcohol, do you gulp your first few drinks down as fast as possible?
    (1) Almost never
    (2) Sometimes
    (3) Often
    (4) Nearly always
11. The day after drinking alcohol, do you drink to get rid of the shakes?
    (1) Almost never
    (2) Sometimes
    (3) Often
    (4) Nearly always
12. The day after drinking alcohol, do you have a strong craving for drink when you wake up?
    (1) Almost never
    (2) Sometimes
    (3) Often
    (4) Nearly always
13. During a heavy drinking period, do you drink more than 1/4 bottle of spirits (or 1 bottle of wine, or 4 pints of beer) each day.
    (1) Almost never
    (2) Sometimes
    (3) Often
    (4) Nearly always
14. During a heavy drinking period, do you drink more than half a bottle of spirits per day (8 pints of beer, 2 bottles of wine).
    (1) Almost never
    (2) Sometimes
    (3) Often
    (4) Nearly always
15. During a heavy drinking period, do you drink more than a bottle of spirits per day (3 bottles of wine, 5 litres of cider or 10 pints of lager)
    (1) Almost never
    (2) Sometimes
    (3) Often
    (4) Nearly always
16. During a heavy drinking period, do you drink more than 2 bottles of spirits per day (7 bottles of wine, 9 litres of cider, 20 pints of beer).
    (1) Almost never
    (2) Sometimes
    (3) Often
    (4) Nearly alwaysFOR THE NEXT 4 QUESTIONS:
    Imagine you have been abstinent for a few weeks, then drink heavily for a couple of days.
17. The morning after would you start to sweat?
    (0) Not at all
    (1) Slightly
    (2) Moderately
    (3) Nearly always
    (4) I haven't been abstinent for that long, so it's hard to say
18. ...would your hands shake?
    (0) Not at all
    (1) Slightly
    (2) Moderately
    (3) Nearly always
    (4) I haven't been abstinent for that long, so it's hard to say
19. ...would your body shake?
    (0) Not at all
    (1) Slightly
    (2) Moderately
    (3) Nearly always
    (4) I haven't been abstinent for that long, so it's hard to say
20. ...would you be craving for a drink?
    (0) Not at all
    (1) Slightly
    (2) Moderately
    (3) Nearly always
    (4) I haven't been abstinent for that long, so it's hard to say

Scoring the Test

The test is scored by totaling the numbers in the parenthesis next to the answers given by the participant.

• A score of less than 3 indicates no alcohol dependence.
• A score between 4 and 20 indicates mild dependence.
• A score between 20 and 30 indicates moderate dependence.
• A score of over 30 indicates severe dependence.

Truly Holistic Program That Treats Body, Mind, and Spirit

Summit Malibu offers a holistic program based on our belief that we are treating the whole person and not just a collection of symptoms and problems.

Our program includes medically supervised detoxification for physical symptoms, psychotherapeutic counseling for mental and emotional distress, and optional practices such as Yoga, Meditation, and 12-Step Groups for the spirit.

If you are considering another treatment center, ask them if their program is truly holistic, or if they require their clients to adhere to limited programs such as an “addiction cure."

Owned and Operated by People Dedicated to Helping Others

Summit Malibu is owned and operated by people committed to helping other people, not by a corporation focused on continually increasing profits.

The owners of Summit Malibu are long-standing members of the recovery community, and many are in recovery themselves.

If you are considering another treatment center, ask them if their business is owned by people involved in the day-to-day operation of the program, or by a distant, profit-driven corporation.

Extremely Private and Secure Location

Summit Malibu is located on three acres of private land, one full mile inside a private gated community, surrounded on three sides by wild hills, and on the fourth side by a beautiful ocean view.

Many other residential treatment centers claim to offer privacy while they are actually located in typical houses on standard residential lots facing public streets.

If you are considering another treatment center, ask them how much private land surrounds their facility, and how much of their facility is within view of public streets.

Fewer Residents Means Individualized Treatment

Summit Malibu’s residential center is limited to seven clients, allowing us to provide individualized treatment to each and every client.

By maintaining one of the highest client-to-staff ratios in the industry we are able to customize treatment according to the specific needs of the individual, rather than having to impose a generalized treatment onto a large group.

If you are considering another treatment center, find out how many clients in total they can accommodate and what their client-to-staff ratio is when their facility is full.

Highly Experienced in Dual Diagnosis Treatment

Summit Malibu’s world class therapists have decades of experience treating the many dual diagnosis/co-occurring disorders that often accompany chemical dependency, such as depression, anxiety, and PTSD.

Other treatment centers accept dual diagnosis clients but may not have the long-term experience required to treat these complex and demanding issues.

If you are considering another treatment center, find out how much clinical experience therapists actually have treating dual diagnosis and co-occurring disorders.

Methylyn Abuse and Addiction

Methylyn (methylphenidate) is a psychostimulant drug approved for treatment of Attention Deficit Hyperactivity Disorder, Postural Orthostatic Tachycardia Syndrome, and narcolepsy.  It may also be prescribed for treatment-resistant cases of lethargy, depression, neural insult, obesity, and Obsessive Compulsive Disorder.

Methylphenidate belongs to the piperidine class of compounds, which increase the levels of dopamine and norepinephrine in the brain.  Methylphenidate is structurally similar to amphetamine, and its pharmacological effects are closely related to those of cocaine.

In the United States, Methylyn (methylphenidate) is classified as a Schedule II controlled substance, the designation used for substances that have a recognized medical value but present a high likelihood for abuse because of their addictive potential.

Methylyn is approved by the FDA for the treatment of Attention Deficit hyperactivity disorder because of its effects of increasing or maintaining alertness, combating fatigue, and improving attention.  The long term effects of methylphenidate on the developing brain are unknown, and it is not approved for children under six years of age.

Methylphenidate has shown some benefits as a replacement therapy for methamphetamine addiction.  Methylphenidate and amphetamine have also been investigated as a chemical replacement for the treatment of cocaine dependence, in the same way that methadone is used as a replacement for heroin.  Methylphenidate is actually more potent than cocaine in its effect on dopamine transporters.

Methylphenidate has a high potential for drug abuse and drug dependence due to its pharmacological similarity to cocaine and amphetamine.

Methylphenidate abuse is higher among college students compared to non-college attending young adults.  College students abuse methylphenidate as a so-called "study drug" to improve concentration or stay awake.  Methylphenidate has been dubbed "kiddie coke" due to its low price and high availability among young people.  It is one of the top ten stolen prescription drugs in the United States.

Increased alcohol consumption due to abuse of stimulants such as Methylyn has additional negative effects on the health, particularly in young adult abusers.

Methylyn long term use, and use in high doses, has been associated with higher levels of psychiatric admissions, drug dependence, paranoia, schizophrenia and psychosis.  Psychotic symptoms from Mehyphenidate can include hearing voices, visual hallucinations, urges to harm oneself, severe anxiety, euphoria, grandiosity, paranoid delusions, confusion, and increased aggression.

Tolerance may occur with long-term use of methylphenidate, including cross tolerance with other stimulants such as amphetamines and cocaine.

Withdrawal symptoms of methylphenidate can include psychosis, depression, irritability and a temporary worsening of the original symptoms for which the drug was prescribed, known as rebound.

Meprobamate Abuse and Addiction

Meprobamate (brand name Miltown, Equanil and Meprospan) is a an anti-anxiety drug that was once the best-selling minor tranquilizer in the United States.  It has largely been replaced by benzodiazepines such as Valium, Librium, and Xanax.

Meprobamate is a Schedule IV drug under the Convention on Psychotropic Substances.

Symptoms of Meprobamate overdose include drowsiness, unresponsiveness, loss of muscle control, severe impairment or cessation of breathing, coma, and shock.

Death has been reported with ingestion of as little as 12 grams of Meprobamate.

Prolonged use of Meprobamate can lead to physical dependence and has a life-threatening abstinence syndrome similar to alcohol and barbiturates.  Sudden abstinence from Meprobamate can lead to severe reactions including insomnia, vomiting, tremor, muscle twitching and overt anxiety in the first 3 to 4 days.

Acute psychotic reactions and hallucinations resembling delirium tremens have been noticed in severe cases of Mebrobamate abuse.

Medically supervised detoxification (detox) followed by psychosocial treatment is highly recommended in cases of long-term Mebprobamate abuse and dependence.

Meperidine Abuse and Addiction

Meperdine (Demerol, Pethedine, Lidol, Pethanol, Alodan and Dispadol) is a fast-acting opioid analgesic drug used for the treatment of moderate to severe pain.  It is most commonly known by its brand name, Demerol.  It is administered in tablets, syrup or by intramuscular or intravenous injection.

Meperidine causes users to experience marked euphoria because it triggers the brain's pleasure centers while it blocks pain.

Meperidine's effects are felt a few minutes after ingestion and last from two to four hours.  Meperidine’s effects are similar to morphine, but with sedation, respiratory depression, and euphoria less intense than morphine.  Nausea and vomiting are common with oral use but less likely when administered by injection.

For much of the 20th century Meperidine was the opioid of choice for many physicians.

Meperidine was considered to be safer and to carry less risk of addictionthan Morphine.  It was also thought to be superior in treating pain due to its antispasmodic effects.  Physicians now consider Meperidine to be no more effective than Morphine in treating pain. In addition, its low potency, short duration, and toxicity has caused it to lose popularity in recent years.

Meperidine toxicity can result in seizures, delirium, and other serious neuropsychological effects.

The side effects of Meperidine are similar to those of other opiods: nausea, vomiting, sedation, dizziness, urinary retention and constipation. Meperidine overdose can cause muscle flaccidity, respiratory depression, cold and clammy skin, hypotension, and coma.

Fatalities have occurred with both oral and intravenous Meperidine overdose.

Serotonin syndrome, a potentially life-threatening build up of excess serotonin in the brain, has occurred in patients taking Meperidine during antidepressant therapy or with selective serotonon reuptake inhibitors (SSRIs) or monoamine oxidase inhibitors (MOIs).

Despite being structurally distinct from Morphine and related opiates, Meperidine's effects on opiate receptors in the brain are similar to those of morphine.

The major hazard of Demerol is respiratory depression, but other risks include circulatory depression, respiratory arrest, shock, and cardiac arrest.

Physical tolerance and psychological dependence can develop, especially with excessive doses or long-term use.  Stopping usage abruptly after prolonged or high dosage can result in extreme fatigue and mental depression.

Medially supervised detoxification is highly recommended when experiencing Meperidine withdrawal.

Severity of withdrawal symptoms is directly related to the amount of Meperidine taken and the length of time it has been taken.  Dependence can develop after even a few weeks of regular use.  Treatment will ultimately depend on the degree of addiction.

Lomotil Abuse and Addiction

Lomotil is the brand name of diphenoxylate, an anti-diarrheal that is chemically related to the narcotic drug meperidine (aka Demerol).  It works by slowing down the movement of the intestines.  It is often combined with Atropine, which reduces spasms in the bladder, stomach and intestines.

Lomotil and Atropine are generally safe in short-term use and with recommended dosage, but long-term use may present problems of dependence.

Lomotil abuse can cause side effects including dry mouth, headache, constipation, blurred vision, drowsiness and dizziness.  Because of these efects, Lomotil shouldn't be used by motorists or operators of machinery.

Symptoms of Lomatil overdose can take up to 12 hours to appear.

Overdose is common among drug abusers, possibly because of its relatively mild initial effects that may cause them to take additional amounts to feel the desired effects.  Symptoms of Lomatil overdose include convulsions, respiratory depression, dilated eye pupils, rapid side-to-side eye movements, flushed skin, constipation, nausea, vomiting, tachycardia, drowsiness, coma and hallucinations.

Treatment of Lomotil overdose must begin immediately after diagnosis and may include the following: emesis (induced vomiting), gastric lavage, ingestion of activated charcoal, laxative and a counteracting medication such as a narcotic neutralizer.

Recovery from Lomatil overdose usually occurs within 24 to 48 hours, but children and young adults are at risk of a very poor outcome and must be kept for observation.

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