Substance Use Self-Monitoring Log

Personal Information

Name: _________________________ Date Started: _____________

Daily Tracking Sheet

Date: _______________

Substance Use

• Type of substance(s) used today: _______________________
• Amount consumed: _________________________________
• Time of use: _____________________________________

Triggers and Circumstances

• Location: _______________________________________
• Who were you with?: ______________________________
• Emotional state before use:
  • Anxious
  • Depressed
  • Angry
  • Happy
  • Stressed
  • Other: ________________

Coping Strategies Used

• Did you try to resist? □ Yes □ No
• Coping methods attempted: _________________________

Consequences

• Physical effects: _________________________________
• Emotional effects: ________________________________
• Impact on daily activities: _________________________

Recovery Goals

• Today's achievements: ____________________________
• Challenges faced: ________________________________
• Support needed: _________________________________

Support Network Contact

• Contacted sponsor/counselor today? □ Yes □ No
• Attended support group? □ Yes □ No

Weekly Summary

Total substance-free days this week: ___/7 Most challenging triggers: _________________________ Most effective coping strategies: ____________________

Bring this log to your next counseling session