| ENTRY SPECIFICATION |
{"name": "ASSIST-WHOV3",
{"id": "q3934", "type": "ChoiceQuestion", "required": false, "inline": true,
{"id": "q3961", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "1j. Other",
"intro": "Question 1: In your life, which of the following substances have you ever used?
(Do not count medication taken as prescribed, but do record it here if taken
more often, or at higher doses, than prescribed.) ",
"columns": 3,
"choices":[
{"id": "c237", "text": "0. No", "quickKey": 0},
{"id": "c241", "text": "1. Yes", "quickKey": 1}
]},
"text": "1a. Tobacco products (cigarettes, chewing tobacco, cigars, etc.)",
{"id": "q3964", "type": "StringQuestion", "required": false, "inline": true,
"text": " Specify:",
"intro": "Question 1: In your life, which of the following substances have you ever used?
(Do not count medication taken as prescribed, but do record it here if taken
more often, or at higher doses, than prescribed.) ",
"controlWidth": 365, "min": 0, "max": 0},
{"id": "i514", "type": "IntroText",
"text": "Question 2: In the past three months, how often have you used the substances you
mentioned (FIRST DRUG, SECOND DRUG, ETC)? "
},
"intro": "Question 1: In your life, which of the following substances have you ever used?
{"id": "q3965", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "2a. Tobacco products (cigarettes, chewing tobacco, cigars, etc.)",
"intro": "Question 2: In the past three months, how often have you used the substances you
mentioned (FIRST DRUG, SECOND DRUG, ETC)? ",
"columns": 2,
"choices":[
{"id": "c2391", "text": "0. Never: not used in the last 3 months", "quickKey": 0},
{"id": "c2392", "text": "1. Once or twice: 1 to 2 times in the last 3 months.", "quickKey": 1},
{"id": "c2393", "text": "2. Monthly: 1 to 3 times in one month.", "quickKey": 2},
{"id": "c2394", "text": "3. Weekly: 1 to 4 times per week.", "quickKey": 3},
(Do not count medication taken as prescribed, but do record it here if taken
{"id": "c2395", "text": "4. Daily or almost daily: 5 to 7 days per week.", "quickKey": 4}
]},
{"id": "q3969", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "2b. Alcoholic beverages (beer, wine, spirits, etc.)",
"intro": "Question 2: In the past three months, how often have you used the substances you
mentioned (FIRST DRUG, SECOND DRUG, ETC)? ",
"columns": 2,
"choices":[
{"id": "c2391", "text": "0. Never: not used in the last 3 months", "quickKey": 0},
{"id": "c2392", "text": "1. Once or twice: 1 to 2 times in the last 3 months.", "quickKey": 1},
more often, or at higher doses, than prescribed.) ",
{"id": "c2393", "text": "2. Monthly: 1 to 3 times in one month.", "quickKey": 2},
{"id": "c2394", "text": "3. Weekly: 1 to 4 times per week.", "quickKey": 3},
{"id": "c2395", "text": "4. Daily or almost daily: 5 to 7 days per week.", "quickKey": 4}
]},
{"id": "q3970", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "2c. Cannabis (marijuana, pot, grass, hash, etc.)",
"intro": "Question 2: In the past three months, how often have you used the substances you
mentioned (FIRST DRUG, SECOND DRUG, ETC)? ",
"columns": 2,
"choices":[
"columns": 3,
{"id": "c2391", "text": "0. Never: not used in the last 3 months", "quickKey": 0},
{"id": "c2392", "text": "1. Once or twice: 1 to 2 times in the last 3 months.", "quickKey": 1},
{"id": "c2393", "text": "2. Monthly: 1 to 3 times in one month.", "quickKey": 2},
{"id": "c2394", "text": "3. Weekly: 1 to 4 times per week.", "quickKey": 3},
{"id": "c2395", "text": "4. Daily or almost daily: 5 to 7 days per week.", "quickKey": 4}
]},
{"id": "q3971", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "2d. Cocaine (coke, crack, etc.)",
"intro": "Question 2: In the past three months, how often have you used the substances you
mentioned (FIRST DRUG, SECOND DRUG, ETC)? ",
"choices":[
"columns": 2,
"choices":[
{"id": "c2391", "text": "0. Never: not used in the last 3 months", "quickKey": 0},
{"id": "c2392", "text": "1. Once or twice: 1 to 2 times in the last 3 months.", "quickKey": 1},
{"id": "c2393", "text": "2. Monthly: 1 to 3 times in one month.", "quickKey": 2},
{"id": "c2394", "text": "3. Weekly: 1 to 4 times per week.", "quickKey": 3},
{"id": "c2395", "text": "4. Daily or almost daily: 5 to 7 days per week.", "quickKey": 4}
]},
{"id": "q3988", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "2e. Amphetamine type stimulants (speed, diet pills, ecstasy, etc.)",
{"id": "c237", "text": "0. No", "quickKey": 0},
"intro": "Question 2: In the past three months, how often have you used the substances you
mentioned (FIRST DRUG, SECOND DRUG, ETC)? ",
"columns": 2,
"choices":[
{"id": "c2391", "text": "0. Never: not used in the last 3 months", "quickKey": 0},
{"id": "c2392", "text": "1. Once or twice: 1 to 2 times in the last 3 months.", "quickKey": 1},
{"id": "c2393", "text": "2. Monthly: 1 to 3 times in one month.", "quickKey": 2},
{"id": "c2394", "text": "3. Weekly: 1 to 4 times per week.", "quickKey": 3},
{"id": "c2395", "text": "4. Daily or almost daily: 5 to 7 days per week.", "quickKey": 4}
]},
{"id": "c241", "text": "1. Yes", "quickKey": 1}
{"id": "q3990", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "2f. Inhalants (nitrous, glue, petrol, paint thinner, etc.)",
"intro": "Question 2: In the past three months, how often have you used the substances you
mentioned (FIRST DRUG, SECOND DRUG, ETC)? ",
"columns": 2,
"choices":[
{"id": "c2391", "text": "0. Never: not used in the last 3 months", "quickKey": 0},
{"id": "c2392", "text": "1. Once or twice: 1 to 2 times in the last 3 months.", "quickKey": 1},
{"id": "c2393", "text": "2. Monthly: 1 to 3 times in one month.", "quickKey": 2},
{"id": "c2394", "text": "3. Weekly: 1 to 4 times per week.", "quickKey": 3},
]},
{"id": "c2395", "text": "4. Daily or almost daily: 5 to 7 days per week.", "quickKey": 4}
]},
{"id": "q3991", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "2g. Sedatives or Sleeping Pills (Valium, Serepax, Rohypnol, etc.)",
"intro": "Question 2: In the past three months, how often have you used the substances you
mentioned (FIRST DRUG, SECOND DRUG, ETC)? ",
"columns": 2,
"choices":[
{"id": "c2391", "text": "0. Never: not used in the last 3 months", "quickKey": 0},
{"id": "c2392", "text": "1. Once or twice: 1 to 2 times in the last 3 months.", "quickKey": 1},
"restartDays": 2,
{"id": "q3935", "type": "ChoiceQuestion", "required": false, "inline": true,
{"id": "c2393", "text": "2. Monthly: 1 to 3 times in one month.", "quickKey": 2},
{"id": "c2394", "text": "3. Weekly: 1 to 4 times per week.", "quickKey": 3},
{"id": "c2395", "text": "4. Daily or almost daily: 5 to 7 days per week.", "quickKey": 4}
]},
{"id": "q3992", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "2h. Hallucinogens (LSD, acid, mushrooms, PCP, Special K, etc.)",
"intro": "Question 2: In the past three months, how often have you used the substances you
mentioned (FIRST DRUG, SECOND DRUG, ETC)? ",
"columns": 2,
"choices":[
"text": "1b. Alcoholic beverages (beer, wine, spirits, etc.)",
{"id": "c2391", "text": "0. Never: not used in the last 3 months", "quickKey": 0},
{"id": "c2392", "text": "1. Once or twice: 1 to 2 times in the last 3 months.", "quickKey": 1},
{"id": "c2393", "text": "2. Monthly: 1 to 3 times in one month.", "quickKey": 2},
{"id": "c2394", "text": "3. Weekly: 1 to 4 times per week.", "quickKey": 3},
{"id": "c2395", "text": "4. Daily or almost daily: 5 to 7 days per week.", "quickKey": 4}
]},
{"id": "q3993", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "2i. Opioids (heroin, morphine, methadone, codeine, etc.)",
"intro": "Question 2: In the past three months, how often have you used the substances you
mentioned (FIRST DRUG, SECOND DRUG, ETC)? ",
"intro": "Question 1: In your life, which of the following substances have you ever used?
"columns": 2,
"choices":[
{"id": "c2391", "text": "0. Never: not used in the last 3 months", "quickKey": 0},
{"id": "c2392", "text": "1. Once or twice: 1 to 2 times in the last 3 months.", "quickKey": 1},
{"id": "c2393", "text": "2. Monthly: 1 to 3 times in one month.", "quickKey": 2},
{"id": "c2394", "text": "3. Weekly: 1 to 4 times per week.", "quickKey": 3},
{"id": "c2395", "text": "4. Daily or almost daily: 5 to 7 days per week.", "quickKey": 4}
]},
{"id": "q3994", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "2j. Other (as specified previously)",
(Do not count medication taken as prescribed, but do record it here if taken
"intro": "Question 2: In the past three months, how often have you used the substances you
mentioned (FIRST DRUG, SECOND DRUG, ETC)? ",
"columns": 2,
"choices":[
{"id": "c2391", "text": "0. Never: not used in the last 3 months", "quickKey": 0},
{"id": "c2392", "text": "1. Once or twice: 1 to 2 times in the last 3 months.", "quickKey": 1},
{"id": "c2393", "text": "2. Monthly: 1 to 3 times in one month.", "quickKey": 2},
{"id": "c2394", "text": "3. Weekly: 1 to 4 times per week.", "quickKey": 3},
{"id": "c2395", "text": "4. Daily or almost daily: 5 to 7 days per week.", "quickKey": 4}
]},
more often, or at higher doses, than prescribed.) ",
{"id": "i515", "type": "IntroText",
"text": "Question 3: During the past three months, how often have you had a strong desire
or urge to use (FIRST DRUG, SECOND DRUG, ETC)? "
},
{"id": "q3995", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "3a. Tobacco products (cigarettes, chewing tobacco, cigars, etc.)",
"intro": "Question 3: During the past three months, how often have you had a strong desire
or urge to use (FIRST DRUG, SECOND DRUG, ETC)? ",
"columns": 2,
"choices":[
"columns": 3,
{"id": "c217", "text": "0. Never", "quickKey": 0},
{"id": "c2392", "text": "1. Once or twice: 1 to 2 times in the last 3 months.", "quickKey": 1},
{"id": "c2393", "text": "2. Monthly: 1 to 3 times in one month.", "quickKey": 2},
{"id": "c2394", "text": "3. Weekly: 1 to 4 times per week.", "quickKey": 3},
{"id": "c2395", "text": "4. Daily or almost daily: 5 to 7 days per week.", "quickKey": 4}
]},
{"id": "q3996", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "3b. Alcoholic beverages (beer, wine, spirits, etc.)",
"intro": "Question 3: During the past three months, how often have you had a strong desire
or urge to use (FIRST DRUG, SECOND DRUG, ETC)? ",
"choices":[
"columns": 2,
"choices":[
{"id": "c217", "text": "0. Never", "quickKey": 0},
{"id": "c2392", "text": "1. Once or twice: 1 to 2 times in the last 3 months.", "quickKey": 1},
{"id": "c2393", "text": "2. Monthly: 1 to 3 times in one month.", "quickKey": 2},
{"id": "c2394", "text": "3. Weekly: 1 to 4 times per week.", "quickKey": 3},
{"id": "c2395", "text": "4. Daily or almost daily: 5 to 7 days per week.", "quickKey": 4}
]},
{"id": "q3997", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "3c. Cannabis (marijuana, pot, grass, hash, etc.)",
{"id": "c237", "text": "0. No", "quickKey": 0},
"intro": "Question 3: During the past three months, how often have you had a strong desire
or urge to use (FIRST DRUG, SECOND DRUG, ETC)? ",
"columns": 2,
"choices":[
{"id": "c217", "text": "0. Never", "quickKey": 0},
{"id": "c2392", "text": "1. Once or twice: 1 to 2 times in the last 3 months.", "quickKey": 1},
{"id": "c2393", "text": "2. Monthly: 1 to 3 times in one month.", "quickKey": 2},
{"id": "c2394", "text": "3. Weekly: 1 to 4 times per week.", "quickKey": 3},
{"id": "c2395", "text": "4. Daily or almost daily: 5 to 7 days per week.", "quickKey": 4}
]},
{"id": "c241", "text": "1. Yes", "quickKey": 1}
{"id": "q3998", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "3d. Cocaine (coke, crack, etc.)",
"intro": "Question 3: During the past three months, how often have you had a strong desire
or urge to use (FIRST DRUG, SECOND DRUG, ETC)? ",
"columns": 2,
"choices":[
{"id": "c217", "text": "0. Never", "quickKey": 0},
{"id": "c2392", "text": "1. Once or twice: 1 to 2 times in the last 3 months.", "quickKey": 1},
{"id": "c2393", "text": "2. Monthly: 1 to 3 times in one month.", "quickKey": 2},
{"id": "c2394", "text": "3. Weekly: 1 to 4 times per week.", "quickKey": 3},
]},
{"id": "c2395", "text": "4. Daily or almost daily: 5 to 7 days per week.", "quickKey": 4}
]},
{"id": "q3999", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "3e. Amphetamine type stimulants (speed, diet pills, ecstasy, etc.)",
"intro": "Question 3: During the past three months, how often have you had a strong desire
or urge to use (FIRST DRUG, SECOND DRUG, ETC)? ",
"columns": 2,
"choices":[
{"id": "c217", "text": "0. Never", "quickKey": 0},
{"id": "c2392", "text": "1. Once or twice: 1 to 2 times in the last 3 months.", "quickKey": 1},
"printTitle": "The Alcohol, Smoking and Substance Involvement Screening Test",
{"id": "q3936", "type": "ChoiceQuestion", "required": false, "inline": true,
{"id": "c2393", "text": "2. Monthly: 1 to 3 times in one month.", "quickKey": 2},
{"id": "c2394", "text": "3. Weekly: 1 to 4 times per week.", "quickKey": 3},
{"id": "c2395", "text": "4. Daily or almost daily: 5 to 7 days per week.", "quickKey": 4}
]},
{"id": "q4000", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "3f. Inhalants (nitrous, glue, petrol, paint thinner, etc.)",
"intro": "Question 3: During the past three months, how often have you had a strong desire
or urge to use (FIRST DRUG, SECOND DRUG, ETC)? ",
"columns": 2,
"choices":[
"text": "1c. Cannabis (marijuana, pot, grass, hash, etc.)",
{"id": "c217", "text": "0. Never", "quickKey": 0},
{"id": "c2392", "text": "1. Once or twice: 1 to 2 times in the last 3 months.", "quickKey": 1},
{"id": "c2393", "text": "2. Monthly: 1 to 3 times in one month.", "quickKey": 2},
{"id": "c2394", "text": "3. Weekly: 1 to 4 times per week.", "quickKey": 3},
{"id": "c2395", "text": "4. Daily or almost daily: 5 to 7 days per week.", "quickKey": 4}
]},
{"id": "q4001", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "3g. Sedatives or Sleeping Pills (Valium, Serepax, Rohypnol, etc.)",
"intro": "Question 3: During the past three months, how often have you had a strong desire
or urge to use (FIRST DRUG, SECOND DRUG, ETC)? ",
"intro": "Question 1: In your life, which of the following substances have you ever used?
"columns": 2,
"choices":[
{"id": "c217", "text": "0. Never", "quickKey": 0},
{"id": "c2392", "text": "1. Once or twice: 1 to 2 times in the last 3 months.", "quickKey": 1},
{"id": "c2393", "text": "2. Monthly: 1 to 3 times in one month.", "quickKey": 2},
{"id": "c2394", "text": "3. Weekly: 1 to 4 times per week.", "quickKey": 3},
{"id": "c2395", "text": "4. Daily or almost daily: 5 to 7 days per week.", "quickKey": 4}
]},
{"id": "q4002", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "3h. Hallucinogens (LSD, acid, mushrooms, PCP, Special K, etc.)",
(Do not count medication taken as prescribed, but do record it here if taken
"intro": "Question 3: During the past three months, how often have you had a strong desire
or urge to use (FIRST DRUG, SECOND DRUG, ETC)? ",
"columns": 2,
"choices":[
{"id": "c217", "text": "0. Never", "quickKey": 0},
{"id": "c2392", "text": "1. Once or twice: 1 to 2 times in the last 3 months.", "quickKey": 1},
{"id": "c2393", "text": "2. Monthly: 1 to 3 times in one month.", "quickKey": 2},
{"id": "c2394", "text": "3. Weekly: 1 to 4 times per week.", "quickKey": 3},
{"id": "c2395", "text": "4. Daily or almost daily: 5 to 7 days per week.", "quickKey": 4}
]},
more often, or at higher doses, than prescribed.) ",
{"id": "q4003", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "3i. Opioids (heroin, morphine, methadone, codeine, etc.)",
"intro": "Question 3: During the past three months, how often have you had a strong desire
or urge to use (FIRST DRUG, SECOND DRUG, ETC)? ",
"columns": 2,
"choices":[
{"id": "c217", "text": "0. Never", "quickKey": 0},
{"id": "c2392", "text": "1. Once or twice: 1 to 2 times in the last 3 months.", "quickKey": 1},
{"id": "c2393", "text": "2. Monthly: 1 to 3 times in one month.", "quickKey": 2},
{"id": "c2394", "text": "3. Weekly: 1 to 4 times per week.", "quickKey": 3},
"columns": 3,
{"id": "c2395", "text": "4. Daily or almost daily: 5 to 7 days per week.", "quickKey": 4}
]},
{"id": "q4007", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "3j. Other (as specified previously)",
"intro": "Question 3: During the past three months, how often have you had a strong desire
or urge to use (FIRST DRUG, SECOND DRUG, ETC)? ",
"columns": 2,
"choices":[
{"id": "c217", "text": "0. Never", "quickKey": 0},
{"id": "c2392", "text": "1. Once or twice: 1 to 2 times in the last 3 months.", "quickKey": 1},
"choices":[
{"id": "c2393", "text": "2. Monthly: 1 to 3 times in one month.", "quickKey": 2},
{"id": "c2394", "text": "3. Weekly: 1 to 4 times per week.", "quickKey": 3},
{"id": "c2395", "text": "4. Daily or almost daily: 5 to 7 days per week.", "quickKey": 4}
]},
{"id": "i516", "type": "IntroText",
"text": "Question 4: During the past three months, how often has your use of (FIRST DRUG,
SECOND DRUG, ETC) led to health, social, legal or financial problems? "
},
{"id": "q4008", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "4a. Tobacco products (cigarettes, chewing tobacco, cigars, etc.)",
{"id": "c237", "text": "0. No", "quickKey": 0},
"intro": "Question 4: During the past three months, how often has your use of (FIRST DRUG,
SECOND DRUG, ETC) led to health, social, legal or financial problems? ",
"columns": 2,
"choices":[
{"id": "c217", "text": "0. Never", "quickKey": 0},
{"id": "c2392", "text": "1. Once or twice: 1 to 2 times in the last 3 months.", "quickKey": 1},
{"id": "c2393", "text": "2. Monthly: 1 to 3 times in one month.", "quickKey": 2},
{"id": "c2394", "text": "3. Weekly: 1 to 4 times per week.", "quickKey": 3},
{"id": "c2395", "text": "4. Daily or almost daily: 5 to 7 days per week.", "quickKey": 4}
]},
{"id": "c241", "text": "1. Yes", "quickKey": 1}
{"id": "q4009", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "4b. Alcoholic beverages (beer, wine, spirits, etc.)",
"intro": "Question 4: During the past three months, how often has your use of (FIRST DRUG,
SECOND DRUG, ETC) led to health, social, legal or financial problems? ",
"columns": 2,
"choices":[
{"id": "c217", "text": "0. Never", "quickKey": 0},
{"id": "c2392", "text": "1. Once or twice: 1 to 2 times in the last 3 months.", "quickKey": 1},
{"id": "c2393", "text": "2. Monthly: 1 to 3 times in one month.", "quickKey": 2},
{"id": "c2394", "text": "3. Weekly: 1 to 4 times per week.", "quickKey": 3},
]},
{"id": "c2395", "text": "4. Daily or almost daily: 5 to 7 days per week.", "quickKey": 4}
]},
{"id": "q4010", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "4c. Cannabis (marijuana, pot, grass, hash, etc.)",
"intro": "Question 4: During the past three months, how often has your use of (FIRST DRUG,
SECOND DRUG, ETC) led to health, social, legal or financial problems? ",
"columns": 2,
"choices":[
{"id": "c217", "text": "0. Never", "quickKey": 0},
{"id": "c2392", "text": "1. Once or twice: 1 to 2 times in the last 3 months.", "quickKey": 1},
"content":[
{"id": "q3937", "type": "ChoiceQuestion", "required": false, "inline": true,
{"id": "c2393", "text": "2. Monthly: 1 to 3 times in one month.", "quickKey": 2},
{"id": "c2394", "text": "3. Weekly: 1 to 4 times per week.", "quickKey": 3},
{"id": "c2395", "text": "4. Daily or almost daily: 5 to 7 days per week.", "quickKey": 4}
]},
{"id": "q4011", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "4d. Cocaine (coke, crack, etc.)",
"intro": "Question 4: During the past three months, how often has your use of (FIRST DRUG,
SECOND DRUG, ETC) led to health, social, legal or financial problems? ",
"columns": 2,
"choices":[
"text": "1d. Cocaine (coke, crack, etc.)",
{"id": "c217", "text": "0. Never", "quickKey": 0},
{"id": "c2392", "text": "1. Once or twice: 1 to 2 times in the last 3 months.", "quickKey": 1},
{"id": "c2393", "text": "2. Monthly: 1 to 3 times in one month.", "quickKey": 2},
{"id": "c2394", "text": "3. Weekly: 1 to 4 times per week.", "quickKey": 3},
{"id": "c2395", "text": "4. Daily or almost daily: 5 to 7 days per week.", "quickKey": 4}
]},
{"id": "q4012", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "4e. Amphetamine type stimulants (speed, diet pills, ecstasy, etc.)",
"intro": "Question 4: During the past three months, how often has your use of (FIRST DRUG,
SECOND DRUG, ETC) led to health, social, legal or financial problems? ",
"intro": "Question 1: In your life, which of the following substances have you ever used?
"columns": 2,
"choices":[
{"id": "c217", "text": "0. Never", "quickKey": 0},
{"id": "c2392", "text": "1. Once or twice: 1 to 2 times in the last 3 months.", "quickKey": 1},
{"id": "c2393", "text": "2. Monthly: 1 to 3 times in one month.", "quickKey": 2},
{"id": "c2394", "text": "3. Weekly: 1 to 4 times per week.", "quickKey": 3},
{"id": "c2395", "text": "4. Daily or almost daily: 5 to 7 days per week.", "quickKey": 4}
]},
{"id": "q4013", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "4f. Inhalants (nitrous, glue, petrol, paint thinner, etc.)",
(Do not count medication taken as prescribed, but do record it here if taken
"intro": "Question 4: During the past three months, how often has your use of (FIRST DRUG,
SECOND DRUG, ETC) led to health, social, legal or financial problems? ",
"columns": 2,
"choices":[
{"id": "c217", "text": "0. Never", "quickKey": 0},
{"id": "c2392", "text": "1. Once or twice: 1 to 2 times in the last 3 months.", "quickKey": 1},
{"id": "c2393", "text": "2. Monthly: 1 to 3 times in one month.", "quickKey": 2},
{"id": "c2394", "text": "3. Weekly: 1 to 4 times per week.", "quickKey": 3},
{"id": "c2395", "text": "4. Daily or almost daily: 5 to 7 days per week.", "quickKey": 4}
]},
more often, or at higher doses, than prescribed.) ",
{"id": "q4014", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "4g. Sedatives or Sleeping Pills (Valium, Serepax, Rohypnol, etc.)",
"intro": "Question 4: During the past three months, how often has your use of (FIRST DRUG,
SECOND DRUG, ETC) led to health, social, legal or financial problems? ",
"columns": 2,
"choices":[
{"id": "c217", "text": "0. Never", "quickKey": 0},
{"id": "c2392", "text": "1. Once or twice: 1 to 2 times in the last 3 months.", "quickKey": 1},
{"id": "c2393", "text": "2. Monthly: 1 to 3 times in one month.", "quickKey": 2},
{"id": "c2394", "text": "3. Weekly: 1 to 4 times per week.", "quickKey": 3},
"columns": 3,
{"id": "c2395", "text": "4. Daily or almost daily: 5 to 7 days per week.", "quickKey": 4}
]},
{"id": "q4017", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "4h. Hallucinogens (LSD, acid, mushrooms, PCP, Special K, etc.)",
"intro": "Question 4: During the past three months, how often has your use of (FIRST DRUG,
SECOND DRUG, ETC) led to health, social, legal or financial problems? ",
"columns": 2,
"choices":[
{"id": "c217", "text": "0. Never", "quickKey": 0},
{"id": "c2392", "text": "1. Once or twice: 1 to 2 times in the last 3 months.", "quickKey": 1},
"choices":[
{"id": "c2393", "text": "2. Monthly: 1 to 3 times in one month.", "quickKey": 2},
{"id": "c2394", "text": "3. Weekly: 1 to 4 times per week.", "quickKey": 3},
{"id": "c2395", "text": "4. Daily or almost daily: 5 to 7 days per week.", "quickKey": 4}
]},
{"id": "q4018", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "4i. Opioids (heroin, morphine, methadone, codeine, etc.)",
"intro": "Question 4: During the past three months, how often has your use of (FIRST DRUG,
SECOND DRUG, ETC) led to health, social, legal or financial problems? ",
"columns": 2,
"choices":[
{"id": "c237", "text": "0. No", "quickKey": 0},
{"id": "c217", "text": "0. Never", "quickKey": 0},
{"id": "c2392", "text": "1. Once or twice: 1 to 2 times in the last 3 months.", "quickKey": 1},
{"id": "c2393", "text": "2. Monthly: 1 to 3 times in one month.", "quickKey": 2},
{"id": "c2394", "text": "3. Weekly: 1 to 4 times per week.", "quickKey": 3},
{"id": "c2395", "text": "4. Daily or almost daily: 5 to 7 days per week.", "quickKey": 4}
]},
{"id": "q4020", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "4j. Other (as specified previously)",
"intro": "Question 4: During the past three months, how often has your use of (FIRST DRUG,
SECOND DRUG, ETC) led to health, social, legal or financial problems? ",
{"id": "c241", "text": "1. Yes", "quickKey": 1}
"columns": 2,
"choices":[
{"id": "c217", "text": "0. Never", "quickKey": 0},
{"id": "c2392", "text": "1. Once or twice: 1 to 2 times in the last 3 months.", "quickKey": 1},
{"id": "c2393", "text": "2. Monthly: 1 to 3 times in one month.", "quickKey": 2},
{"id": "c2394", "text": "3. Weekly: 1 to 4 times per week.", "quickKey": 3},
{"id": "c2395", "text": "4. Daily or almost daily: 5 to 7 days per week.", "quickKey": 4}
]},
{"id": "i517", "type": "IntroText",
"text": "Question 5: During the past three months, how often have you failed to do what
]},
was normally expected of you because of your use of (FIRST DRUG, SECOND DRUG,
ETC)? "
},
{"id": "q4021", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "5a. Tobacco products",
"intro": "Question 5: During the past three months, how often have you failed to do what
was normally expected of you because of your use of (FIRST DRUG, SECOND DRUG,
ETC)? ",
"columns": 2,
"choices":[
{"id": "i513", "type": "IntroText",
{"id": "q3945", "type": "ChoiceQuestion", "required": false, "inline": true,
{"id": "c217", "text": "0. Never", "quickKey": 0},
{"id": "c2392", "text": "1. Once or twice: 1 to 2 times in the last 3 months.", "quickKey": 1},
{"id": "c2393", "text": "2. Monthly: 1 to 3 times in one month.", "quickKey": 2},
{"id": "c2394", "text": "3. Weekly: 1 to 4 times per week.", "quickKey": 3},
{"id": "c2395", "text": "4. Daily or almost daily: 5 to 7 days per week.", "quickKey": 4}
]},
{"id": "q4023", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "5b. Alcoholic beverages (beer, wine, spirits, etc.)",
"intro": "Question 5: During the past three months, how often have you failed to do what
was normally expected of you because of your use of (FIRST DRUG, SECOND DRUG,
"text": "1e. Amphetamine type stimulants (speed, diet pills, ecstasy, etc.)",
ETC)? ",
"columns": 2,
"choices":[
{"id": "c217", "text": "0. Never", "quickKey": 0},
{"id": "c2392", "text": "1. Once or twice: 1 to 2 times in the last 3 months.", "quickKey": 1},
{"id": "c2393", "text": "2. Monthly: 1 to 3 times in one month.", "quickKey": 2},
{"id": "c2394", "text": "3. Weekly: 1 to 4 times per week.", "quickKey": 3},
{"id": "c2395", "text": "4. Daily or almost daily: 5 to 7 days per week.", "quickKey": 4}
]},
{"id": "q4024", "type": "ChoiceQuestion", "required": false, "inline": true,
"intro": "Question 1: In your life, which of the following substances have you ever used?
"text": "5c. Cannabis (marijuana, pot, grass, hash, etc.)",
"intro": "Question 5: During the past three months, how often have you failed to do what
was normally expected of you because of your use of (FIRST DRUG, SECOND DRUG,
ETC)? ",
"columns": 2,
"choices":[
{"id": "c217", "text": "0. Never", "quickKey": 0},
{"id": "c2392", "text": "1. Once or twice: 1 to 2 times in the last 3 months.", "quickKey": 1},
{"id": "c2393", "text": "2. Monthly: 1 to 3 times in one month.", "quickKey": 2},
{"id": "c2394", "text": "3. Weekly: 1 to 4 times per week.", "quickKey": 3},
(Do not count medication taken as prescribed, but do record it here if taken
{"id": "c2395", "text": "4. Daily or almost daily: 5 to 7 days per week.", "quickKey": 4}
]},
{"id": "q4025", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "5d. Cocaine (coke, crack, etc.)",
"intro": "Question 5: During the past three months, how often have you failed to do what
was normally expected of you because of your use of (FIRST DRUG, SECOND DRUG,
ETC)? ",
"columns": 2,
"choices":[
{"id": "c217", "text": "0. Never", "quickKey": 0},
more often, or at higher doses, than prescribed.) ",
{"id": "c2392", "text": "1. Once or twice: 1 to 2 times in the last 3 months.", "quickKey": 1},
{"id": "c2393", "text": "2. Monthly: 1 to 3 times in one month.", "quickKey": 2},
{"id": "c2394", "text": "3. Weekly: 1 to 4 times per week.", "quickKey": 3},
{"id": "c2395", "text": "4. Daily or almost daily: 5 to 7 days per week.", "quickKey": 4}
]},
{"id": "q4026", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "5e. Amphetamine type stimulants (speed, diet pills, ecstasy, etc.)",
"intro": "Question 5: During the past three months, how often have you failed to do what
was normally expected of you because of your use of (FIRST DRUG, SECOND DRUG,
ETC)? ",
"columns": 3,
"columns": 2,
"choices":[
{"id": "c217", "text": "0. Never", "quickKey": 0},
{"id": "c2392", "text": "1. Once or twice: 1 to 2 times in the last 3 months.", "quickKey": 1},
{"id": "c2393", "text": "2. Monthly: 1 to 3 times in one month.", "quickKey": 2},
{"id": "c2394", "text": "3. Weekly: 1 to 4 times per week.", "quickKey": 3},
{"id": "c2395", "text": "4. Daily or almost daily: 5 to 7 days per week.", "quickKey": 4}
]},
{"id": "q4027", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "5f. Inhalants (nitrous, glue, petrol, paint thinner, etc.)",
"choices":[
"intro": "Question 5: During the past three months, how often have you failed to do what
was normally expected of you because of your use of (FIRST DRUG, SECOND DRUG,
ETC)? ",
"columns": 2,
"choices":[
{"id": "c217", "text": "0. Never", "quickKey": 0},
{"id": "c2392", "text": "1. Once or twice: 1 to 2 times in the last 3 months.", "quickKey": 1},
{"id": "c2393", "text": "2. Monthly: 1 to 3 times in one month.", "quickKey": 2},
{"id": "c2394", "text": "3. Weekly: 1 to 4 times per week.", "quickKey": 3},
{"id": "c2395", "text": "4. Daily or almost daily: 5 to 7 days per week.", "quickKey": 4}
{"id": "c237", "text": "0. No", "quickKey": 0},
]},
{"id": "q4028", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "5g. Sedatives or Sleeping Pills (Valium, Serepax, Rohypnol, etc.)",
"intro": "Question 5: During the past three months, how often have you failed to do what
was normally expected of you because of your use of (FIRST DRUG, SECOND DRUG,
ETC)? ",
"columns": 2,
"choices":[
{"id": "c217", "text": "0. Never", "quickKey": 0},
{"id": "c2392", "text": "1. Once or twice: 1 to 2 times in the last 3 months.", "quickKey": 1},
{"id": "c241", "text": "1. Yes", "quickKey": 1}
{"id": "c2393", "text": "2. Monthly: 1 to 3 times in one month.", "quickKey": 2},
{"id": "c2394", "text": "3. Weekly: 1 to 4 times per week.", "quickKey": 3},
{"id": "c2395", "text": "4. Daily or almost daily: 5 to 7 days per week.", "quickKey": 4}
]},
{"id": "q4029", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "5h. Hallucinogens (LSD, acid, mushrooms, PCP, Special K, etc.)",
"intro": "Question 5: During the past three months, how often have you failed to do what
was normally expected of you because of your use of (FIRST DRUG, SECOND DRUG,
ETC)? ",
"columns": 2,
]},
"choices":[
{"id": "c217", "text": "0. Never", "quickKey": 0},
{"id": "c2392", "text": "1. Once or twice: 1 to 2 times in the last 3 months.", "quickKey": 1},
{"id": "c2393", "text": "2. Monthly: 1 to 3 times in one month.", "quickKey": 2},
{"id": "c2394", "text": "3. Weekly: 1 to 4 times per week.", "quickKey": 3},
{"id": "c2395", "text": "4. Daily or almost daily: 5 to 7 days per week.", "quickKey": 4}
]},
{"id": "q4030", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "5i. Opioids (heroin, morphine, methadone, codeine, etc.)",
"intro": "Question 5: During the past three months, how often have you failed to do what
"text": "Question 1: In your life, which of the following substances have you ever used?
{"id": "q3956", "type": "ChoiceQuestion", "required": false, "inline": true,
was normally expected of you because of your use of (FIRST DRUG, SECOND DRUG,
ETC)? ",
"columns": 2,
"choices":[
{"id": "c217", "text": "0. Never", "quickKey": 0},
{"id": "c2392", "text": "1. Once or twice: 1 to 2 times in the last 3 months.", "quickKey": 1},
{"id": "c2393", "text": "2. Monthly: 1 to 3 times in one month.", "quickKey": 2},
{"id": "c2394", "text": "3. Weekly: 1 to 4 times per week.", "quickKey": 3},
{"id": "c2395", "text": "4. Daily or almost daily: 5 to 7 days per week.", "quickKey": 4}
]},
"text": "1f. Inhalants (nitrous, glue, petrol, paint thinner, etc.)",
{"id": "q4031", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "5j. Other (as previous specified)",
"intro": "Question 5: During the past three months, how often have you failed to do what
was normally expected of you because of your use of (FIRST DRUG, SECOND DRUG,
ETC)? ",
"columns": 2,
"choices":[
{"id": "c217", "text": "0. Never", "quickKey": 0},
{"id": "c2392", "text": "1. Once or twice: 1 to 2 times in the last 3 months.", "quickKey": 1},
{"id": "c2393", "text": "2. Monthly: 1 to 3 times in one month.", "quickKey": 2},
"intro": "Question 1: In your life, which of the following substances have you ever used?
{"id": "c2394", "text": "3. Weekly: 1 to 4 times per week.", "quickKey": 3},
{"id": "c2395", "text": "4. Daily or almost daily: 5 to 7 days per week.", "quickKey": 4}
]},
{"id": "i518", "type": "IntroText",
"text": "Question 6: Has a friend or relative or anyone else EVER expressed concern about
your use of<br />(FIRST DRUG, SECOND DRUG, ETC.)? "
},
{"id": "q4032", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "6a. Tobacco products (cigarettes, chewing tobacco, cigars, etc.)",
"intro": "Question 6: Has a friend or relative or anyone else EVER expressed concern about
(Do not count medication taken as prescribed, but do record it here if taken
your use of<br />(FIRST DRUG, SECOND DRUG, ETC.)? ",
"columns": 2,
"choices":[
{"id": "c275", "text": "0. No, never", "quickKey": 0},
{"id": "c2396", "text": "1. Yes, in the past 3 months", "quickKey": 1},
{"id": "c2397", "text": "2. Yes, but not in the past 3 months", "quickKey": 2}
]},
{"id": "q4034", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "6b. Alcoholic beverages (beer, wine, spirits, etc.)",
"intro": "Question 6: Has a friend or relative or anyone else EVER expressed concern about
more often, or at higher doses, than prescribed.) ",
your use of<br />(FIRST DRUG, SECOND DRUG, ETC.)? ",
"columns": 2,
"choices":[
{"id": "c275", "text": "0. No, never", "quickKey": 0},
{"id": "c2396", "text": "1. Yes, in the past 3 months", "quickKey": 1},
{"id": "c2397", "text": "2. Yes, but not in the past 3 months", "quickKey": 2}
]},
{"id": "q4044", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "6c. Cannabis (marijuana, pot, grass, hash, etc.)",
"intro": "Question 6: Has a friend or relative or anyone else EVER expressed concern about
"columns": 3,
your use of<br />(FIRST DRUG, SECOND DRUG, ETC.)? ",
"columns": 2,
"choices":[
{"id": "c275", "text": "0. No, never", "quickKey": 0},
{"id": "c2396", "text": "1. Yes, in the past 3 months", "quickKey": 1},
{"id": "c2397", "text": "2. Yes, but not in the past 3 months", "quickKey": 2}
]},
{"id": "q4045", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "6d. Cocaine (coke, crack, etc.)",
"intro": "Question 6: Has a friend or relative or anyone else EVER expressed concern about
"choices":[
your use of<br />(FIRST DRUG, SECOND DRUG, ETC.)? ",
"columns": 2,
"choices":[
{"id": "c275", "text": "0. No, never", "quickKey": 0},
{"id": "c2396", "text": "1. Yes, in the past 3 months", "quickKey": 1},
{"id": "c2397", "text": "2. Yes, but not in the past 3 months", "quickKey": 2}
]},
{"id": "q4046", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "6e. Amphetamine type stimulants (speed, diet pills, ecstasy, etc.)",
"intro": "Question 6: Has a friend or relative or anyone else EVER expressed concern about
{"id": "c237", "text": "0. No", "quickKey": 0},
your use of<br />(FIRST DRUG, SECOND DRUG, ETC.)? ",
"columns": 2,
"choices":[
{"id": "c275", "text": "0. No, never", "quickKey": 0},
{"id": "c2396", "text": "1. Yes, in the past 3 months", "quickKey": 1},
{"id": "c2397", "text": "2. Yes, but not in the past 3 months", "quickKey": 2}
]},
{"id": "q4047", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "6f. Inhalants (nitrous, glue, petrol, paint thinner, etc.)",
"intro": "Question 6: Has a friend or relative or anyone else EVER expressed concern about
{"id": "c241", "text": "1. Yes", "quickKey": 1}
your use of<br />(FIRST DRUG, SECOND DRUG, ETC.)? ",
"columns": 2,
"choices":[
{"id": "c275", "text": "0. No, never", "quickKey": 0},
{"id": "c2396", "text": "1. Yes, in the past 3 months", "quickKey": 1},
{"id": "c2397", "text": "2. Yes, but not in the past 3 months", "quickKey": 2}
]},
{"id": "q4048", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "6g. Sedatives or Sleeping Pills (Valium, Serepax, Rohypnol, etc.)",
"intro": "Question 6: Has a friend or relative or anyone else EVER expressed concern about
]},
your use of<br />(FIRST DRUG, SECOND DRUG, ETC.)? ",
"columns": 2,
"choices":[
{"id": "c275", "text": "0. No, never", "quickKey": 0},
{"id": "c2396", "text": "1. Yes, in the past 3 months", "quickKey": 1},
{"id": "c2397", "text": "2. Yes, but not in the past 3 months", "quickKey": 2}
]},
{"id": "q4049", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "6h. Hallucinogens (LSD, acid, mushrooms, PCP, Special K, etc.)",
"intro": "Question 6: Has a friend or relative or anyone else EVER expressed concern about
(Do not count medication taken as prescribed, but do record it here if taken
{"id": "q3957", "type": "ChoiceQuestion", "required": false, "inline": true,
your use of<br />(FIRST DRUG, SECOND DRUG, ETC.)? ",
"columns": 2,
"choices":[
{"id": "c275", "text": "0. No, never", "quickKey": 0},
{"id": "c2396", "text": "1. Yes, in the past 3 months", "quickKey": 1},
{"id": "c2397", "text": "2. Yes, but not in the past 3 months", "quickKey": 2}
]},
{"id": "q4050", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "6i. Opioids (heroin, morphine, methadone, codeine, etc.)",
"intro": "Question 6: Has a friend or relative or anyone else EVER expressed concern about
"text": "1g. Sedatives or Sleeping Pills (Valium, Serepax, Rohypnol, etc.)",
your use of<br />(FIRST DRUG, SECOND DRUG, ETC.)? ",
"columns": 2,
"choices":[
{"id": "c275", "text": "0. No, never", "quickKey": 0},
{"id": "c2396", "text": "1. Yes, in the past 3 months", "quickKey": 1},
{"id": "c2397", "text": "2. Yes, but not in the past 3 months", "quickKey": 2}
]},
{"id": "q4051", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "6j. Other (as previously specified)",
"intro": "Question 6: Has a friend or relative or anyone else EVER expressed concern about
"intro": "Question 1: In your life, which of the following substances have you ever used?
your use of<br />(FIRST DRUG, SECOND DRUG, ETC.)? ",
"columns": 2,
"choices":[
{"id": "c275", "text": "0. No, never", "quickKey": 0},
{"id": "c2396", "text": "1. Yes, in the past 3 months", "quickKey": 1},
{"id": "c2397", "text": "2. Yes, but not in the past 3 months", "quickKey": 2}
]},
{"id": "i519", "type": "IntroText",
"text": "Question 7: Have you EVER tried and failed to control, cut down or stop using
(FIRST DRUG, SECOND DRUG, ETC.)? "
(Do not count medication taken as prescribed, but do record it here if taken
},
{"id": "q4052", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "7a. Tobacco products (cigarettes, chewing tobacco, cigars, etc.)",
"intro": "Question 7: Have you EVER tried and failed to control, cut down or stop using
(FIRST DRUG, SECOND DRUG, ETC.)? ",
"columns": 2,
"choices":[
{"id": "c275", "text": "0. No, never", "quickKey": 0},
{"id": "c2396", "text": "1. Yes, in the past 3 months", "quickKey": 1},
{"id": "c2397", "text": "2. Yes, but not in the past 3 months", "quickKey": 2}
more often, or at higher doses, than prescribed.) ",
]},
{"id": "q4053", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "7b. Alcoholic beverages (beer, wine, spirits, etc.)",
"intro": "Question 7: Have you EVER tried and failed to control, cut down or stop using
(FIRST DRUG, SECOND DRUG, ETC.)? ",
"columns": 2,
"choices":[
{"id": "c275", "text": "0. No, never", "quickKey": 0},
{"id": "c2396", "text": "1. Yes, in the past 3 months", "quickKey": 1},
{"id": "c2397", "text": "2. Yes, but not in the past 3 months", "quickKey": 2}
"columns": 3,
]},
{"id": "q4054", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "7c. Cannabis (marijuana, pot, grass, hash, etc.)",
"intro": "Question 7: Have you EVER tried and failed to control, cut down or stop using
(FIRST DRUG, SECOND DRUG, ETC.)? ",
"columns": 2,
"choices":[
{"id": "c275", "text": "0. No, never", "quickKey": 0},
{"id": "c2396", "text": "1. Yes, in the past 3 months", "quickKey": 1},
{"id": "c2397", "text": "2. Yes, but not in the past 3 months", "quickKey": 2}
"choices":[
]},
{"id": "q4055", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "7d. Cocaine (coke, crack, etc.)",
"intro": "Question 7: Have you EVER tried and failed to control, cut down or stop using
(FIRST DRUG, SECOND DRUG, ETC.)? ",
"columns": 2,
"choices":[
{"id": "c275", "text": "0. No, never", "quickKey": 0},
{"id": "c2396", "text": "1. Yes, in the past 3 months", "quickKey": 1},
{"id": "c2397", "text": "2. Yes, but not in the past 3 months", "quickKey": 2}
{"id": "c237", "text": "0. No", "quickKey": 0},
]},
{"id": "q4086", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "7e. Amphetamine type stimulants (speed, diet pills, ecstasy, etc.)",
"intro": "Question 7: Have you EVER tried and failed to control, cut down or stop using
(FIRST DRUG, SECOND DRUG, ETC.)? ",
"columns": 2,
"choices":[
{"id": "c275", "text": "0. No, never", "quickKey": 0},
{"id": "c2396", "text": "1. Yes, in the past 3 months", "quickKey": 1},
{"id": "c2397", "text": "2. Yes, but not in the past 3 months", "quickKey": 2}
{"id": "c241", "text": "1. Yes", "quickKey": 1}
]},
{"id": "q4087", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "7f. Inhalants (nitrous, glue, petrol, paint thinner, etc.)",
"intro": "Question 7: Have you EVER tried and failed to control, cut down or stop using
(FIRST DRUG, SECOND DRUG, ETC.)? ",
"columns": 2,
"choices":[
{"id": "c275", "text": "0. No, never", "quickKey": 0},
{"id": "c2396", "text": "1. Yes, in the past 3 months", "quickKey": 1},
{"id": "c2397", "text": "2. Yes, but not in the past 3 months", "quickKey": 2}
]},
]},
{"id": "q4088", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "7g. Sedatives or Sleeping Pills (Valium, Serepax, Rohypnol, etc.)",
"intro": "Question 7: Have you EVER tried and failed to control, cut down or stop using
(FIRST DRUG, SECOND DRUG, ETC.)? ",
"columns": 2,
"choices":[
{"id": "c275", "text": "0. No, never", "quickKey": 0},
{"id": "c2396", "text": "1. Yes, in the past 3 months", "quickKey": 1},
{"id": "c2397", "text": "2. Yes, but not in the past 3 months", "quickKey": 2}
more often, or at higher doses, than prescribed.) "
{"id": "q3958", "type": "ChoiceQuestion", "required": false, "inline": true,
]},
{"id": "q4089", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "7h. Hallucinogens (LSD, acid, mushrooms, PCP, Special K, etc.)",
"intro": "Question 7: Have you EVER tried and failed to control, cut down or stop using
(FIRST DRUG, SECOND DRUG, ETC.)? ",
"columns": 2,
"choices":[
{"id": "c275", "text": "0. No, never", "quickKey": 0},
{"id": "c2396", "text": "1. Yes, in the past 3 months", "quickKey": 1},
{"id": "c2397", "text": "2. Yes, but not in the past 3 months", "quickKey": 2}
"text": "1h. Hallucinogens (LSD, acid, mushrooms, PCP, Special K, etc.)",
]},
{"id": "q4090", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "7i. Opioids (heroin, morphine, methadone, codeine, etc.)",
"intro": "Question 7: Have you EVER tried and failed to control, cut down or stop using
(FIRST DRUG, SECOND DRUG, ETC.)? ",
"columns": 2,
"choices":[
{"id": "c275", "text": "0. No, never", "quickKey": 0},
{"id": "c2396", "text": "1. Yes, in the past 3 months", "quickKey": 1},
{"id": "c2397", "text": "2. Yes, but not in the past 3 months", "quickKey": 2}
"intro": "Question 1: In your life, which of the following substances have you ever used?
]},
{"id": "q4189", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "7j. Other (as previously specified)",
"intro": "Question 7: Have you EVER tried and failed to control, cut down or stop using
(FIRST DRUG, SECOND DRUG, ETC.)? ",
"columns": 2,
"choices":[
{"id": "c275", "text": "0. No, never", "quickKey": 0},
{"id": "c2396", "text": "1. Yes, in the past 3 months", "quickKey": 1},
{"id": "c2397", "text": "2. Yes, but not in the past 3 months", "quickKey": 2}
(Do not count medication taken as prescribed, but do record it here if taken
]},
{"id": "q4237", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "8. Have you EVER used any drug by injection? (Non-medical use only)",
"intro": "Question 7: Have you EVER tried and failed to control, cut down or stop using
(FIRST DRUG, SECOND DRUG, ETC.)? ",
"columns": 2,
"choices":[
{"id": "c275", "text": "0. No, never", "quickKey": 0},
{"id": "c2396", "text": "1. Yes, in the past 3 months", "quickKey": 1},
{"id": "c2397", "text": "2. Yes, but not in the past 3 months", "quickKey": 2}
more often, or at higher doses, than prescribed.) ",
]},
{"id": "q4254", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "8a. What is your pattern of injecting?",
"intro": "Question 7: Have you EVER tried and failed to control, cut down or stop using
(FIRST DRUG, SECOND DRUG, ETC.)? ",
"columns": 2,
"choices":[
{"id": "c2398", "text": "1. Once weekly or less", "quickKey": 1},
{"id": "c2399", "text": "2. Fewer than 3 days in a row", "quickKey": 2},
{"id": "c927", "text": "3. More than once a week", "quickKey": 3},
"columns": 3,
{"id": "c2400", "text": "4. Three or more days in a row", "quickKey": 4}
]}],
"rules":[
{"question": "q3934", "operator": "EQ", "value": "c237",
"skips":["q3965","q3995","q4008","q4021","q4032","q4052"]},
{"question": "q3935", "operator": "EQ", "value": "c237",
"skips":["q3969","q3996","q4009","q4023","q4034","q4053"]},
{"question": "q3936", "operator": "EQ", "value": "c237",
"skips":["q3970","q3997","q4010","q4024","q4044","q4054"]},
{"question": "q3937", "operator": "EQ", "value": "c237",
"choices":[
"skips":["q3971","q3998","q4011","q4025","q4045","q4055"]},
{"question": "q3945", "operator": "EQ", "value": "c237",
"skips":["q3988","q3999","q4012","q4026","q4046","q4086"]},
{"question": "q3956", "operator": "EQ", "value": "c237",
"skips":["q3990","q4000","q4013","q4027","q4047","q4087"]},
{"question": "q3957", "operator": "EQ", "value": "c237",
"skips":["q3991","q4001","q4014","q4028","q4048","q4088"]},
{"question": "q3958", "operator": "EQ", "value": "c237",
"skips":["q3992","q4002","q4017","q4029","q4049","q4089"]},
{"question": "q3960", "operator": "EQ", "value": "c237",
{"id": "c237", "text": "0. No", "quickKey": 0},
"skips":["q3993","q4003","q4018","q4030","q4050","q4090"]},
{"question": "q3961", "operator": "EQ", "value": "c237",
"skips":["q3964","q3994","q4007","q4020","q4031","q4051","q4189"]},
{"question": "q3965", "operator": "EQ", "value": "c2391",
"skips":["q3995","q4008","q4021"]},
{"question": "q3969", "operator": "EQ", "value": "c2391",
"skips":["q3996","q4009","q4023"]},
{"question": "q3970", "operator": "EQ", "value": "c2391",
"skips":["q3997","q4010","q4024"]},
{"question": "q3971", "operator": "EQ", "value": "c2391",
{"id": "c241", "text": "1. Yes", "quickKey": 1}
"skips":["q3998","q4011","q4025"]},
{"question": "q3988", "operator": "EQ", "value": "c2391",
"skips":["q3999","q4012","q4026"]},
{"question": "q3990", "operator": "EQ", "value": "c2391",
"skips":["q4000","q4013","q4027"]},
{"question": "q3991", "operator": "EQ", "value": "c2391",
"skips":["q4001","q4014","q4028"]},
{"question": "q3992", "operator": "EQ", "value": "c2391",
"skips":["q4002","q4017","q4029"]},
{"question": "q3993", "operator": "EQ", "value": "c2391",
]},
"skips":["q4003","q4018","q4030"]},
{"question": "q3994", "operator": "EQ", "value": "c2391",
"skips":["q4007","q4020","q4031"]},
{"question": "q4237", "operator": "EQ", "value": "c275",
"skips":["q4254"]}]
}
},
{"id": "q3960", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "1i. Opioids (heroin, morphine, methadone, codeine, etc.)",
"intro": "Question 1: In your life, which of the following substances have you ever used?
(Do not count medication taken as prescribed, but do record it here if taken
more often, or at higher doses, than prescribed.) ",
"columns": 3,
"choices":[
{"id": "c237", "text": "0. No", "quickKey": 0},
{"id": "c241", "text": "1. Yes", "quickKey": 1}
]},
|
