| ENTRY SPECIFICATION |
{"name": "BAM-R",
"columns": 3,
(Tylenol 2,3,4), Percocet, Vicodin, Fentanyl, etc.)?",
"intro": "7. In the past 30 days, how many days did you use any of the following drugs: ",
"controlWidth": 60, "min": 0, "max": 30},
{"id": "q6509", "type": "IntegerQuestion", "required": false,
"text": "7F. Inhalants (glues, adhesives, nail polish remover, paint thinner, etc.)?",
"intro": "7. In the past 30 days, how many days did you use any of the following drugs: ",
"controlWidth": 60, "min": 0, "max": 30},
{"id": "q6510", "type": "IntegerQuestion", "required": false,
"text": "7G. Other drugs (steroids, non-prescription sleep and diet pills, Benadryl,
Ephedra, other over-the-counter or unknown medications)?",
"choices":[
"intro": "7. In the past 30 days, how many days did you use any of the following drugs: ",
"controlWidth": 60, "min": 0, "max": 30},
{"id": "q6489", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "8. In the past 30 days, how much were you bothered by cravings or urges to drink
alcohol or use drugs?",
"intro": "7. In the past 30 days, how many days did you use any of the following drugs: ",
"columns": 2,
"choices":[
{"id": "c212", "text": "0. Not at all", "quickKey": 0},
{"id": "c717", "text": "1. Slightly", "quickKey": 1},
{"id": "c2418", "text": "1. Clinician Interview", "quickKey": 1},
{"id": "c685", "text": "2. Moderately", "quickKey": 2},
{"id": "c2312", "text": "3. Considerably", "quickKey": 3},
{"id": "c687", "text": "4. Extremely", "quickKey": 4}
]},
{"id": "q6490", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "9. How confident are you that you will NOT use alcohol and drugs in the next 30
days?",
"intro": "7. In the past 30 days, how many days did you use any of the following drugs: ",
"columns": 2,
"choices":[
{"id": "c2419", "text": "2. Self Report", "quickKey": 2},
{"id": "c212", "text": "0. Not at all", "quickKey": 0},
{"id": "c717", "text": "1. Slightly", "quickKey": 1},
{"id": "c685", "text": "2. Moderately", "quickKey": 2},
{"id": "c2312", "text": "3. Considerably", "quickKey": 3},
{"id": "c687", "text": "4. Extremely", "quickKey": 4}
]},
{"id": "q6511", "type": "IntegerQuestion", "required": false,
"text": "10. In the past 30 days, how many days did you attend self-help meetings like AA
or NA to support your recovery?",
"intro": "7. In the past 30 days, how many days did you use any of the following drugs: ",
{"id": "c2420", "text": "3. Phone", "quickKey": 3}
"controlWidth": 60, "min": 0, "max": 30},
{"id": "q6512", "type": "IntegerQuestion", "required": false,
"text": "11. In the past 30 days, how many days were you in any situations or with any
people that might put you at an increased risk for using alcohol or drugs (i.e.,
around risky \u0022people, places or things\u0022)?",
"intro": "7. In the past 30 days, how many days did you use any of the following drugs: ",
"controlWidth": 60, "min": 0, "max": 30},
{"id": "q6493", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "12. Does your religion or spirituality help support your recovery?",
"intro": "7. In the past 30 days, how many days did you use any of the following drugs: ",
]},
"columns": 2,
"choices":[
{"id": "c212", "text": "0. Not at all", "quickKey": 0},
{"id": "c717", "text": "1. Slightly", "quickKey": 1},
{"id": "c685", "text": "2. Moderately", "quickKey": 2},
{"id": "c2312", "text": "3. Considerably", "quickKey": 3},
{"id": "c687", "text": "4. Extremely", "quickKey": 4}
]},
{"id": "q6513", "type": "IntegerQuestion", "required": false,
"text": "13. In the past 30 days, how many days did you spend much of the time at work,
{"id": "i1096", "type": "IntroText",
school, or doing volunteer work?",
"intro": "7. In the past 30 days, how many days did you use any of the following drugs: ",
"controlWidth": 60, "min": 0, "max": 30},
{"id": "q6495", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "14. Do you have enough income (from legal sources) to pay for necessities such as
housing, transportation, food and clothing for yourself and your dependents?",
"intro": "7. In the past 30 days, how many days did you use any of the following drugs: ",
"columns": 2,
"choices":[
{"id": "c237", "text": "0. No", "quickKey": 0},
"text": "Instructions<br />This is a standard set of questions about several areas of your
{"id": "c241", "text": "1. Yes", "quickKey": 1}
]},
{"id": "q6496", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "15. In the past 30 days, how much have you been bothered by arguments or problems
getting along with any family members or friends?",
"intro": "7. In the past 30 days, how many days did you use any of the following drugs: ",
"columns": 2,
"choices":[
{"id": "c212", "text": "0. Not at all", "quickKey": 0},
{"id": "c717", "text": "1. Slightly", "quickKey": 1},
life such as your health, alcohol and drug use, etc. The questions generally ask
{"id": "c685", "text": "2. Moderately", "quickKey": 2},
{"id": "c2312", "text": "3. Considerably", "quickKey": 3},
{"id": "c687", "text": "4. Extremely", "quickKey": 4}
]},
{"id": "q6514", "type": "IntegerQuestion", "required": false,
"text": "16. In the past 30 days, how many days did you contact or spend time with any
family members or friends who are supportive of your recovery?",
"intro": "7. In the past 30 days, how many days did you use any of the following drugs: ",
"controlWidth": 60, "min": 0, "max": 30},
{"id": "q6498", "type": "ChoiceQuestion", "required": false, "inline": true,
about the past 30 days. Please consider each question and answer as accurately
"text": "17. How satisfied are you with your progress toward achieving your recovery
goals?",
"intro": "7. In the past 30 days, how many days did you use any of the following drugs: ",
"columns": 2,
"choices":[
{"id": "c212", "text": "0. Not at all", "quickKey": 0},
{"id": "c717", "text": "1. Slightly", "quickKey": 1},
{"id": "c685", "text": "2. Moderately", "quickKey": 2},
{"id": "c2312", "text": "3. Considerably", "quickKey": 3},
{"id": "c687", "text": "4. Extremely", "quickKey": 4}
"restartDays": 7,
as possible.<br /> "
]}],
"rules":[
{"question": "q6501", "operator": "EQ", "value": 0,
"skips":["q6502"]},
{"question": "q6503", "operator": "EQ", "value": 0,
"skips":["q6504","q6505","q6506","q6507","q6508","q6509","q6510"]}]
}
},
{"id": "q6476", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "1. In the past 30 days, how would you say your physical health has been?",
"intro": "Instructions<br />This is a standard set of questions about several areas of your
life such as your health, alcohol and drug use, etc. The questions generally ask
about the past 30 days. Please consider each question and answer as accurately
as possible.<br /> ",
"columns": 2,
"choices":[
"printTitle": "Brief Addiction Monitor - Revised",
{"id": "c1059", "text": "0. Excellent", "quickKey": 0},
{"id": "c1060", "text": "1. Very good", "quickKey": 1},
{"id": "c1061", "text": "2. Good", "quickKey": 2},
{"id": "c1062", "text": "3. Fair", "quickKey": 3},
{"id": "c1063", "text": "4. Poor", "quickKey": 4}
]},
{"id": "q6499", "type": "IntegerQuestion", "required": false,
"text": "2. In the past 30 days, how many nights did you have trouble falling asleep or
staying asleep?",
"intro": "Instructions<br />This is a standard set of questions about several areas of your
"content":[
life such as your health, alcohol and drug use, etc. The questions generally ask
about the past 30 days. Please consider each question and answer as accurately
as possible.<br /> ",
"controlWidth": 60, "min": 0, "max": 30},
{"id": "q6500", "type": "IntegerQuestion", "required": false,
"text": "3. In the past 30 days, how many days have you felt depressed, anxious, angry or
very upset throughout most of the day?",
"intro": "Instructions<br />This is a standard set of questions about several areas of your
life such as your health, alcohol and drug use, etc. The questions generally ask
about the past 30 days. Please consider each question and answer as accurately
{"id": "q6474", "type": "DateQuestion", "required": false, "inline": true,
as possible.<br /> ",
"controlWidth": 60, "min": 0, "max": 30},
{"id": "q6501", "type": "IntegerQuestion", "required": false,
"text": "4. In the past 30 days, how many days did you drink ANY alcohol?",
"intro": "Instructions<br />This is a standard set of questions about several areas of your
life such as your health, alcohol and drug use, etc. The questions generally ask
about the past 30 days. Please consider each question and answer as accurately
as possible.<br /> ",
"controlWidth": 60, "min": 0, "max": 30},
{"id": "q6502", "type": "IntegerQuestion", "required": false,
"text": "A. Date of administration:",
"text": "5. In the past 30 days, how many days did you have at least 5 drinks (if you are
a man) or at least 4 drinks (if you are a woman)? [One drink is considered one
shot of hard liquor (1.5 oz.) or 12-ounce can/bottle of beer or 5-ounce glass of
wine.]",
"intro": "Instructions<br />This is a standard set of questions about several areas of your
life such as your health, alcohol and drug use, etc. The questions generally ask
about the past 30 days. Please consider each question and answer as accurately
as possible.<br /> ",
"controlWidth": 60, "min": 0, "max": 30},
{"id": "q6503", "type": "IntegerQuestion", "required": false,
"controlWidth": 120, "daysBack": 30, "daysAhead": 0},
"text": "6. In the past 30 days, how many days did you use any illegal or street drugs or
abuse any prescription medications?",
"intro": "Instructions<br />This is a standard set of questions about several areas of your
life such as your health, alcohol and drug use, etc. The questions generally ask
about the past 30 days. Please consider each question and answer as accurately
as possible.<br /> ",
"controlWidth": 60, "min": 0, "max": 30},
{"id": "i1097", "type": "IntroText",
"text": "7. In the past 30 days, how many days did you use any of the following drugs: "
},
{"id": "q6475", "type": "ChoiceQuestion", "required": false, "inline": true,
{"id": "q6504", "type": "IntegerQuestion", "required": false,
"text": "7A. Marijuana (cannabis, pot, weed)?",
"intro": "7. In the past 30 days, how many days did you use any of the following drugs: ",
"controlWidth": 60, "min": 0, "max": 30},
{"id": "q6505", "type": "IntegerQuestion", "required": false,
"text": "7B. Sedatives and/or Tranquilizers (benzos, Valium, Xanax, Ativan, Ambien, barbs,
Phenobarbital, downers, etc.)?",
"intro": "7. In the past 30 days, how many days did you use any of the following drugs: ",
"controlWidth": 60, "min": 0, "max": 30},
{"id": "q6506", "type": "IntegerQuestion", "required": false,
"text": "B. Method of administration:",
"text": "7C. Cocaine and/or Crack?",
"intro": "7. In the past 30 days, how many days did you use any of the following drugs: ",
"controlWidth": 60, "min": 0, "max": 30},
{"id": "q6507", "type": "IntegerQuestion", "required": false,
"text": "7D. Other Stimulants (amphetamine, methamphetamine, Dexedrine, Ritalin, Adderall,
speed, crystal meth, ice, etc.)?",
"intro": "7. In the past 30 days, how many days did you use any of the following drugs: ",
"controlWidth": 60, "min": 0, "max": 30},
{"id": "q6508", "type": "IntegerQuestion", "required": false,
"text": "7E. Opiates (Heroin, Morphine, Dilaudid, Demerol, Oxycontin, oxy, codeine
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