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nly":null,"submitNational":true,"suicideriskRoutine":null,"suicideriskTag":null,"targetPopulation":"Adults (18 years of age and older) being treated in SUD specialty care settings.","version":"03-2012","wasOperational":true},"report":{"id":
319,"instrument":318,"template":" Brief Addiction Monitor: IOP version for CSG-SUD (BAM-IOP-CSG-SUD)\r\n| \r\n| Date Given: <.Date_Given.>\r\n| Clinician: <.Staff_Ordered_By.>\r\n| Location: <.Location.>\r\n| \r\n| Vete
ran: <.Patient_Name_Last_First.>\r\n| SSN: <.Patient_SSN.>\r\n| DOB: <.Patient_Date_Of_Birth.> (<.Patient_Age.>)\r\n| Gender: <.Patient_Gender.>
\r\n| \r\n| \r\n| Clinical Subscales:\r\n| \r\n| Use: <-Use->\r\n| Items 4, 5A, 6. A high score indicates more use, range is 0 to 12. If\r\n| a patient scores a 1 or greater, it calls for further assessment and
\r\n| clinical attention, e.g., consider addition\/change of pharmacotherapy\r\n| or psychosocial intervention.\r\n| \r\n| Risk Factors: <-Risk Factors->\r\n| Items 1, 2, 3, 8, 11, 15. A high score indicates incre
ased risk, range\r\n| is 0 to 24. Clinicians are encouraged to consider scores on individual\r\n| Risk items in offering interventions as indicated during initial \r\n| treatment planning and following re-assessment.\r\n|
\r\n| Protective Factors: <-Protective Factors->\r\n| Items 9, 10, 12, 13, 14, 16. A high score indicates greater protective\r\n| factors, range is 0 to 24. Clinicians are encouraged to consider\r\n| scores on
individual Protective items in offering interventions as \r\n| indicated during initial treatment planning and following\r\n| re-assessment.\r\n|\r\n| Average Drinks (5B): <*Answer_9156*> \r\n| Highest Consumed (5C
): <*Answer_9157*>\r\n| Items 5B and 5C should be reviewed and interpreted at the item-level \r\n| and are not included in any composite scores. These items provide \r\n| additional, clinically useful information about qua
ntity of alcohol\r\n| use that users are encouraged to review and monitor, in addition to \r\n| the frequency of use, risk and protective composite scores, to inform \r\n| treatment planning and treatment progress.\r\n|
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\r\n| Questions and Answers\r\n| \r\n| A. Date of administration:\r\n| <*Answer_9131*>\r\n| B. Method of administration:\r\n| <*Answer_9132*>\r\n| \r\n| 1. In the past 7 days, how would you say your physica
l health has been?\r\n| <*Answer_9133*>\r\n| \r\n| 2. In the past 7 days, how many nights did you have trouble falling\r\n| asleep or staying asleep?\r\n| <*Answer_9134*>\r\n| \r\n| 3. In the past 7 days,
how many days have you felt depressed, anxious,\r\n| angry or very upset throughout most of the day?\r\n| <*Answer_9135*>\r\n| \r\n| 4. In the past 7 days, how many days did you drink ANY alcohol?\r\n| <*Answer_9
136*>\r\n| \r\n| 5A. In the past 7 days, how many days did you have at least 5 drinks (if \r\n| you are a man) or at least 4 drinks (if you are a woman)?\r\n| [One drink is considered one shot of hard liquor (1.5 oz.) or
\r\n| 12-ounce can\/bottle of beer or 5 ounce glass of wine.]\r\n| <*Answer_9137*>\r\n|\r\n| 5B. In the past 7 days, on the days that you consumed alcohol, what was\r\n| the average number of drinks you consumed on t
hose days?\r\n| <*Answer_9156*>\r\n| \r\n| 5C. In the past 7 days, on the days that you consumed alcohol, what was \r\n| the highest number of drinks you consumed in one day?\r\n| <*Answer_9157*>\r\n| \r\n| 6.
In the past 7 days, how many days did you use any illegal or street\r\n| drugs or abuse any prescription medications?\r\n| <*Answer_9138*>\r\n| \r\n| 7. In the past 7 days, how many days did you use any of the followin
g \r\n| drugs:\r\n| \r\n| 7A. Marijuana (cannabis, pot, weed)?\r\n| <*Answer_9139*>\r\n| 7B. Sedatives and\/or Tranquilizers (benzos, Valium, Xanax, Ativan,\r\n| Ambien, barbs, Phenobarbital, do
wners, etc.)?\r\n| <*Answer_9140*>\r\n| 7C. Cocaine and\/or Crack?\r\n| <*Answer_9141*>\r\n| 7D. Other Stimulants (amphetamine, methamphetamine, Dexedrine,\r\n| Ritalin, Adderall, speed, crysta
l meth, ice, etc.)?\r\n| <*Answer_9142*>\r\n| 7E. Opiates (Heroin, Morphine, Dilaudid, Demerol, Oxycontin, oxy,
omponent":null,"fontBold":false,"fontColor":"clWindowText","fontItalic":false,"fontName":"MS Sans Serif","fontSize":10,"fontUnderlined":false,"id":57145,"left":3,"mask":null},{"alignment":"L","columns":0,"component":"DA","fontBold":false,"f
\r\n| codeine (Tylenol 2,3,4), Percocet, Vicodin, Fentanyl, etc.)?\r\n| <*Answer_9143*>\r\n| 7F. Inhalants (glues, adhesives, nail polish remover, paint thinner, \r\n| etc.)?\r\n| <*Answer_
9144*>\r\n| 7G. Other drugs (steroids, non-prescription sleep and diet pills, \r\n| Benadryl, Ephedra, other over-the-counter or unknown\r\n| medications)?\r\n| <*Answer_9145*>\r\n| \r\n| 8. I
n the past 7 days, how much were you bothered by cravings or urges\r\n| to drink alcohol or use drugs?\r\n| <*Answer_9146*>\r\n| \r\n| 9. How confident are you that you will NOT use alcohol and drugs in the\r\n|
next 7 days?\r\n| <*Answer_9147*>\r\n| \r\n| 10. In the past 7 days, how many days did you attend self-help meetings\r\n| like AA or NA to support your recovery?\r\n| <*Answer_9148*>\r\n| \r\n| 11. In the pa
st 7 days, how many days were you in any situations or with \r\n| any people that might put you at an increased risk for using alcohol\r\n| or drugs (i.e., around risky \"people, places or things\")?\r\n| <*Answer_9149*
>\r\n| \r\n| 12. Does your religion or spirituality help support your recovery?\r\n| <*Answer_9150*>\r\n| \r\n| 13. In the past 7 days, how many days did you spend much of the time at\r\n| work, school, or doing vo
lunteer work?\r\n| <*Answer_9151*>\r\n| \r\n| 14. Do you have enough income (from legal sources) to pay for necessities\r\n| such as housing, transportation, food and clothing for yourself and\r\n| your dependents
?\r\n| <*Answer_9152*>\r\n| \r\n| 15. In the past 7 days, how much have you been bothered by arguments or \r\n| problems getting along with any family members or friends?\r\n| <*Answer_9153*>\r\n| \r\n| 16.
In the past 7 days, how many days did you contact or spend time with\r\n| any family members or friends who are supportive of your recovery?\r\n| <*Answer_9154*>\r\n| \r\n| 17. How satisfied are you with your progress to
ward achieving your\r\n| recovery goals?\r\n| <*Answer_9155*>\r\n| \r\n| Information contained in this note is based on a self-report assessment\r\n and is not sufficient to use alone for diagnostic purposes. Assessmen
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wo days\", \"quickKey\": 2}, \r\n {\"id\": \"c3163\", \"text\": \"3. Three days\", \"quickKey\": 3}, \r\n {\"id\": \"c3164\", \"text\": \"4. Four or more days\", \"quickKey\": 4}\r\n ]}, \r\n {\"id\": \"q9156\", \"type\": \"Inte
gerQuestion\", \"required\": false, \r\n \"text\": \"5B. In the past 7 days, on the days that you consumed alcohol, what was the\r\n average number of drinks you consumed on those days?\", \r\n \"intro\": \"Instructions<br \/>This is
a standard set of questions about several areas of your\r\n life such as your health, alcohol and drug use, etc. The questions generally ask\r\n about the past 7 days. Please consider each question and answer as accurately\r\n as possible
. \", \r\n \"controlWidth\": 658, \"min\": 0, \"max\": 999}, \r\n {\"id\": \"q9157\", \"type\": \"IntegerQuestion\", \"required\": false, \r\n \"text\": \"5C. In the past 7 days, on the days that you consumed alcohol, what was the\
r\n highest number of drinks you consumed in one day?\", \r\n \"intro\": \"Instructions<br \/>This is a standard set of questions about several areas of your\r\n life such as your health, alcohol and drug use, etc. The questions generall
y ask\r\n about the past 7 days. Please consider each question and answer as accurately\r\n as possible. \", \r\n \"controlWidth\": 658, \"min\": 0, \"max\": 999}, \r\n {\"id\": \"q9138\", \"type\": \"ChoiceQuestion\", \"required\":
false, \"inline\": true, \r\n \"text\": \"6. In the past 7 days, how many days did you use any illegal or street drugs or\r\n abuse any prescription medications?\", \r\n \"intro\": \"Instructions<br \/>This is a standard set of quest
ions about several areas of your\r\n life such as your health, alcohol and drug use, etc. The questions generally ask\r\n about the past 7 days. Please consider each question and answer as accurately\r\n as possible. \", \r\n \"column
s\": 2, \r\n \"choices\":[\r\n {\"id\": \"c1\", \"text\": \"0. None\", \"quickKey\": 0}, \r\n {\"id\": \"c3161\", \"text\": \"1. One day\", \"quickKey\": 1}, \r\n {\"id\": \"c3162\", \"text\": \"2. Two days\", \"quickKey\": 2
:null,"component":null,"fontBold":false,"fontColor":"clWindowText","fontItalic":false,"fontName":"MS Sans Serif","fontSize":10,"fontUnderlined":false,"id":57156,"left":3,"mask":null},{"alignment":"L","columns":null,"component":null,"fontBol
}, \r\n {\"id\": \"c3163\", \"text\": \"3. Three days\", \"quickKey\": 3}, \r\n {\"id\": \"c3164\", \"text\": \"4. Four or more days\", \"quickKey\": 4}\r\n ]}, \r\n {\"id\": \"i1063\", \"type\": \"IntroText\", \r\n \"text\":
\"7. In the past 7 days, how many days did you use any of the following drugs: \"\r\n },
\r\n {\"id\": \"q9139\", \"type\": \"ChoiceQuestion\", \"required\": false, \"inline\": true, \r\n \"text\": \"7A. Marijuana (cannabis, pot, weed)?\", \r\n \"intro\": \"7. In the past 7 days, how many days did you use any of the fol
lowing drugs: \", \r\n \"columns\": 2, \r\n \"choices\":[\r\n {\"id\": \"c1\", \"text\": \"0. None\", \"quickKey\": 0}, \r\n {\"id\": \"c3161\", \"text\": \"1. One day\", \"quickKey\": 1}, \r\n {\"id\": \"c3162\", \"text\
": \"2. Two days\", \"quickKey\": 2}, \r\n {\"id\": \"c3163\", \"text\": \"3. Three days\", \"quickKey\": 3}, \r\n {\"id\": \"c3164\", \"text\": \"4. Four or more days\", \"quickKey\": 4}\r\n ]}, \r\n {\"id\": \"q9140\", \"type\
": \"ChoiceQuestion\", \"required\": false, \"inline\": true, \r\n \"text\": \"7B. Sedatives and\/or Tranquilizers (benzos, Valium, Xanax, Ativan, Ambien, barbs,\r\n Phenobarbital, downers, etc.)?\", \r\n \"intro\": \"7. In the past 7
days, how many days did you use any of the following drugs: \", \r\n \"columns\": 2, \r\n \"choices\":[\r\n {\"id\": \"c1\", \"text\": \"0. None\", \"quickKey\": 0}, \r\n {\"id\": \"c3161\", \"text\": \"1. One day\", \"quick
Key\": 1}, \r\n {\"id\": \"c3162\", \"text\": \"2. Two days\", \"quickKey\": 2}, \r\n {\"id\": \"c3163\", \"text\": \"3. Three days\", \"quickKey\": 3}, \r\n {\"id\": \"c3164\", \"text\": \"4. Four or more days\", \"quickKey\":
4}\r\n ]}, \r\n {\"id\": \"q9141\", \"type\": \"ChoiceQuestion\", \"required\": false, \"inline\": true, \r\n \"text\": \"7C. Cocaine and\/or Crack?\", \r\n \"intro\": \"7. In the past 7 days, how many days did you use any of the
following drugs: \", \r\n \"columns\": 2, \r\n \"choices\":[\r\n {\"id\": \"c1\", \"text\": \"0. None\", \"quickKey\": 0}, \r\n {\"id\": \"c3161\", \"text\": \"1. One day\", \"quickKey\": 1}, \r\n {\"id\": \"c3162\", \"te
nator":"B.","hint":null,"id":9158,"instrument":316,"introDisplay":57128,"introId":null,"introText":null,"max":0,"min":0,"questionDisplay":57147,"questionId":9093,"questionText":"Method of administration:","required":false,"responseTypeId":1
d":false,"fontColor":"clWindowText","fontItalic":false,"fontName":"MS Sans Serif","fontSize":10,"fontUnderlined":false,"id":57157,"left":10,"mask":null},{"alignment":"L","columns":0,"component":"SP","fontBold":false,"fontColor":"clWindowTex
xt\": \"2. Two days\", \"quickKey\": 2}, \r\n {\"id\": \"c3163\", \"text\": \"3. Three days\", \"quickKey\": 3}, \r\n {\"id\": \"c3164\", \"text\": \"4. Four or more days\", \"quickKey\": 4}\r\n ]}, \r\n {\"id\": \"q9142\", \"ty
pe\": \"ChoiceQuestion\", \"required\": false, \"inline\": true, \r\n \"text\": \"7D. Other Stimulants (amphetamine, methamphetamine, Dexedrine, Ritalin, Adderall,\r\n speed, crystal meth, ice, etc.)?\", \r\n \"intro\": \"7. In the pa
st 7 days, how many days did you use any of the following drugs: \", \r\n \"columns\": 2, \r\n \"choices\":[\r\n {\"id\": \"c1\", \"text\": \"0. None\", \"quickKey\": 0}, \r\n {\"id\": \"c3161\", \"text\": \"1. One day\", \"q
uickKey\": 1}, \r\n {\"id\": \"c3162\", \"text\": \"2. Two days\", \"quickKey\": 2}, \r\n {\"id\": \"c3163\", \"text\": \"3. Three days\", \"quickKey\": 3}, \r\n {\"id\": \"c3164\", \"text\": \"4. Four or more days\", \"quickKey
\": 4}\r\n ]}, \r\n {\"id\": \"q9143\", \"type\": \"ChoiceQuestion\", \"required\": false, \"inline\": true, \r\n \"text\": \"7E. Opiates (Heroin, Morphine, Dilaudid, Demerol, Oxycontin, oxy, codeine\r\n (Tylenol 2,3,4), Percocet, Vi
codin, Fentanyl, etc.)?\", \r\n \"intro\": \"7. In the past 7 days, how many days did you use any of the following drugs: \", \r\n \"columns\": 2, \r\n \"choices\":[\r\n {\"id\": \"c1\", \"text\": \"0. None\", \"quickKey\": 0}
, \r\n {\"id\": \"c3161\", \"text\": \"1. One day\", \"quickKey\": 1}, \r\n {\"id\": \"c3162\", \"text\": \"2. Two days\", \"quickKey\": 2}, \r\n {\"id\": \"c3163\", \"text\": \"3. Three days\", \"quickKey\": 3}, \r\n {\"id\
": \"c3164\", \"text\": \"4. Four or more days\", \"quickKey\": 4}\r\n ]}, \r\n {\"id\": \"q9144\", \"type\": \"ChoiceQuestion\", \"required\": false, \"inline\": true, \r\n \"text\": \"7F. Inhalants (glues, adhesives, nail polish re
mover, paint thinner, etc.)?\", \r\n \"intro\": \"7. In the past 7 days, how many days did you use any of the following drugs: \", \r\n \"columns\": 2,
\r\n \"choices\":[\r\n {\"id\": \"c1\", \"text\": \"0. None\", \"quickKey\": 0}, \r\n {\"id\": \"c3161\", \"text\": \"1. One day\", \"quickKey\": 1}, \r\n {\"id\": \"c3162\", \"text\": \"2. Two days\", \"quickKey\": 2}, \r\n
t","fontItalic":false,"fontName":"MS Sans Serif","fontSize":10,"fontUnderlined":false,"id":57158,"left":25,"mask":"60|0|N|"},{"alignment":"L","columns":null,"component":null,"fontBold":false,"fontColor":"clWindowText","fontItalic":false,"fo
{\"id\": \"c3163\", \"text\": \"3. Three days\", \"quickKey\": 3}, \r\n {\"id\": \"c3164\", \"text\": \"4. Four or more days\", \"quickKey\": 4}\r\n ]}, \r\n {\"id\": \"q9145\", \"type\": \"ChoiceQuestion\", \"required\": false,
\"inline\": true, \r\n \"text\": \"7G. Other drugs (steroids, non-prescription sleep and diet pills, Benadryl,\r\n Ephedra, other over-the-counter or unknown medications)?\", \r\n \"intro\": \"7. In the past 7 days, how many days did
you use any of the following drugs: \", \r\n \"columns\": 2, \r\n \"choices\":[\r\n {\"id\": \"c1\", \"text\": \"0. None\", \"quickKey\": 0}, \r\n {\"id\": \"c3161\", \"text\": \"1. One day\", \"quickKey\": 1}, \r\n {\"i
d\": \"c3162\", \"text\": \"2. Two days\", \"quickKey\": 2}, \r\n {\"id\": \"c3163\", \"text\": \"3. Three days\", \"quickKey\": 3}, \r\n {\"id\": \"c3164\", \"text\": \"4. Four or more days\", \"quickKey\": 4}\r\n ]}, \r\n {\"i
d\": \"q9146\", \"type\": \"ChoiceQuestion\", \"required\": false, \"inline\": true, \r\n \"text\": \"8. In the past 7 days, how much were you bothered by cravings or urges to drink\r\n alcohol or use drugs?\", \r\n \"intro\": \"7. In
the past 7 days, how many days did you use any of the following drugs: \", \r\n \"columns\": 2, \r\n \"choices\":[\r\n {\"id\": \"c212\", \"text\": \"0. Not at all\", \"quickKey\": 0}, \r\n {\"id\": \"c717\", \"text\": \"1.
Slightly\", \"quickKey\": 1}, \r\n {\"id\": \"c685\", \"text\": \"2. Moderately\", \"quickKey\": 2}, \r\n {\"id\": \"c2312\", \"text\": \"3. Considerably\", \"quickKey\": 3}, \r\n {\"id\": \"c687\", \"text\": \"4. Extremely\", \
"quickKey\": 4}\r\n ]}, \r\n {\"id\": \"q9147\", \"type\": \"ChoiceQuestion\", \"required\": false, \"inline\": true, \r\n \"text\": \"9. How confident are you in your ability to be completely abstinent (clean) from\r\n alcohol and d
rugs in the next 7 days?\", \r\n \"intro\": \"7. In the past 7 days, how many days did you use any of the following drugs: \", \r\n \"columns\": 2, \r\n \"choices\":[\r\n {\"id\": \"c212\", \"text\": \"0. Not at all\", \"quick
Key\": 0}, \r\n {\"id\": \"c717\", \"text\": \"1. Slightly\", \"quickKey\": 1}, \r\n {\"id\": \"c685\", \"text\": \"2. Moderately\", \"quickKey\": 2}, \r\n {\"id\": \"c2312\", \"text\": \"3. Considerably\", \"quickKey\": 3}, \r\
ntName":"MS Sans Serif","fontSize":10,"fontUnderlined":false,"id":57159,"left":10,"mask":null},{"alignment":"L","columns":0,"component":"SP","fontBold":false,"fontColor":"clWindowText","fontItalic":false,"fontName":"MS Sans Serif","fontSize
n {\"id\": \"c687\", \"text\": \"4. Extremely\", \"quickKey\": 4}\r\n ]}, \r\n {\"id\": \"q9148\", \"type\": \"ChoiceQuestion\", \"required\": false, \"inline\": true, \r\n \"text\": \"10. In the past 7 days, how many days did yo
u attend self-help meetings like AA\r\n or NA to support your recovery?\", \r\n \"intro\": \"7. In the past 7 days, how many days did you use any of the following drugs: \", \r\n \"columns\": 2, \r\n \"choices\":[\r\n {\"id\":
\"c1\", \"text\": \"0. None\", \"quickKey\": 0}, \r\n {\"id\": \"c3161\", \"text\": \"1. One day\", \"quickKey\": 1}, \r\n {\"id\": \"c3162\", \"text\": \"2. Two days\", \"quickKey\": 2}, \r\n {\"id\": \"c3163\", \"text\": \"3.
Three days\", \"quickKey\": 3}, \r\n {\"id\": \"c3164\", \"text\": \"4. Four or more days\", \"quickKey\": 4}\r\n ]}, \r\n {\"id\": \"q9149\", \"type\": \"ChoiceQuestion\", \"required\": false, \"inline\": true, \r\n \"text\": \
"11. In the past 7 days, how many days were you in any situations or with any\r\n people that might put you at an increased risk for using alcohol or drugs (i.e.,\r\n around risky \\u0022people, places or things\\u0022)?\", \r\n \"intro\
": \"7. In the past 7 days, how many days did you use any of the following drugs: \", \r\n \"columns\": 2, \r\n \"choices\":[
\r\n {\"id\": \"c1\", \"text\": \"0. None\", \"quickKey\": 0}, \r\n {\"id\": \"c3161\", \"text\": \"1. One day\", \"quickKey\": 1}, \r\n {\"id\": \"c3162\", \"text\": \"2. Two days\", \"quickKey\": 2}, \r\n {\"id\": \"c3163\
", \"text\": \"3. Three days\", \"quickKey\": 3}, \r\n {\"id\": \"c3164\", \"text\": \"4. Four or more days\", \"quickKey\": 4}\r\n ]}, \r\n {\"id\": \"q9150\", \"type\": \"ChoiceQuestion\", \"required\": false, \"inline\": true, \r
\n \"text\": \"12. Does your religion or spirituality help support your recovery?\", \r\n \"intro\": \"7. In the past 7 days, how many days did you use any of the following drugs: \", \r\n \"columns\": 2, \r\n \"choices\":[\r\n
{\"id\": \"c212\", \"text\": \"0. Not at all\", \"quickKey\": 0}, \r\n {\"id\": \"c717\", \"text\": \"1. Slightly\", \"quickKey\": 1}, \r\n {\"id\": \"c685\", \"text\": \"2. Moderately\", \"quickKey\": 2}, \r\n {\"id\": \"c
":10,"fontUnderlined":false,"id":57160,"left":25,"mask":"60|0|N|"},{"alignment":"L","columns":null,"component":null,"fontBold":false,"fontColor":"clWindowText","fontItalic":false,"fontName":"MS Sans Serif","fontSize":10,"fontUnderlined":fal
2312\", \"text\": \"3. Considerably\", \"quickKey\": 3}, \r\n {\"id\": \"c687\", \"text\": \"4. Extremely\", \"quickKey\": 4}\r\n ]}, \r\n {\"id\": \"q9151\", \"type\": \"ChoiceQuestion\", \"required\": false, \"inline\": true, \r\n
\"text\": \"13. In the past 7 days, how many days did you spend much of the time at work,\r\n school, or doing volunteer work?\", \r\n \"intro\": \"7. In the past 7 days, how many days did you use any of the following drugs: \", \r\
n \"columns\": 2, \r\n \"choices\":[\r\n {\"id\": \"c1\", \"text\": \"0. None\", \"quickKey\": 0}, \r\n {\"id\": \"c3161\", \"text\": \"1. One day\", \"quickKey\": 1}, \r\n {\"id\": \"c3162\", \"text\": \"2. Two days\", \"
quickKey\": 2}, \r\n {\"id\": \"c3163\", \"text\": \"3. Three days\", \"quickKey\": 3}, \r\n {\"id\": \"c3164\", \"text\": \"4. Four or more days\", \"quickKey\": 4}\r\n ]}, \r\n {\"id\": \"q9152\", \"type\": \"ChoiceQuestion\",
\"required\": false, \"inline\": true, \r\n \"text\": \"14. Do you have enough income (from legal sources) to pay for necessities such as\r\n housing, transportation, food and clothing for yourself and your dependents?\", \r\n \"intr
o\": \"7. In the past 7 days, how many days did you use any of the following drugs: \", \r\n \"columns\": 2, \r\n \"choices\":[\r\n {\"id\": \"c237\", \"text\": \"0. No\", \"quickKey\": 0}, \r\n {\"id\": \"c241\", \"text\": \
"1. Yes\", \"quickKey\": 1}\r\n ]}, \r\n {\"id\": \"q9153\", \"type\": \"ChoiceQuestion\", \"required\": false, \"inline\": true, \r\n \"text\": \"15. In the past 7 days, how much have you been bothered by arguments or problems\r\n g
etting along with any family members or friends?\", \r\n \"intro\": \"7. In the past 7 days, how many days did you use any of the following drugs: \", \r\n \"columns\": 2, \r\n \"choices\":[\r\n {\"id\": \"c212\", \"text\": \"
0. Not at all\", \"quickKey\": 0}, \r\n {\"id\": \"c717\", \"text\": \"1. Slightly\", \"quickKey\": 1}, \r\n {\"id\": \"c685\", \"text\": \"2. Moderately\", \"quickKey\": 2}, \r\n {\"id\": \"c2312\", \"text\": \"3. Considerably\
", \"quickKey\": 3}, \r\n {\"id\": \"c687\", \"text\": \"4. Extremely\", \"quickKey\": 4}\r\n ]}, \r\n {\"id\": \"q9154\", \"type\": \"ChoiceQuestion\", \"required\": false, \"inline\": true, \r\n \"text\": \"16. In the past 7 da
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ys, how many days were you in contact or spent time with any\r\n family members or friends who are supportive of your recovery?\", \r\n \"intro\": \"7. In the past 7 days, how many days did you use any of the following drugs: \", \r\n
\"columns\": 2, \r\n \"choices\":[\r\n {\"id\": \"c1\", \"text\": \"0. None\", \"quickKey\": 0}, \r\n {\"id\": \"c3161\", \"text\": \"1. One day\", \"quickKey\": 1}, \r\n {\"id\": \"c3162\", \"text\": \"2. Two days\", \"qui
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our progress toward achieving your recovery\r\n goals?\", \r\n \"intro\": \"7. In the past 7 days, how many days did you use any of the following drugs: \", \r\n \"columns\": 2, \r\n \"choices\":[\r\n {\"id\": \"c212\", \"text
\": \"0. Not at all\", \"quickKey\": 0}, \r\n {\"id\": \"c717\", \"text\": \"1. Slightly\", \"quickKey\": 1}, \r\n {\"id\": \"c685\", \"text\": \"2. Moderately\", \"quickKey\": 2}, \r\n {\"id\": \"c2312\", \"text\": \"3. Conside
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Submitted for publication in 2011.","requireSignature":false,"requiresLicense":"N","scoringRevision":1,"scoringRoutine":"YTSBAMCC","scoringTag":"DLL","staffOnly":null,"submitNational":true,"suicideriskRoutine":null,"suicideriskTag":null,"
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targetPopulation":"Adults (18 years of age and older) being treated in SUD specialty care settings.","version":"02-2012","wasOperational":true},"report":{"id":317,"instrument":316,"template":"Brief Addiction Monitor - Consumption Items for
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CBT-SUD (BAM-C-CBT-SUD)\r\n| \r\n| Date Given: <.Date_Given.>\r\n| Clinician: <.Staff_Ordered_By.>\r\n| Location: <.Location.>\r\n| \r\n| Veteran: <.Patient_Name_Last_First.>\r\n| SSN: <.Patient_SSN.>\r\n| DOB: <.Patient_Dat
","fontItalic":false,"fontName":"MS Sans Serif","fontSize":10,"fontUnderlined":false,"id":57289,"left":8,"mask":"662|||"},{"alignment":"L","columns":null,"component":null,"fontBold":false,"fontColor":"clWindowText","fontItalic":false,"fontN
ame":"MS Sans Serif","fontSize":10,"fontUnderlined":false,"id":57290,"left":3,"mask":null},{"alignment":"L","columns":0,"component":"SP","fontBold":false,"fontColor":"clWindowText","fontItalic":false,"fontName":"MS Sans Serif","fontSize":10
,"fontUnderlined":false,"id":57291,"left":15,"mask":"60|0|N|"},{"alignment":"L","columns":null,"component":null,"fontBold":false,"fontColor":"clWindowText","fontItalic":false,"fontName":"MS Sans Serif","fontSize":10,"fontUnderlined":false,"
id":57292,"left":3,"mask":null},{"alignment":"L","columns":2,"component":"RA","fontBold":false,"fontColor":"clWindowText","fontItalic":false,"fontName":"MS Sans Serif","fontSize":10,"fontUnderlined":false,"id":57293,"left":8,"mask":"662|||"
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or":"clWindowText","fontItalic":false,"fontName":"MS Sans Serif","fontSize":10,"fontUnderlined":false,"id":57299,"left":8,"mask":"662|||"}],"info":{"author":"Dominick Dephilippis","auxDate":null,"auxVersion":"1.0.3.2","copyrightText":null,"
stions about alcohol and drug use since the last session. Please\r\n answer the requested items as accurately as possible and indicate the method of assessment\r\n in item B above. |","max":30,"min":0,"questionDisplay":57150,"questionId":90
e_Of_Birth.> (<.Patient_Age.>)\r\n| Gender: <.Patient_Gender.>\r\n| \r\n| \r\n| Days Alcohol Use: <-Days Alcohol Use->\r\n| Days of Heavy Alcohol Use: <-Days Heavy Alcohol Use->\r\n| Days Other Drug Use: <-Days Other Drug Use->\r
copyrighted":false,"dllDate":null,"dllVersion":null,"enteredBy":"SCHULTZ,ROGER F","entryDate":"2009-10-26","fullText":true,"id":317,"interpretiveText":" Guide for interpreting BAM-R scores (range 0-180):\r\n\r\n A high score on the subsc
ales Use (above 0) and Risk Factors (above 11) calls for further examination. \r\n A score below 13 on Protective Factors is clinically significant.","lastEditDate":3230817.1815,"lastEditedBy":"HOWELL,LYNN","legacy":false,"licenseCurrent"
:false,"name":"BAM-R-CSG-SUD","national":true,"normSample":"Norms have not been developed. The initial evaluation of BAM psychometrics was performed on data from 150 veterans in the Philadelphia VAMC SUD specialty care program.","operation
al":"Y","printTitle":"Brief Addiction Monitor - Revised for CSG-SUD (BAM-R-CSG-SUD)","publicationDate":2010,"publisher":"Philadelphia CESATE","purpose":"To support symptom monitoring and measurement-based care in SUD specialty care settings
.","reference":"Development and initial evaluation of the Brief Addiction Monitor (BAM). Submitted for publication in 2011.","requireSignature":false,"requiresLicense":"N","scoringRevision":1,"scoringRoutine":"YTSBAMRC","scoringTag":"DLL",
"staffOnly":null,"submitNational":true,"suicideriskRoutine":null,"suicideriskTag":null,"targetPopulation":"Adults (18 years of age and older) being treated in SUD specialty care settings.","version":"03-2012","wasOperational":true},"report"
:{"id":318,"instrument":317,"template":"| Brief Addiction Monitor - Revised for CSG-SUD (BAM-R-CSG-SUD)\r\n| \r\n| Date Given: <.Date_Given.>\r\n| Clinician: <.Staff_Ordered_By.>\r\n| Location: <.Location.>\r\n| \r\n|
Veteran: <.Patient_Name_Last_First.>\r\n| SSN: <.Patient_SSN.>\r\n| DOB: <.Patient_Date_Of_Birth.> (<.Patient_Age.>)\r\n| Gender: <.Patient_Gender.>\r\n| \r\n| \r\n|Clinical Subscales\r\n|\r\n| Use: <-Use->\r\n| Items 4,
5A, 6. A high score indicates more use, range is 0 to 90. If a\r\n| patient scores a 1 or greater, it calls for further assessment and clinical\r\n| attention, e.g., consider addition\/change of pharmacotherapy or\r\n| psychosocial inte
rvention.\r\n|\r\n| Risk Factors: <-Risk Factors->\r\n| Items 1, 2, 3, 8, 11, 15. A high score indicates increased risk, range is 0\r\n| to 180. For subscale scores, items with ordinal response options (0-4) were\r\n| converted to contr
\n|\r\n| Range is 0 to 30. If a patient scores a 1 or greater, it calls for \r\n| further examination and clinical attention, e.g. consider addition of\r\n| pharmacotherapy or higher level of care, add motivational interviewing.\r\n|
ibute proportionately consistent with items on days of\r\n| use (0-30). Clinicians are encouraged to consider scores on individual\r\n| Risk items in offering interventions as indicated during initial treatment \r\n| planning and followi
ng re-assessment.\r\n|\r\n| Protective Factors: <-Protective Factors->\r\n| Items 9, 10, 12, 13, 14, 16. A high score indicates greater protective\r\n| factors, range is 0 to 180. For subscale scores, items with ordinal\r\n| response op
tions (0-4) were converted to contribute proportionately\r\n| consistent with items on days of use (0-30). Clinicians are encouraged
\r\n| to consider scores on individual Protective items in offering interventions\r\n| as indicated during initial treatment planning and following re-assessment.\r\n|\r\n| Average Drinks (5B): <*Answer_9129*>\r\n| Highest Consumed (5
C): <*Answer_9130*>\r\n| Items 5B and 5C should be reviewed and interpreted at the item-level and\r\n| are not included in any composite scores. These items provide additional, \r\n| clinically useful information about quantity of alcoho
l use that users are \r\n| encouraged to review and monitor, in addition to the frequency of use, risk \r\n| and protective composite scores, to inform treatment planning and treatment \r\n| progress.\r\n| \r\n|\r\n| Questions and Answ
ers \r\n|\r\n| A. Date of administration:\r\n| <*Answer_9104*>\r\n| \r\n| B. Method of administration:\r\n| <*Answer_9105*>\r\n| \r\n| 1. In the past 30 days, how would you say your physical health has been?\r\n| <*Answ
er_9106*>\r\n| \r\n| 2. In the past 30 days, how many nights did you have trouble falling asleep\r\n| or staying asleep?\r\n| <*Answer_9113*>\r\n|\r\n| 3. In the past 30 days, how many days have you felt depressed, anxious,\r\n|
angry or very upset throughout most of the day?\r\n| <*Answer_9114*>\r\n| \r\n| 4. In the past 30 days, how many days did you drink ANY alcohol?\r\n| <*Answer_9115*>\r\n| \r\n| 5A. In the past 30 days, how many days did
you have at least 5 drinks (if\r\n| you are a man) or at least 4 drinks (if you are a woman)?\r\n| [One drink is considered one shot of hard liquor (1.5 oz.) or 12-ounce\r\n| can\/bottle of beer or 5-ounce glass of wine.]\r\n|
\r\n| Questions and Answers\r\n| \r\n| A. Date of administration:\r\n| <*Answer_9092*>\r\n| B. Method of administration:\r\n| <*Answer_9093*>\r\n| \r\n| 1. Since the last session, how many days did you drink ANY alcoh
<*Answer_9116*>\r\n| \r\n| 5B. In the past 30 days, on the days that you consumed alcohol, what was the\r\n| average number of drinks you consumed on those days?\r\n| <*Answer_9129*>\r\n| \r\n| 5C. In the past 30 days, on the
days that you consumed alcohol, what was the\r\n| highest number of drinks you consumed in one day?\r\n| <*Answer_9130*>\r\n| \r\n| 6. In the past 30 days, how many days did you use any illegal or street\r\n| drugs or abuse a
ny prescription medications?\r\n| <*Answer_9117*>\r\n| \r\n| 7A. Marijuana (cannabis, pot, weed)?\r\n| <*Answer_9118*>\r\n| \r\n| 7B. Sedatives and\/or Tranquilizers (benzos, Valium, Xanax, Ativan, Ambien,\r\n| barbs, Phen
obarbital, downers, etc.)?\r\n| <*Answer_9119*>\r\n| \r\n| 7C. Cocaine and\/or Crack?\r\n| <*Answer_9120*>\r\n| \r\n| 7D. Other Stimulants (amphetamine, methamphetamine, Dexedrine, Ritalin,\r\n| Adderall, speed, crystal meth
, ice, etc.)?\r\n| <*Answer_9121*>\r\n| \r\n| 7E. Opiates (Heroin, Morphine, Dilaudid, Demerol, Oxycontin, oxy, codeine\r\n| (Tylenol 2,3,4), Percocet, Vicodin, Fentanyl, etc.)?\r\n| <*Answer_9122*>\r\n| \r\n| 7F. Inhalants
(glues, adhesives, nail polish remover, paint thinner, etc.)?\r\n| <*Answer_9123*>\r\n| \r\n| 7G. Other drugs (steroids, non-prescription sleep and diet pills, Benadryl,\r\n| Ephedra, other over-the-counter or unknown medications)
?\r\n| <*Answer_9124*>\r\n| \r\n| 8. In the past 30 days, how much were you bothered by cravings or urges to\r\n| drink alcohol or use drugs?\r\n| <*Answer_9107*>\r\n| \r\n| 9. How confident are you that you will NOT use a
lcohol and drugs in the\r\n| next 30 days?\r\n| <*Answer_9108*>\r\n| \r\n| 10. In the past 30 days, how many days did you attend self-help meetings like\r\n| AA or NA to support your recovery?\r\n| <*Answer_9125*>\r\n| \
r\n| 11. In the past 30 days, how many days were you in any situations or with\r\n| any people that might put you at an increased risk for using alcohol or\r\n| drugs (i.e., around risky \"people, places or things\")?\r\n| <*Ans
wer_9126*>\r\n| \r\n| 12. Does your religion or spirituality help support your recovery?\r\n| <*Answer_9109*>\r\n|
ol?\r\n| <*Answer_9094*>\r\n| \r\n| 2. Since the last session, how many days did you have at least 5 drinks\r\n| (if you are a man) or at least 4 drinks (if you are a woman)?\r\n| [One drink is considered one shot of hard
\r\n| 13. In the past 30 days, how many days did you spend much of the time at\r\n| work, school, or doing volunteer work?\r\n| <*Answer_9127*>\r\n| \r\n| 14. Do you have enough income (from legal sources) to pay for necessities\r
\n| such as housing, transportation, food and clothing for yourself and your\r\n| dependents?\r\n| <*Answer_9110*>\r\n| \r\n| 15. In the past 30 days, how much have you been bothered by arguments or\r\n| problems getting a
long with any family members or friends?\r\n| <*Answer_9111*>\r\n| \r\n| 16. In the past 30 days, how many days did you contact or spend time with\r\n| any family members or friends who are supportive of your recovery?\r\n| <*
Answer_9128*>\r\n| \r\n| 17. How satisfied are you with your progress toward achieving your recovery\r\n| goals?\r\n| <*Answer_9112*>\r\n| \r\n| \r\n| Information contained in this note is based on a self-report assessment
\r\n and is not sufficient to use alone for diagnostic purposes. Assessment\r\n results should be verified for accuracy and used in conjunction with other\r\n diagnostic activities and procedures."},"rule":[{"booleanOperator":"AND","consis
tencyCheck":null,"id":406,"indexOperator":"Equals","indexQuestionId":9115,"indexValue":0,"indexValueDataType":"NUMBER","instrumentId":317,"instrumentQuestionId":9115,"instrumentRuleId":512,"messageText":null,"skippedQuestion":[{"id":2006,"i
nstrumentId":317,"questionId":9116,"ruleId":406},{"id":2014,"instrumentId":317,"questionId":9129,"ruleId":406},{"id":2015,"instrumentId":317,"questionId":9130,"ruleId":406}],"targetOperator":null,"targetQuestionId":null,"targetValue":null,"
targetValueDataType":null},{"booleanOperator":"AND","consistencyCheck":null,"id":407,"indexOperator":"Equals","indexQuestionId":9117,"indexValue":0,"indexValueDataType":"NUMBER","instrumentId":317,"instrumentQuestionId":9117,"instrumentRule
Id":513,"messageText":null,"skippedQuestion":[{"id":2007,"instrumentId":317,"questionId":9118,"ruleId":407},{"id":2008,"instrumentId":317,"questionId":9119,"ruleId":407},{"id":2009,"instrumentId":317,"questionId":9120,"ruleId":407},{"id":20
10,"instrumentId":317,"questionId":9121,"ruleId":407},{"id":2011,"instrumentId":317,"questionId":9122,"ruleId":407},{"id":2012,"instrumentId":317,"questionId":9123,"ruleId":407},{"id":2013,"instrumentId":317,"questionId":9124,"ruleId":407}]
liquor (1.5 oz.) or 12-ounce\r\n| can\/bottle of beer or 5-ounce glass of wine.]\r\n| <*Answer_9095*>\r\n| \r\n| 3. Since the last session, how many days did you use any illegal or\r\n| street drugs or abuse any prescrip
,"targetOperator":null,"targetQuestionId":null,"targetValue":null,"targetValueDataType":null}],"scaleGroup":[{"grid1":0,"grid2":0,"grid3":0,"id":373,"instrument":317,"name":"Clinical Subscales","ordInc":10,"ordMax":184,"ordMin":0,"ordTitle"
:"Score","scale":[{"groupId":373,"id":1506,"name":"Use","sequence":1,"xLabel":"Use"},{"groupId":373,"id":1507,"name":"Risk Factors","sequence":2,"xLabel":"Risk"},{"groupId":373,"id":1508,"name":"Protective Factors","sequence":3,"xLabel":"Pr
ote"}],"sequence":1},{"grid1":0,"grid2":0,"grid3":0,"id":374,"instrument":317,"name":"Use Items","ordInc":5,"ordMax":31,"ordMin":0,"ordTitle":"Days","scale":[{"groupId":374,"id":1509,"name":"Days Alcohol Use","sequence":1,"xLabel":"Alcoh"},
{"groupId":374,"id":1510,"name":"Days Heavy Alcohol Use","sequence":2,"xLabel":"Heavy"},{"groupId":374,"id":1511,"name":"Days Other Drug Use","sequence":3,"xLabel":"Drug"}],"sequence":2},{"grid1":0,"grid2":0,"grid3":0,"id":375,"instrument":
317,"name":"Risk Items","ordInc":5,"ordMax":31,"ordMin":0,"ordTitle":"Days\/Score","scale":[{"groupId":375,"id":1512,"name":"Physical Health","sequence":1,"xLabel":"Heal"},{"groupId":375,"id":1513,"name":"Days Sleep Problems","sequence":2,"
xLabel":"Sleep"},{"groupId":375,"id":1514,"name":"Days Distressed","sequence":3,"xLabel":"Distr"},{"groupId":375,"id":1515,"name":"Urges, Cravings","sequence":4,"xLabel":"Urges"},{"groupId":375,"id":1516,"name":"Days Risky Situations","sequ
ence":5,"xLabel":"Risky"},{"groupId":375,"id":1517,"name":"Relationship Problems","sequence":6,"xLabel":"Relat"}],"sequence":3},{"grid1":0,"grid2":0,"grid3":0,
"id":376,"instrument":317,"name":"Protective Items","ordInc":5,"ordMax":31,"ordMin":0,"ordTitle":"Days\/Score","scale":[{"groupId":376,"id":1518,"name":"Confidence in No Use","sequence":1,"xLabel":"Confi"},{"groupId":376,"id":1519,"name":"D
ays Self-help","sequence":2,"xLabel":"Self"},{"groupId":376,"id":1520,"name":"Spiritual Supportive","sequence":3,"xLabel":"Spiri"},{"groupId":376,"id":1521,"name":"Days Work\/School","sequence":4,"xLabel":"Work"},{"groupId":376,"id":1522,"n
ame":"Adequate Income","sequence":5,"xLabel":"Incom"},{"groupId":376,"id":1523,"name":"Days Supportive Persons","sequence":6,"xLabel":"Sup"}],"sequence":4}],"spec":{"entryChecksum":3915208716,"entrySpec":"{\"name\": \"BAM-R-CSG-SUD\", \r\n
tion medications?\r\n| <*Answer_9096*>\r\n| \r\n| 4. Since the last session, how many days did you use any of the following\r\n| drugs: \r\n|\r\n| 4A. Marijuana (cannabis, pot, weed)?\r\n| <*Answer_9097*>\r\n|
\"restartDays\": 7, \r\n \"printTitle\": \"Brief Addiction Monitor - Revised for CSG-SUD (BAM-R-CSG-SUD)\", \r\n \"content\":[\r\n {\"id\": \"q9104\", \"type\": \"DateQuestion\", \"required\": false, \"inline\": true, \r\n \"text\": \"
A. Date of administration:\", \r\n \"controlWidth\": 120}, \r\n {\"id\": \"q9105\", \"type\": \"ChoiceQuestion\", \"required\": false, \"inline\": true, \r\n \"text\": \"B. Method of administration:\", \r\n \"columns\": 3, \r\n
\"choices\":[\r\n {\"id\": \"c2418\", \"text\": \"1. Clinician Interview\", \"quickKey\": 1}, \r\n {\"id\": \"c2419\", \"text\": \"2. Self Report\", \"quickKey\": 2}, \r\n {\"id\": \"c2420\", \"text\": \"3. Phone\", \"quickKey
\": 3}\r\n ]}, \r\n {\"id\": \"i1096\", \"type\": \"IntroText\", \r\n \"text\": \"Instructions<br \/>This is a standard set of questions about several areas of your\r\n life such as your health, alcohol and drug use, etc. The questio
ns generally ask\r\n about the past 30 days. Please consider each question and answer as accurately\r\n as possible.<br \/> \"\r\n }, \r\n {\"id\": \"q9106\", \"type\": \"ChoiceQuestion\", \"required\": false, \"inline\": true, \r\n
\"text\": \"1. In the past 30 days, how would you say your physical health has been?\", \r\n \"intro\": \"Instructions<br \/>This is a standard set of questions about several areas of your\r\n life such as your health, alcohol and drug
use, etc. The questions generally ask\r\n about the past 30 days. Please consider each question and answer as accurately\r\n as possible.<br \/> \", \r\n \"columns\": 2, \r\n \"choices\":[\r\n {\"id\": \"c1059\", \"text\": \"0.
Excellent\", \"quickKey\": 0}, \r\n {\"id\": \"c1060\", \"text\": \"1. Very good\", \"quickKey\": 1}, \r\n {\"id\": \"c1061\", \"text\": \"2. Good\", \"quickKey\": 2}, \r\n {\"id\": \"c1062\", \"text\": \"3. Fair\", \"quickKey\"
: 3}, \r\n {\"id\": \"c1063\", \"text\": \"4. Poor\", \"quickKey\": 4}\r\n ]}, \r\n {\"id\": \"q9113\", \"type\": \"IntegerQuestion\", \"required\": false, \r\n \"text\": \"2. In the past 30 days, how many nights did you have tro
uble falling asleep or\r\n staying asleep?\", \r\n \"intro\": \"Instructions<br \/>This is a standard set of questions about several areas of your\r\n life such as your health, alcohol and drug use, etc. The questions generally ask\r\n a
\r\n| 4B. Sedatives and\/or Tranquilizers (benzos, Valium, Xanax, Ativan, \r\n| Ambien, barbs, Phenobarbital, downers, etc.)?\r\n| <*Answer_9098*>\r\n| \r\n| 4C. Cocaine and\/or Crack?\r\n| <*Answe
bout the past 30 days. Please consider each question and answer as accurately\r\n as possible.<br \/> \", \r\n \"controlWidth\": 60, \"min\": 0, \"max\": 30}, \r\n {\"id\": \"q9114\", \"type\": \"IntegerQuestion\", \"required\": false
, \r\n \"text\": \"3. In the past 30 days, how many days have you felt depressed, anxious, angry or\r\n very upset throughout most of the day?\", \r\n \"intro\": \"Instructions<br \/>This is a standard set of questions about several a
reas of your\r\n life such as your health, alcohol and drug use, etc. The questions generally ask\r\n about the past 30 days. Please consider each question and answer as accurately\r\n as possible.<br \/> \", \r\n \"controlWidth\": 60,
\"min\": 0, \"max\": 30}, \r\n {\"id\": \"q9115\", \"type\": \"IntegerQuestion\", \"required\": false,
\r\n \"text\": \"4. In the past 30 days, how many days did you drink ANY alcohol?\", \r\n \"intro\": \"Instructions<br \/>This is a standard set of questions about several areas of your\r\n life such as your health, alcohol and drug u
se, etc. The questions generally ask\r\n about the past 30 days. Please consider each question and answer as accurately\r\n as possible.<br \/> \", \r\n \"controlWidth\": 60, \"min\": 0, \"max\": 30}, \r\n {\"id\": \"q9116\", \"type\"
: \"IntegerQuestion\", \"required\": false, \r\n \"text\": \"5A. In the past 30 days, how many days did you have at least 5 drinks (if you are\r\n a man) or at least 4 drinks (if you are a woman)? [One drink is considered one\r\n shot o
f hard liquor (1.5 oz.) or 12-ounce can\/bottle of beer or 5-ounce glass of\r\n wine.]\", \r\n \"intro\": \"Instructions<br \/>This is a standard set of questions about several areas of your\r\n life such as your health, alcohol and drug
use, etc. The questions generally ask\r\n about the past 30 days. Please consider each question and answer as accurately\r\n as possible.<br \/> \", \r\n \"controlWidth\": 60, \"min\": 0, \"max\": 30}, \r\n {\"id\": \"q9129\", \"type
\": \"IntegerQuestion\", \"required\": false, \r\n \"text\": \"5B. In the past 30 days, on the days that you consumed alcohol, what was the\r\n average number of drinks you consumed on those days?\", \r\n \"intro\": \"Instructions<br
r_9099*>\r\n| \r\n| 4D. Other Stimulants (e.g., amphetamine, methamphetamine, Dexedrine,\r\n| Ritalin, Adderall, \"speed\", \"crystal meth\", \"ice\", etc.)?\r\n| <*Answer_9100*>\r\n| \r\n| 4E. Opiates (H
\/>This is a standard set of questions about several areas of your\r\n life such as your health, alcohol and drug use, etc. The questions generally ask\r\n about the past 30 days. Please consider each question and answer as accurately\r\n a
s possible.<br \/> \", \r\n \"controlWidth\": 60, \"min\": 0, \"max\": 999}, \r\n {\"id\": \"q9130\", \"type\": \"IntegerQuestion\", \"required\": false, \r\n \"text\": \"5C. In the past 30 days, on the days that you consumed alcoh
ol, what was the\r\n highest number of drinks you consumed in one day?\", \r\n \"intro\": \"Instructions<br \/>This is a standard set of questions about several areas of your\r\n life such as your health, alcohol and drug use, etc. The q
uestions generally ask\r\n about the past 30 days. Please consider each question and answer as accurately\r\n as possible.<br \/> \", \r\n \"controlWidth\": 60, \"min\": 0, \"max\": 999}, \r\n {\"id\": \"q9117\", \"type\": \"IntegerQu
estion\", \"required\": false, \r\n \"text\": \"6. In the past 30 days, how many days did you use any illegal or street drugs or\r\n abuse any prescription medications?\", \r\n \"intro\": \"Instructions<br \/>This is a standard set of
questions about several areas of your\r\n life such as your health, alcohol and drug use, etc. The questions generally ask\r\n about the past 30 days. Please consider each question and answer as accurately\r\n as possible.<br \/> \", \r\n
\"controlWidth\": 60, \"min\": 0, \"max\": 30}, \r\n {\"id\": \"i1097\", \"type\": \"IntroText\", \r\n \"text\": \"7. In the past 30 days, how many days did you use any of the following drugs: \"\r\n }, \r\n {\"id\": \"q9118\
", \"type\": \"IntegerQuestion\", \"required\": false, \r\n \"text\": \"7A. Marijuana (cannabis, pot, weed)?\", \r\n \"intro\": \"7. In the past 30 days, how many days did you use any of the following drugs: \", \r\n \"controlWidt
h\": 60, \"min\": 0, \"max\": 30}, \r\n {\"id\": \"q9119\", \"type\": \"IntegerQuestion\", \"required\": false, \r\n \"text\": \"7B. Sedatives and\/or Tranquilizers (benzos, Valium, Xanax, Ativan, Ambien, barbs,\r\n Phenobarbital, down
ers, etc.)?\", \r\n \"intro\": \"7. In the past 30 days, how many days did you use any of the following drugs: \", \r\n \"controlWidth\": 60, \"min\": 0, \"max\": 30}, \r\n {\"id\": \"q9120\", \"type\": \"IntegerQuestion\", \"requi
eroin, Morphine, Dilaudid, Demerol, Oxycontin, oxy, \r\n| codeine (Tylenol 2,3,4), Percocet, Vicodin, Fentanyl, etc.)?\r\n| <*Answer_9101*>
red\": false, \r\n \"text\": \"7C. Cocaine and\/or Crack?\",
\r\n \"intro\": \"7. In the past 30 days, how many days did you use any of the following drugs: \", \r\n \"controlWidth\": 60, \"min\": 0, \"max\": 30}, \r\n {\"id\": \"q9121\", \"type\": \"IntegerQuestion\", \"required\": false, \
r\n \"text\": \"7D. Other Stimulants (amphetamine, methamphetamine, Dexedrine, Ritalin, Adderall,\r\n speed, crystal meth, ice, etc.)?\", \r\n \"intro\": \"7. In the past 30 days, how many days did you use any of the following drugs:
\", \r\n \"controlWidth\": 60, \"min\": 0, \"max\": 30}, \r\n {\"id\": \"q9122\", \"type\": \"IntegerQuestion\", \"required\": false, \r\n \"text\": \"7E. Opiates (Heroin, Morphine, Dilaudid, Demerol, Oxycontin, oxy, codeine\r\n (T
ylenol 2,3,4), Percocet, Vicodin, Fentanyl, etc.)?\", \r\n \"intro\": \"7. In the past 30 days, how many days did you use any of the following drugs: \", \r\n \"controlWidth\": 60, \"min\": 0, \"max\": 30}, \r\n {\"id\": \"q9123\",
\"type\": \"IntegerQuestion\", \"required\": false, \r\n \"text\": \"7F. Inhalants (glues, adhesives, nail polish remover, paint thinner, etc.)?\", \r\n \"intro\": \"7. In the past 30 days, how many days did you use any of the follow
ing drugs: \", \r\n \"controlWidth\": 60, \"min\": 0, \"max\": 30}, \r\n {\"id\": \"q9124\", \"type\": \"IntegerQuestion\", \"required\": false, \r\n \"text\": \"7G. Other drugs (steroids, non-prescription sleep and diet pills, Ben
adryl,\r\n Ephedra, other over-the-counter or unknown medications)?\", \r\n \"intro\": \"7. In the past 30 days, how many days did you use any of the following drugs: \", \r\n \"controlWidth\": 60, \"min\": 0, \"max\": 30}, \r\n {\
"id\": \"q9107\", \"type\": \"ChoiceQuestion\", \"required\": false, \"inline\": true, \r\n \"text\": \"8. In the past 30 days, how much were you bothered by cravings or urges to drink\r\n alcohol or use drugs?\", \r\n \"intro\": \"7.
In the past 30 days, how many days did you use any of the following drugs: \", \r\n \"columns\": 2, \r\n \"choices\":[\r\n {\"id\": \"c212\", \"text\": \"0. Not at all\", \"quickKey\": 0}, \r\n {\"id\": \"c717\", \"text\": \
\r\n| \r\n| 4F. Inhalants (glues, adhesives, nail polish remover, paint thinner,\r\n| etc.)?\r\n| <*Answer_9102*>\r\n| \r\n| 4G. Other drugs (steroids, non-prescription sleep and diet pills,\r\n|
"1. Slightly\", \"quickKey\": 1}, \r\n {\"id\": \"c685\", \"text\": \"2. Moderately\", \"quickKey\": 2}, \r\n {\"id\": \"c2312\", \"text\": \"3. Considerably\", \"quickKey\": 3}, \r\n {\"id\": \"c687\", \"text\": \"4. Extremely\
", \"quickKey\": 4}\r\n ]}, \r\n {\"id\": \"q9108\", \"type\": \"ChoiceQuestion\", \"required\": false, \"inline\": true, \r\n \"text\": \"9. How confident are you that you will NOT use alcohol and drugs in the next 30\r\n days?\", \
r\n \"intro\": \"7. In the past 30 days, how many days did you use any of the following drugs: \", \r\n \"columns\": 2, \r\n \"choices\":[\r\n {\"id\": \"c212\", \"text\": \"0. Not at all\", \"quickKey\": 0}, \r\n {\"id\":
\"c717\", \"text\": \"1. Slightly\", \"quickKey\": 1}, \r\n {\"id\": \"c685\", \"text\": \"2. Moderately\", \"quickKey\": 2}, \r\n {\"id\": \"c2312\", \"text\": \"3. Considerably\", \"quickKey\": 3}, \r\n {\"id\": \"c687\", \"t
ext\": \"4. Extremely\", \"quickKey\": 4}\r\n ]}, \r\n {\"id\": \"q9125\", \"type\": \"IntegerQuestion\", \"required\": false, \r\n \"text\": \"10. In the past 30 days, how many days did you attend self-help meetings like AA\r\n or N
A to support your recovery?\", \r\n \"intro\": \"7. In the past 30 days, how many days did you use any of the following drugs: \", \r\n \"controlWidth\": 60, \"min\": 0, \"max\": 30}, \r\n {\"id\": \"q9126\", \"type\": \"IntegerQue
stion\", \"required\": false, \r\n \"text\": \"11. In the past 30 days, how many days were you in any situations or with any\r\n people that might put you at an increased risk for using alcohol or drugs (i.e.,\r\n around risky \\u0022peo
ple, places or things\\u0022)?\", \r\n \"intro\": \"7. In the past 30 days, how many days did you use any of the following drugs: \",
\r\n \"controlWidth\": 60, \"min\": 0, \"max\": 30}, \r\n {\"id\": \"q9109\", \"type\": \"ChoiceQuestion\", \"required\": false, \"inline\": true, \r\n \"text\": \"12. Does your religion or spirituality help support your recovery?\"
, \r\n \"intro\": \"7. In the past 30 days, how many days did you use any of the following drugs: \", \r\n \"columns\": 2, \r\n \"choices\":[\r\n {\"id\": \"c212\", \"text\": \"0. Not at all\", \"quickKey\": 0}, \r\n {\"id
94,"questionText":"Since the last session, how many days did you drink ANY alcohol?","required":false,"responseTypeId":2,"responseTypeText":"INTEGER","sequence":40},{"choiceDisplay":57153,"choiceTypeId":null,"designator":"2.","hint":null,"i
Benadryl, Ephedra, other over-the-counter or unknown medications)?\r\n| <*Answer_9103*>\r\n| \r\n| \r\n| Information contained in this note is based on a self-report assessment\r\n and is not sufficient to use alone for diag
\": \"c717\", \"text\": \"1. Slightly\", \"quickKey\": 1}, \r\n {\"id\": \"c685\", \"text\": \"2. Moderately\", \"quickKey\": 2}, \r\n {\"id\": \"c2312\", \"text\": \"3. Considerably\", \"quickKey\": 3}, \r\n {\"id\": \"c687\",
\"text\": \"4. Extremely\", \"quickKey\": 4}\r\n ]}, \r\n {\"id\": \"q9127\", \"type\": \"IntegerQuestion\", \"required\": false, \r\n \"text\": \"13. In the past 30 days, how many days did you spend much of the time at work,\r\n sch
ool, or doing volunteer work?\", \r\n \"intro\": \"7. In the past 30 days, how many days did you use any of the following drugs: \", \r\n \"controlWidth\": 60, \"min\": 0, \"max\": 30}, \r\n {\"id\": \"q9110\", \"type\": \"ChoiceQu
estion\", \"required\": false, \"inline\": true, \r\n \"text\": \"14. Do you have enough income (from legal sources) to pay for necessities such as\r\n housing, transportation, food and clothing for yourself and your dependents?\", \r\n
\"intro\": \"7. In the past 30 days, how many days did you use any of the following drugs: \", \r\n \"columns\": 2, \r\n \"choices\":[\r\n {\"id\": \"c237\", \"text\": \"0. No\", \"quickKey\": 0}, \r\n {\"id\": \"c241\", \
"text\": \"1. Yes\", \"quickKey\": 1}\r\n ]}, \r\n {\"id\": \"q9111\", \"type\": \"ChoiceQuestion\", \"required\": false, \"inline\": true, \r\n \"text\": \"15. In the past 30 days, how much have you been bothered by arguments or pro
blems\r\n getting along with any family members or friends?\", \r\n \"intro\": \"7. In the past 30 days, how many days did you use any of the following drugs: \", \r\n \"columns\": 2, \r\n \"choices\":[\r\n {\"id\": \"c212\",
\"text\": \"0. Not at all\", \"quickKey\": 0}, \r\n {\"id\": \"c717\", \"text\": \"1. Slightly\", \"quickKey\": 1}, \r\n {\"id\": \"c685\", \"text\": \"2. Moderately\", \"quickKey\": 2}, \r\n {\"id\": \"c2312\", \"text\": \"3. C
onsiderably\", \"quickKey\": 3}, \r\n {\"id\": \"c687\", \"text\": \"4. Extremely\", \"quickKey\": 4}\r\n ]}, \r\n {\"id\": \"q9128\", \"type\": \"IntegerQuestion\", \"required\": false, \r\n \"text\": \"16. In the past 30 days,
how many days did you contact or spend time with any\r\n family members or friends who are supportive of your recovery?\", \r\n \"intro\": \"7. In the past 30 days, how many days did you use any of the following drugs: \", \r\n \"con
nostic purposes. Assessment\r\n results should be verified for accuracy and used in conjunction with other\r\n diagnostic activities and procedures."},"rule":[{"booleanOperator":"AND","consistencyCheck":null,"id":404,"indexOperator":"Equal
trolWidth\": 60, \"min\": 0, \"max\": 30}, \r\n {\"id\": \"q9112\", \"type\": \"ChoiceQuestion\", \"required\": false, \"inline\": true, \r\n \"text\": \"17. How satisfied are you with your progress toward achieving your recovery\r\n g
oals?\", \r\n \"intro\": \"7. In the past 30 days, how many days did you use any of the following drugs: \", \r\n \"columns\": 2, \r\n \"choices\":[\r\n {\"id\": \"c212\", \"text\": \"0. Not at all\", \"quickKey\": 0}, \r\n
{\"id\": \"c717\", \"text\": \"1. Slightly\", \"quickKey\": 1}, \r\n {\"id\": \"c685\", \"text\": \"2. Moderately\", \"quickKey\": 2}, \r\n {\"id\": \"c2312\", \"text\": \"3. Considerably\", \"quickKey\": 3}, \r\n {\"id\": \"c
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tor\": \"EQ\", \"value\": 0, \r\n \"skips\":[\"q9118\",\"q9119\",\"q9120\",\"q9121\",\"q9122\",\"q9123\",\"q9124\"]}]\r\n}","instrument":317,"lastUpdate":
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],"targetOperator":null,"targetQuestionId":null,"targetValue":null,"targetValueDataType":null},{"booleanOperator":"AND","consistencyCheck":null,"id":405,"indexOperator":"Equals","indexQuestionId":9096,"indexValue":0,"indexValueDataType":"NU
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id":2001,"instrumentId":316,"questionId":9099,"ruleId":405},{"id":2002,"instrumentId":316,"questionId":9100,"ruleId":405},{"id":2003,"instrumentId":316,"questionId":9101,"ruleId":405},{"id":2004,"instrumentId":316,"questionId":9102,"ruleId"
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"},{"groupId":372,"id":1505,"name":"Days Other Drug Use","sequence":3,"xLabel":"Drug"}],"sequence":1}],"spec":{"entryChecksum":4120097029,"entrySpec":"{\"name\": \"BAM-C-CBT-SUD\", \r\n \"restartDays\": 7, \r\n \"printTitle\": \"Brief Addic
tion Monitor - Consumption Items for CBT-SUD (BAM-C-CBT-SUD)\", \r\n \"content\":[\r\n {\"id\": \"q9092\", \"type\": \"DateQuestion\", \"required\": false, \"inline\": true, \r\n \"text\": \"A. Date of administration:\", \r\n \"cont
d":9160,"instrument":316,"introDisplay":57149,"introId":2527,"introText":"Instructions\r\n|This is a standard set of questions about alcohol and drug use since the last session. Please\r\n answer the requested items as accurately as possibl
rolWidth\": 120}, \r\n {\"id\": \"q9093\", \"type\": \"ChoiceQuestion\", \"required\": false, \"inline\": true, \r\n \"text\": \"B. Method of administration:\", \r\n \"columns\": 3, \r\n \"choices\":[\r\n {\"id\": \"c2418\",
\"text\": \"1. Clinician Interview\", \"quickKey\": 1}, \r\n {\"id\": \"c2419\", \"text\": \"2. Self Report\", \"quickKey\": 2}, \r\n {\"id\": \"c2420\", \"text\": \"3. Phone\", \"quickKey\": 3}\r\n ]}, \r\n {\"id\": \"i2527\",
\"type\": \"IntroText\", \r\n \"text\": \"Instructions <br \/>This is a standard set of questions about alcohol and drug use\r\n since the last session. Please answer the requested items as accurately as\r\n possible and indicate the met
hod of assessment in item B above. <br \/>\"\r\n }, \r\n {\"id\": \"q9094\", \"type\": \"IntegerQuestion\", \"required\": false, \r\n \"text\": \"1. Since the last session, how many days did you drink ANY alcohol?\", \r\n \"intro
\": \"Instructions <br \/>This is a standard set of questions about alcohol and drug use\r\n since the last session. Please answer the requested items as accurately as\r\n possible and indicate the method of assessment in item B above. <br
\/>\", \r\n \"controlWidth\": 60, \"min\": 0, \"max\": 30}, \r\n {\"id\": \"q9095\", \"type\": \"IntegerQuestion\", \"required\": false,
\r\n \"text\": \"2. Since the last session, how many days did you have at least 5 drinks (if you\r\n are a man) or at least 4 drinks (if you are a woman)? [One drink is considered\r\n one shot of hard liquor (1.5 oz.) or 12-ounce can\/b
ottle of beer or 5-ounce\r\n glass of wine.]\", \r\n \"intro\": \"Instructions <br \/>This is a standard set of questions about alcohol and drug use\r\n since the last session. Please answer the requested items as accurately as\r\n possi
ble and indicate the method of assessment in item B above. <br \/>\", \r\n \"controlWidth\": 60, \"min\": 0, \"max\": 30}, \r\n {\"id\": \"q9096\", \"type\": \"IntegerQuestion\", \"required\": false, \r\n \"text\": \"3. Since the la
st session, how many days did you use any illegal or street drugs\r\n or abuse any prescription medications?\", \r\n \"intro\": \"Instructions <br \/>This is a standard set of questions about alcohol and drug use\r\n since the last sessi
e and indicate the method of assessment\r\n in item B above. |","max":30,"min":0,"questionDisplay":57152,"questionId":9095,"questionText":"Since the last session, how many days did you have at least 5 drinks (if you are a man) or at least 4
on. Please answer the requested items as accurately as\r\n possible and indicate the method of assessment in item B above. <br \/>\", \r\n \"controlWidth\": 60, \"min\": 0, \"max\": 30}, \r\n {\"id\": \"i2528\", \"type\": \"IntroText\"
, \r\n \"text\": \"4. Since the last session, how many days did you use any of the following drugs: \"\r\n }, \r\n {\"id\": \"q9097\", \"type\": \"IntegerQuestion\", \"required\": false, \r\n \"text\": \"4A. Marijuana (cannabis,
pot, weed)?\", \r\n \"intro\": \"4. Since the last session, how many days did you use any of the following drugs: \", \r\n \"controlWidth\": 60, \"min\": 0, \"max\": 30}, \r\n {\"id\": \"q9098\", \"type\": \"IntegerQuestion\", \"req
uired\": false, \r\n \"text\": \"4B. Sedatives and\/or Tranquilizers (benzos, Valium, Xanax, Ativan, Ambien, barbs,\r\n Phenobarbital, downers, etc.)?\", \r\n \"intro\": \"4. Since the last session, how many days did you use any of th
e following drugs: \", \r\n \"controlWidth\": 60, \"min\": 0, \"max\": 30}, \r\n {\"id\": \"q9099\", \"type\": \"IntegerQuestion\", \"required\": false, \r\n \"text\": \"4C. Cocaine and\/or Crack?\", \r\n \"intro\": \"4. Since th
e last session, how many days did you use any of the following drugs: \", \r\n \"controlWidth\": 60, \"min\": 0, \"max\": 30}, \r\n {\"id\": \"q9100\", \"type\": \"IntegerQuestion\", \"required\": false, \r\n \"text\": \"4D. Other S
timulants (amphetamine, methamphetamine, Dexedrine, Ritalin, Adderall,\r\n speed, crystal meth, ice, etc.)?\", \r\n \"intro\": \"4. Since the last session, how many days did you use any of the following drugs: \", \r\n \"controlWidth\
": 60, \"min\": 0, \"max\": 30}, \r\n {\"id\": \"q9101\", \"type\": \"IntegerQuestion\", \"required\": false, \r\n \"text\": \"4E. Opiates (Heroin, Morphine, Dilaudid, Demerol, Oxycontin, oxy, codeine\r\n (Tylenol 2,3,4), Percocet, Vic
odin, Fentanyl, etc.)?\", \r\n \"intro\": \"4. Since the last session, how many days did you use any of the following drugs: \", \r\n \"controlWidth\": 60, \"min\": 0, \"max\": 30}, \r\n {\"id\": \"q9102\", \"type\": \"IntegerQuesti
on\", \"required\": false, \r\n \"text\": \"4F. Inhalants (glues, adhesives, nail polish remover, paint thinner, etc.)?\", \r\n \"intro\": \"4. Since the last session, how many days did you use any of the following drugs: \", \r\n
|
