Data Structure
Substance Use Monthly Form
Version 01780 Shared Subjects
Short Name: subusmf01
Data Type: Clinical Assessments
Categories: Substance Use
No description.
Name, Type, Required, Description, Value Range, Notes
Name | Type | Required | Description | Value Range | Notes |
|---|---|---|---|---|---|
| subjectkey | GUID | Required | The NDAR Global Unique Identifier (GUID) for research subject | NDAR* | |
| src_subject_id | String | Required | Subject ID how it's defined in lab/project | ||
| interview_date | Date | Required | Date on which the interview/genetic test/sampling/imaging/biospecimen was completed. MM/DD/YYYY | ||
| interview_age | Integer | Required | Age in months at the time of the interview/test/sampling/imaging. | 0::1440 | Age is rounded to chronological month. If the research participant is 15-days-old at time of interview, the appropriate value would be 0 months. If the participant is 16-days-old, the value would be 1 month. |
| sex | String | Required | Sex of subject at birth | M;F; O; NR | M = Male; F = Female; O=Other; NR = Not reported |
| monthsbl | Float | Recommended | Actual number of months from Baseline | ||
| days_baseline | Integer | Recommended | Days since baseline | ||
| subus25 | Integer | Recommended | Does the client currently use alcohol? | 1;0 | 1=Yes; 0=No |
| subus26 | Integer | Recommended | If client currently uses alcohol, number of drinks/week | ||
| subus27 | Integer | Recommended | If currently using alcohol, has client tried to cut back or stop drinking? | 1;0 | 1=Yes; 0=No |
| ca824 | Integer | Recommended | Lifetime history - Marijuana: Currently abuses the substance - current use | 0;1 | 0=No; 1=Yes |
| subus29 | Integer | Recommended | If not currently using marijuana, has the client used marijuana in the past? | 1;0 | 1=Yes; 0=No |
| subus30 | Integer | Recommended | Does the client currently use any other recreational drugs? | 1;0 | 1=Yes; 0=No |
| subus31 | String | Recommended | Specify other recreational drugs | ||
| scid21 | Integer | Recommended | 21. Have you ever been treated as an outpatient or hospitalized for drugs or alcohol problems | 0;1; 999 | 0 = No; 1 = Yes; 999 = Legitimately Skipped |
| subus33 | Integer | Recommended | Age at first treatment or hospitalization for substance use (in years) | ||
| subtr4 | Integer | Recommended | In the past 30 days, did you spend the night in a substance use program? | 1;0 | 1=Yes; 0=No |
| night | Integer | Recommended | 3c. Total Number of Nights in Past Month | ||
| subtr4b | Integer | Recommended | Provider code of program | ||
| subtr50 | Integer | Recommended | In the past 30 days, did you receive any alcohol or drug counseling? | 0;1 | 1=Yes; 0=No |
| outvisit | Integer | Recommended | outpatient number of visits | ||
| subtr50b | Integer | Recommended | Average duration of this type of visit | ||
| subus66 | Integer | Recommended | In the past 30 days, how many days have you used any alcohol at all? | ||
| surq_1e | Integer | Recommended | In the past 30, what is your best estimate for the number of days you got drunk or "very, very high" on alcohol | -99 = Not answered | |
| surq_3a | Integer | Recommended | In the past 30 days, what is your best estimate as to how many days you used marijuana | ||
| frquency_other | Integer | Recommended | Think specifically about the past 30 days, including today. During the past 30 days, on how many days did you use any other medicines or drugs or substances? PX031301_Frequency_Other | 0::31;-5; -9; -999 | Number of days; -5= Item seen but not answered; -9= Item skipped by show-if logic; -999= Data not submitted (incomplete, item not seen) |
| subus70 | Integer | Recommended | In the past 30 days, how many days have you used prescription medications that were not prescribed for you? | ||
| visit | String | Recommended | Visit name | ||
| alcmj01 | Integer | Recommended | On how many occasions (if any) during the last 30 days have you used alcohol and marijuana at the same time?that is, so that their effects overlapped? | 0::100 | |
| auti_02 | Integer | Recommended | [baseline only] In the 30 days before you became pregnant, how often did you usually have any kind of drink containing alcohol? [all other timepoints] In the past 30 days, how often did you usually have any kind of drink containing alcohol? | 0::7 | 0 = Never; 1 = Once; 2 = 2 to 3 times; 3 = Once a week; 4 = Twice a week; 5 = 3 to 4 days a week; 6 = 5 to 6 days a week; 7 = Everyday |
| auti_03 | Integer | Recommended | On the days that you drank alcohol, how many standard drinks did you normally have? | 1::10; 77 | 1 = 1 drink; 2 = 2 drinks; 3 = 3 drinks; 4 = 4 drinks; 5 = 5 to 7 drinks; 6 = 8 to 11 drinks; 7 = 12 to 17 drinks; 8 = 18 to 23 drinks; 9 = 24 to 35 drinks; 10 = 36 drinks or more; 77 = Prefer not to answer |
| auti_04 | Integer | Recommended | [Baseline only] Please indicate how many times you tried to quit using alcohol in the 30 days before you became pregnant. [all timepoints, including baseline] Please indicate how many times you tried to quit using alcohol in the past 30 days. | 0::6 | 0 = Never; 1 = Once; 2 = Two or three times; 3 = Four to six times; 4 = Seven to nine times; 5 = Ten to twelve times; 6 = More than twelve times |
| auti_05 | Integer | Recommended | [Baseline only] Please indicate which services you have used in the past 30 days. [all other timepoints] Please indicate which services you have used since we last spoke on <date>. | 0::9 | 0 = None; 1 = Talked with a substance use counselor; 2 = Talked with another type of counselor for my alcohol use; 3 = Day treatment or partial day treatment; 4 = Residential (live-in) treatment; 5 = Hospitalization for alcohol use; 6 = 12 step meetings, like Alcoholics Anonymous; 7= Called the United Way 2-1-1 hotline to find help for my alcohol use; 8 = Called the SAMHSA National Helpline 1-800-662-HELP (4357); 9 = Used the online National Treatment Locator (SAMHSA) |
| auti_06 | Integer | Recommended | [Baseline only] Please indicate whether or not you talked to a doctor, nurse, or other medical provider about your alcohol use in the past 30 days. Check all that apply. [all other timepoints] Please indicate whether or not you talked to a doctor, nurse, or other medical provider about your alcohol use since we last spoke on <date>. Check all that apply. | 0::3 | 0 = None; 1 = Yes, with my doctor; 2 = Yes, with my nurse; 3 = Yes, with another medical provider |
| auti_07 | Integer | Recommended | Please indicate whether or not you talked to a doctor, nurse, or other medical provider about your alcohol use - If any checked, who initiated the conversation? | 0::2 | 0 = I did; 1 = My medical provider; 2 = We both did |
| auti_08 | Integer | Recommended | Please indicate whether or not you talked to a doctor, nurse, or other medical provider about your alcohol use - If any checked, how many times have any health professionals talked with you about alcohol during this pregnancy? | 0::4 | 0 = None; 1 = 1; 2 = 2; 3 = 3; 4 = 4 or more |
| drugs30_heroin | Integer | Recommended | In the past 30 days, how many days have you used Heroin? For example smack, black tar, poppy, opium (including fentanyl) | ||
| drugs30_painkillers | Integer | Recommended | In the past 30 days, how many days have you used Painkillers? For example methadone, codeine, Demerol, Vicodin, OxyContin, oxy, Percocet, Dilaudid, Percodan, or morphine |