PHI stands for "Protected Health Information" (Y = Yes, N = No)
| Display | Field | Phi | Field type | Condition choices | Field note | Header | |
|---|---|---|---|---|---|---|---|
| 1. How often do you have a drink containing alcohol or use other drugs (e.g., marijuana, cocaine, narcotics)? | audit_1 | N | radio | 0, Never | 1, Less than monthly | 2, At least monthly | - | This questionnaire asks you some questions about your use of alcohol and drugs during the past year. Alcoholic beverages include beer, wine, and liquor (vodka, whiskey, brandy, etc). Drugs include cocaine, marijuana, narcotics, and tranquilizers. | |
| Alcohol | audit_1_alcohol | N | radio | 0, Never | 1, Monthly | 2, Weekly | 3, Daily or almost daily | - | <i>If you chose at least monthly</i>: Which of the following do you use at least monthly? | |
| Cocaine | audit_1_cocaine | N | radio | 0, Never | 1, Monthly | 2, Weekly | 3, Daily or almost daily | - | - | |
| Marijuana | audit_1_marijuana | N | radio | 0, Never | 1, Monthly | 2, Weekly | 3, Daily or almost daily | - | - | |
| Tranquilizers | audit_1_tranquilizers | N | radio | 0, Never | 1, Monthly | 2, Weekly | 3, Daily or almost daily | - | - | |
| Other | audit_1_other | N | radio | 0, Never | 1, Monthly | 2, Weekly | 3, Daily or almost daily | - | - | |
| List Other | audit_1_other_text | Y | text | - | - | - | |
| Alcohol | audit_2_alcohol | N | radio | 0, Never Use | 1, 1 or 2 | 2, 3 or 4 | 3, 5 or 6 | 4, 7 to 9 | 5, 10 or more | - | 2. On a day when you drink alcohol or use other drugs, how many drinks (alcohol), lines (cocaine), joints (marijuana), or tranquilizer pills do you use? | |
| Cocaine | audit_2_cocaine | N | radio | 0, Never Use | 1, 1 or 2 | 2, 3 or 4 | 3, 5 or 6 | 4, 7 to 9 | 5, 10 or more | - | - | |
| Marijuana | audit_2_marijuana | N | radio | 0, Never Use | 1, 1 or 2 | 2, 3 or 4 | 3, 5 or 6 | 4, 7 to 9 | 5, 10 or more | - | - | |
| Tranquilizers | audit_2_other | N | radio | 0, Never Use | 1, 1 or 2 | 2, 3 or 4 | 3, 5 or 6 | 4, 7 to 9 | 5, 10 or more | - | - | |
| Others | audit_2_o | N | radio | 0, Never Use | 1, 1 or 2 | 2, 3 or 4 | 3, 5 or 6 | 4, 7 to 9 | 5, 10 or more | - | - | |
| Alcohol | audit_3_alcohol | N | radio | 0, Never | 1, Less than monthly | 2, Monthly | 3, Weekly | 4, Daily or almost daily | - | 3. How often do you have 6 or more drinks, 1 or more joints, 10 or more lines, or 3 or more tranquilizer pills on one occasion? | |
| Other drugs | audit_3_other_drugs | N | radio | 0, Never | 1, Less than monthly | 2, Monthly | 3, Weekly | 4, Daily or almost daily | - | - | |
| Alcohol | audit_4_alcohol | N | radio | 0, Never | 1, Less than monthly | 2, Monthly | 3, Weekly | 4, Daily or almost daily | - | 4. How often during the last year have you found that you were unable to stop drinking or using other drugs once you had started? | |
| Other drugs | audit_4_other_drugs | N | radio | 0, Never | 1, Less than monthly | 2, Monthly | 3, Weekly | 4, Daily or almost daily | - | - | |
| Specify which other drugs you have used | audit_other_note | Y | notes | - | - | - | |
| Alcohol | audit_5_alcohol | N | radio | 0, Never | 1, Less than monthly | 2, Monthly | 3, Weekly | 4, Daily or almost daily | - | 5. How often during the last year have you failed to do what was normally expected from you because of drinking or using other drugs? | |
| Other drugs | audit_5_other_drugs | N | radio | 0, Never | 1, Less than monthly | 2, Monthly | 3, Weekly | 4, Daily or almost daily | - | - | |
| Alcohol | audit_6_alcohol | N | radio | 0, Never | 1, Less than monthly | 2, Monthly | 3, Weekly | 4, Daily or almost daily | - | 6. How often during the last year have you needed a first drink or drug in the morning to get yourself going after a heavy drinking or drug using session? | |
| Other drugs | audit_6_other_drugs | N | radio | 0, Never | 1, Less than monthly | 2, Monthly | 3, Weekly | 4, Daily or almost daily | - | - | |
| Alcohol | audit_7_alcohol | N | radio | 0, Never | 1, Less than monthly | 2, Monthly | 3, Weekly | 4, Daily or almost daily | - | 7. How often during the last year have you had a feeling of guilt or remorse after drinking or using other drugs? | |
| Other drugs | audit_7_other_drugs | N | radio | 0, Never | 1, Less than monthly | 2, Monthly | 3, Weekly | 4, Daily or almost daily | - | - | |
| Alcohol | audit_8_alcohol | N | radio | 0, Never | 1, Less than monthly | 2, Monthly | 3, Weekly | 4, Daily or almost daily | - | 8. How often during the last year have you been unable to remember what happened the night before because you had been drinking or using other drugs? | |
| Other drugs | audit_8_other_drugs | N | radio | 0, Never | 1, Less than monthly | 2, Monthly | 3, Weekly | 4, Daily or almost daily | - | - | |
| Alcohol | audit_9_alcohol | N | radio | 0, Never | 1, Less than monthly | 2, Monthly | 3, Weekly | 4, Daily or almost daily | - | 9. Have you or someone else been injured as the result of your drinking or drug use? | |
| Other drugs | audit_9_other_drugs | N | radio | 0, Never | 1, Less than monthly | 2, Monthly | 3, Weekly | 4, Daily or almost daily | - | - | |
| Alcohol | audit_10_alcohol | N | radio | 0, Never | 1, Less than monthly | 2, Monthly | 3, Weekly | 4, Daily or almost daily | - | 10. Has a relative, friend, doctor or other health worker been concerned about your drinking or drug use or suggested you cut down? | |
| Other drugs | audit_10_other_drugs | N | radio | 0, Never | 1, Less than monthly | 2, Monthly | 3, Weekly | 4, Daily or almost daily | - | - | |
| Notes | audit_notes | Y | notes | - | - | - |