Brief Addiction Monitor (BAM) With Scoring & Clinical Guidelines DRAFT 11/02/2009

Transcription

1 Brief Addictin Mnitr (BAM) With Scring & Clinical Guidelines DRAFT 11/2/29 Participant ID: Interviewer ID (Clinician Initials): Date: Methd f Administratin: Clinician Interview Self Reprt Phne Time Started: : Instructins This is a standard set f questins abut several areas f yur life such as yur health, alchl and drug use, etc. The questins generally ask abut the past 3 days. Please cnsider each questin and answer as accurately as pssible. 1. In the past 3 days, wuld yu say yur physical health has been? Excellent () Very Gd (1) Gd (2) Fair (3) Pr (4) 2. In the past 3 days, hw many nights did yu have truble falling asleep r staying asleep? () 16-3 (4) 3. In the past 3 days, hw many days have yu felt depressed, anxius, angry r very upset thrughut mst f the day? () 16-3 (4) 4. In the past 3 days, hw many days did yu drink ANY alchl? (Skip t #6) () 16-3 (4)

2 . In the past 3 days, hw many days did yu have at least drinks (if yu are a man) r at least 4 drinks (if yu are a wman)? [One drink is cnsidered ne sht f hard liqur (1. z.) r 12- unce can/bttle f beer r unce glass f wine.] () 16-3 (4) 6. In the past 3 days, hw many days did yu use any illegal/street drugs r abuse any prescriptin medicatins? (Skip t #8) () 16-3 (4) 7. In the past 3 days, hw many days did yu use any f the fllwing drugs: 7A. Marijuana (cannabis, pt, weed)? B. Sedatives/Tranquilizers (e.g., benzs, Valium, Xanax, Ativan, Ambien, barbs, Phenbarbital, dwners, etc.)? C. Ccaine/Crack?

3 7D. Other Stimulants (e.g., amphetamine, methamphetamine, Dexedrine, Ritalin, Adderall, speed, "crystal meth", ice, etc.)? E. Opiates (e.g., Herin, Mrphine, Dilaudid, Demerl, Oxycntin, xy, cdeine (Tylenl 2,3,4), Perccet, Vicdin, Fentanyl, etc.)? F. Inhalants (glues/adhesives, nail plish remver, paint thinner, etc.)? G. Other drugs (sterids, nn-prescriptin sleep/diet pills, Benadryl, Ephedra, ther verthe-cunter/unknwn medicatins)? In the past 3 days, hw much were yu bthered by cravings r urges t drink alchl r use drugs? Nt at all () Mderately (2) Cnsiderably (3) 3

4 9. Hw cnfident are yu in yur ability t be cmpletely abstinent (clean) frm alchl and drugs in the next 3 days? Nt at all () Mderately (2) Cnsiderably (3) 1. In the past 3 days, hw many days did yu attend self-help meetings like AA r NA t supprt yur recvery? () 16-3 (4) 11. In the past 3 days, hw many days were yu in any situatins r with any peple that might put yu at an increased risk fr using alchl r drugs (i.e., arund risky peple, places r things )? () 16-3 (4) 12. Des yur religin r spirituality help supprt yur recvery? Nt at all () Mderately (2) Cnsiderably (3) 13. In the past 3 days, hw many days did yu spend much f the time at wrk, schl, r ding vlunteer wrk? () 16-3 (4) 4

5 14. D yu have enugh incme (frm legal surces) t pay fr necessities such as husing, transprtatin, fd and clthing fr yurself and yur dependents? N () Yes (4) 1. In the past 3 days, hw much have yu been bthered by arguments r prblems getting alng with any family members r friends? Nt at all () Mderately (2) Cnsiderably (3) 16. In the past 3 days, hw many days were yu in cntact r spent time with any family members r friends wh are supprtive f yur recvery? () 16-3 (4) 17. Hw satisfied are yu with yur prgress tward achieving yur recvery gals? Nt at all (4) Slightly (3) Mderately (2) Cnsiderably (1) Extremely () Time Finished: :

6 Specific items t attend t, and suggested referrals, include: #1 (health), if scred 3 r 4, refer t primary care #3 (md), if scred 2, 3, r 4, prceed t further assessment and address within SUD specialty care r refer t mental health clinic if indicated #,6,7 (heavy alchl use, any drug use, specific drug use), if any scred 1 r higher, discuss with patient and cnsider adjusting treatment (e.g., higher level f care r changing mdality) #8 (craving), if scred 3 r 4, cnsider medicatin such as Naltrexne #14 (adequate incme), if scred, refer t case management #16 (scial supprt), if scred, 1, r 2 cnsider adding netwrk supprt #17 (satisfactin with prgress), if scred 3 r 4, discuss mdifying r supplementing treatment Nte: Examining scres frm individual items as described abve is the mst clinically relevant use f this measure. Summary scres are mre useful fr aggregating acrss patients. Aggregate scring, r subscale scring, is supplementary and very preliminary, based n clinical judgment rather than empirical data. Preliminary Subscale Scring infrmatin Sum f Items 4,, & 6 = Use (Scres range frm t 12 with higher scres meaning mre Use) Sum f Items 1, 2, 3, 8, 11, & 1 = Risk factrs (Scres range frm t 24 with higher scres meaning mre Risk) Sum f Items 9, 1, 12, 13, 14, & 16 = Prtective factrs (Scres range frm t 24 with higher scres meaning mre Prtectin) Number in ( ) is pints fr each respnse *Item 7 (7A-7G) are nt scred as part f the subscales but prvide elabratin fr item 6. *Item 17 can be used as an verall assessment f treatment prgress, but is nt scred n any f the specific subscales. Clinical guidelines: The three subscales include: Use: If a patient scres a 1 r greater, it calls fr further examinatin and clinical attentin, e.g. cnsider additin f pharmactherapy r higher level f care, add mtivatinal interviewing. Any alchl use (item #4) Heavy alchl use (item #) Any drug use (item #6) Risk Factrs: If a patient scres a 12 r greater, it calls fr further examinatin and clinical attentin, e.g. refer fr medical r mental health cnsulatin, add CBT r relapse preventin skills training. Cravings (item #8) Physical Health (item #1) Sleep (item #2) Md (item #3) Risky situatins (item #11) Family/scial prblems (item #1) Prtective Factrs: If a patient scres a 12 r belw, it calls fr further examinatin and clinical attentin, e.g. treatment plan might include building sber supprt netwrks, 12 step facilitatin, r wrk with a case manager fr wrk r incme assistance. Self-efficacy (item #9) Self-help behavirs (item #1) Religin/spirituality (item #12) Wrk/schl participatin (item #13) Adequate Incme (item #14) Sber supprt (item #16) 6

7 Ntes: It is imprtant t cmpare mst recent BAM scres with prir BAM scres t assess changes in functining and risk status. The gal is t see sizeable changes n each scale with each administratin f the BAM. It is imprtant t take int cnsideratin the relative scres n risk and prtective factrs: If prtective factr scre is greater than risk factr scre, the patient is less at risk fr use Risk Factrs Prtective Factrs Beneficial Risk/Prtective Rati 1 If risk factr scre is greater than prtective factr scre, the patient is mre at risk fr use Risk Factrs Prtective Factrs Harmful Risk/Prtective Factr Rati 1 If risk factr scre is is equal t prtective factr scre, the patient is at risk fr use and a fcus f treatment shuld be t shift the balance t building prtective factrs and cping with risk factrs Risk Factrs Prtective Factrs Balanced scres=wrk n shifting 1 7