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)
. 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)? 16-3 7B. Sedatives/Tranquilizers (e.g., benzs, Valium, Xanax, Ativan, Ambien, barbs, Phenbarbital, dwners, etc.)? 16-3 7C. Ccaine/Crack? 16-3 2
7D. Other Stimulants (e.g., amphetamine, methamphetamine, Dexedrine, Ritalin, Adderall, speed, "crystal meth", ice, etc.)? 16-3 7E. Opiates (e.g., Herin, Mrphine, Dilaudid, Demerl, Oxycntin, xy, cdeine (Tylenl 2,3,4), Perccet, Vicdin, Fentanyl, etc.)? 16-3 7F. Inhalants (glues/adhesives, nail plish remver, paint thinner, etc.)? 16-3 7G. Other drugs (sterids, nn-prescriptin sleep/diet pills, Benadryl, Ephedra, ther verthe-cunter/unknwn medicatins)? 16-3 8. 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
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
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: :
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
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. 2 1 1 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. 2 1 1 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. 2 1 1 Risk Factrs Prtective Factrs Balanced scres=wrk n shifting 1 7