HIV/AIDS Treatment and Care : Clinical protocols for the European ...

ANNEX 1 ASI6
C © 2004 University of Pennsylvania
HIV/AIDS TREATMENT AND CARE FOR INJECTING DRUG USERS
ASI6, Alterman, A.I. et al. © University of Pennsylvania. EuropASI6, Kokkevi, A., Uchtenhagen, A., Oberg D. & Sallmén, B. 2005.
E Drug / Alcohol - The following questions are about your
alcohol and drug use, and any substance abuse treatment you
may have received.
Treatment History
E1. How many different times have you been
treated for your alcohol or drug use?
-Include in-person evaluations even if 00 → E6
not followed by additional treatment.
E2. How many of these treatments were for
Detox only?
-Detox not followed by any additional treatment
E3. How old were you the first time you
entered alcohol or drug abuse treatment?
How many days have you:
A. Past 6 months B. 30 Days
E4. attended an outpatient program
or office visits (for alcohol or 000 → E5
drug treatment)?
E5. taken medication prescribed to
treat your alcohol or drug use? 000 →E6
e.g. methadone, naltrexone, Revia, detox meds, etc.
-Exclude Rx for nicotine dependence
E6. attended self-help meetings
like AA, NA, or CA? 000 → E7
E7. What is the longest continuous period of time that you
attended self help meetings at least 2 days a week?
Alcohol Use
Years Months
E8. How many years in your life have you drank
alcohol on a regular basis, 3+ days per week?
- Exclude clean time 00 → E10
E9. How many years in your life have you drank
at least (5-men, 4-women) drinks per day on
a regular basis, 3+ days per week? >0 → E11
E10. Have you drank at least (5-men, 4-women)
drinks in a day 50 or more days in your life? 1-Yes, 0-No
E11. How old were you when you first drank and
felt the effects of alcohol? [if never, code 99]
E12. In the past 6 months, during the month when you were
drinking the most, how often were you drinking?
0 - No Use (→ E20) 3 - 3-6 times per week
1 - 1-3 times per month 4 - Daily
2 - 1-2 times per week
E13. In the past 30 days, how many days did you
drink any alcohol? 00 → E20
E14. When was your last drink?
[00 if today, 01 if yesterday, 02 if 2 days ago, etc.]
E15. In the past 30 days, how many days did
you have at least (5-men, 4-women) drinks
in a day?
E16. In the past 30 days, how
much money have you spent €
on alcohol for yourself?
In the past 30 days:
Alcohol Symptoms
E17. Have you had any withdrawal sickness shortly
after you cut down or quit drinking? 1-Yes, 0-No
E18. Have you had any trouble controlling, cutting
back, or quitting drinking;
or spent much of the day drinking? 1-Yes, 0-No
E19. Because of your drinking -
have you had any medical or psychological
problems;
or
messed up at work (school) or home, 1-Yes, 0-No
or got in arguments;
or
had trouble with the law?
E20. Have you been bothered by
cravings or urges to drink? 1-Yes, 0-No
E21. How many days did you have these or
any other difficulties due to alcohol use? 00 → E23
E22. In the past 30 days, how troubled or bothered
have you been by these alcohol problems?
0 - Not at all 3 - Considerably
1 - Slightly 4 - Extremely
2 - Moderately
E23. How important to you now is (ongoing or additional)
treatment for your alcohol use?
0 - Not at all 3 - Considerably
1 - Slightly 4 - Extremely
2 – Moderately
E24. How important to you is it to achieve/maintain total
abstinence from alcohol (i.e., not drink at all)?
0 - Not at all 3 – Considerably
1 - Slightly 4 - Extremely
2 – Moderately
5
201