Instrument:
| Question | CDE Long Name | CDE |
|---|---|---|
| Have you used drugs other than those required for medical reasons? | Substance Abuse Prescription Illicit Substance Over the Counter Product Personal Medical History Yes No Indicator | 3254039 |
| Do you use more than one drug at a time | Substance Abuse Prescription Illicit Substance Over the Counter Product Concurrent Use Personal Medical History Yes No Indicator | 3254057 |
| Are you always able to stop using drugs when you want to? | Substance Abuse Prescription Illicit Substance Over the Counter Product Cessation Ability Personal Medical History Yes No Indicator | 3254058 |
| Have you had "blackouts" or "flashbacks" as a result of drug use? | Substance Abuse Prescription Illicit Substance Over the Counter Product Blackout Flashbacks Personal Medical History Yes No Indicator | 3254061 |
| Do you ever feel bad or guilty about your drug use? | Substance Abuse Prescription Illicit Substance Over the Counter Product Guilt Regret Personal Medical History Yes No Indicator | 3254063 |
| Does your spouse (or parents) ever complain about your involvement with drugs? | Substance Abuse Prescription Illicit Substance Over the Counter Product Domestic Partnership Spouse Complain Personal Medical History Yes No Indicator | 3254065 |
| Have you neglected your family because of your use of drugs? | Substance Abuse Prescription Illicit Substance Over the Counter Product Family Neglect Personal Medical History Yes No Indicator | 3254066 |
| Have you engaged in illegal activities in order to obtain drugs? | Substance Abuse Prescription Illicit Substance Over the Counter Product Crime Obtain Personal Medical History Yes No Indicator | 3254067 |
| Have you ever experienced withdrawal symptoms (felt sick) when you stopped taking drugs? | Substance Abuse Prescription Illicit Substance Over the Counter Product Substance Withdrawal Syndrome Personal Medical History Yes No Indicator | 3254070 |
| Have you had medical problems as a result of your drug use (e.g., memory loss, hepatitis, convulsions, bleeding, etc.)? | Substance Abuse Prescription Illicit Substance Over the Counter Product Associated Disease or Disorder Personal Medical History Yes No Indicator | 3254072 |
