CARD 1 ALASKAN NATIVE/ESKIMO/ALEUT AMERICAN INDIAN... 20

Transcription

1 CARD 1 ALASKAN NATIVE/ESKIMO/ALEUT AMERICAN INDIAN ASIAN OR ASIAN-AMERICAN Chinese (East) Indian Filipino Japanese Other (Specify): BLACK African American Caribbean West Indian Latino: Cuban Dominican Puerto Rican Other (Specify): LATINO OR HISPANIC, NON-BLACK Cuban Dominican Mexican Puerto Rican Other (Specify): MIDDLE EASTERN (Specify): PACIFIC ISLANDER (Specify): WHITE, CAUCASIAN, EURO-AMERICAN NOT OF LATINO ORIGIN BIRACIAL OR MULTIRACIAL (Specify): OTHER (Specify): /4/99 CIDI-SAM

2 CARD 2 1. A doct nurse advised you to 2. Your family friends asked you to 3. It cost too much 4. You got tired of it 5. It s bad f you 6. It caused unpleasant side effects 7. It was too inconvenient to continue 8. Pregnancy CIDI/SAM 11/12/99

3 CARD 3 B10 B10A made special trips planned ahead so you wouldn t run out of tobacco chain-smoked B11 B11A needed much me tobacco than you used to same amount of tobacco had much less effect than befe B12 often (smoked/used) me tobacco than you intended B13 B15A had a period of wanting to quit cut down on (smoking/using tobacco) me than once were unable to quit cut down f at least one month B18A1 had withdrawal symptoms when you have gone without tobacco B19 (smoked/used tobacco) to avoid get rid of withdrawal symptoms continued to (smoke/use tobacco) after you realized it: B21A B22 B23A caused a serious health problem made a serious illness wse caused a mental emotional problem B27 gave up reduced imptant activities to (smoke/use tobacco) 8/4/99

4 CARD 4 B10 B10A B27 made special trips planned ahead so you wouldn t run out of tobacco chain-smoked gave up reduced imptant activities to (smoke/use tobacco) B11 B11A needed much me tobacco than you used to same amount of tobacco had much less effect than befe B12 B13 B15A often (smoked/used) me tobacco than you intended had a period of wanting to quit cut down on (smoking/using tobacco) me than once were unable to quit cut down f at least one month B18B1 had withdrawal symptoms when you have gone without tobacco B19 (smoked/used tobacco) to avoid get rid of withdrawal symptoms continued to (smoke/use tobacco) after you realized it: B21A B22 B23A caused a serious health problem made a serious illness wse caused a mental emotional problem B26 had a strong desire craving f tobacco 8/4/99

5 CARD 5 ALCOHOL EQUIVALENTS HARD LIQUOR 1 SHOT MIXED DRINK = 1 DRINK 1 SHOT GLASS = 1 DRINK 1/2 PINT OF LIQUOR = 6 DRINKS 1 PINT OF LIQUOR = 12 DRINKS 1 FIFTH OF LIQUOR = 20 DRINKS 1 QUART/LITER OF LIQUOR = 24 DRINKS WINE 1 GLASS OF WINE = 1 DRINK 1 BOTTLE OF WINE (LITER) = 6 DRINKS 1 WINE COOLER = 1 DRINK 1 CARAFE OF WINE = 9 DRINKS 1 GALLON = 30 DRINKS 1 SMALL BOTTLE OF WINE (SPLIT) = 2 DRINKS BEER 1-12 OZ BOTTLE OF BEER = 1 DRINK 1-12 OZ CAN OF BEER = 1 DRINK 1 CAN OF MALT LIQUOR = 1 DRINK 1-40 OZ BOTTLE OF BEER = 3 DRINKS 1-40 OZ BOTTLE OF MALT LIQUOR = 6 DRINKS 1-6 PACK OF BEER = 6 DRINKS 1 PITCHER OF BEER = 5 DRINKS 1 CASE OF BEER = 24 DRINKS CIDI-SAM 8/4/99

6 CARD 6 1. A doct nurse advised you to 2. Your family friends asked you to 3. It cost too much 4. You got tired of it 5. Drinking is bad f you 6. It caused unpleasant side effects 7. Pregnancy 8. Legal Problems CIDI-SAM 1/7/00

7 CARD 7 C16 C16A often drank me than you intended often kept drinking f longer than you intended C17 C17A drank much me than you used to f the effect you wanted found the same amount had much less effect than it once did C18 C20A had a period of wanting to quit cut down on drinking me than once were unable to quit cut down f at least a month C25 spent a lot of time on drinking recovering from the effects of alcohol C26 gave up reduced imptant activities that would interfere with drinking C27A1 had withdrawal symptoms in the first few hours of not drinking C28 had alcohol, a tranquilizer, sedative to avoid get rid of withdrawal symptoms continued to drink after you realized it: C29A C30 C33A caused a physical health problem made a serious physical illness wse caused a psychological emotional problem 1/7/00

8 CARD 8 C15 had a strong desire urge to drink C16 C16A C18 C20A often drank me than you intended to often kept drinking f longer than you intended had a period of wanting to quit cut down on drinking me than once were unable to quit cut down f at least a month C17 C17A drank much me than you used to f the effect you wanted found the same amount had much less effect than it once did C25 C26 spent a lot of time on drinking recovering from the effects of alcohol gave up reduced imptant activities that would interfere with drinking C27B1 had withdrawal symptoms in the first few hours of not drinking C28 had alcohol, a tranquilizer, sedative to avoid get rid of withdrawal symptoms continued to drink after you realized it: C29A C30 C33A caused a physical health problem made a serious physical illness wse caused a psychological emotional problem 1/7/00 CIDI-SAM

9 CARD 9 Stimulants Amphetamines Diet pills Ritalin Other stimulant Sedatives Barbiturates Librium Seconal Sleeping pills Tranquilizers Valium Xanax Other sedative Opioids Codeine Darvon Demerol Dilaudid Methadone Mphine Percodan Talwin Other opioid CIDI-SAM 12/10/99

10 CARD 10 Marijuana Grass Pot Hashish Stimulants Ice Khat Methamphetamine Speed Uppers Other stimulant Club Drugs Ecstasy MDMA GHB Ketamine Rohypnol Other club drug Cocaine Crack Heroin Hallucinogens Inhalants Other drugs Opioids Opium T s & blues PCP DMT LSD Acid Mescaline Mushrooms Peyote Psilocybin Other hallucinogen Glue Toluene Gasoline Paint Paint thinner Amyl nitrite Poppers Anabolic steroids Nitrous oxide Anything else specify CIDI-SAM 12/10/99

11 CARD 11 Marijuana Grass Pot Hashish Stimulants Amphetamines Diet pills Ice Khat Methamphetamine Ritalin Speed Uppers Other stimulant Sedatives Barbiturates Librium Seconal Sleeping pills Tranquilizers Valium Xanax Other sedative Club Drugs Ecstasy MDMA GHB Ketamine Rohypnol Other club drug Cocaine Crack Heroin Opioids Codeine Darvon Demerol Dilaudid Methadone Mphine Opium Percodan Talwin T s & blues Other opioid PCP Hallucinogens DMT LSD Acid Mescaline Mushrooms Peyote Psilocybin Other hallucinogen Inhalants Glue Toluene Gasoline Paint Paint thinner Other drugs Amyl nitrite Poppers Anabolic steroids Nitrous oxide Anything else specify CIDI-SAM 12/10/99

12 CARD 12 HOW TAKEN 1 = By mouth, pills, drinking, chewing 2 = Smoking freebasing 3 = Snting, sniffing, breathing, huffing 4 = Injection into the veins (IV) 5 = Injection into the skin muscle 6 = Other methods CIDI-SAM 12/10/99

13 CARD 13 1 = ampules 13 = lines 2 = bags 14 = milligrams 3 = blotters 15 = ounces 4 = blunts 16 = panes 5 = breaths 17 = pills 6 = buttons 18 = pipefuls 7 = capsules 19 = rocks 8 = cigarettes 20 = sheets 9 = grams 21 = supposities 10 = hits 22 = tablespoons 11 = huffs 23 = teaspoons 12 = joints 24 = other (specify) CIDI-SAM 12/10/99

14 CARD A doct nurse advised you to 2. Your family friends asked you to 3. It cost too much 4. You got tired of it 5. Using drugs is bad f you 6. It caused unpleasant side effects 7. Pregnancy 8. Legal Problems CIDI-SAM 1/11/00

15 CARD 15 DRUG COLUMN EXPERIENCES MARIJUANA STIMULANTS SEDATIVES CLUB DRUGS COCAINE HEROIN OPIOIDS PCP HALLUCINOGENS INHALANTS OTHER ROW A ROW B ROW C ROW D ROW E ROW F ROW G Often used me (DRUG CATEGORY) than you intended f longer than you intended Used much me (DRUG CATEGORY) than you used to f the effect the same amount had much less effect than it once did Wanted to quit cut down on (DRUG CATEGORY) tried to, but were unable to f at least a month Spent a lot of time on using, getting, recovering from the effects of (DRUG CATEGORY) Gave up reduced imptant activities to get use (DRUG CATEGORY) Had withdrawal symptoms from (DRUG CATEGORY) used drugs to avoid get rid of withdrawal symptoms from (DRUG CATEGORY) Continued using (DRUG CATEGORY) after realizing it caused physical emotional problems

16 CARD 16 DRUG COLUMN EXPERIENCES MARIJUANA STIMULANTS SEDATIVES CLUB DRUGS COCAINE HEROIN OPIOIDS PCP HALLUCINOGENS INHALANTS OTHER ROW A Had a strong desire craving f (DRUG CATEGORY) ROW B ROW C ROW D ROW E ROW F Often used me (DRUG CATEGORY) than you intended f longer than you intended, wanted to quit cut down on (DRUG CATEGORY) tried to, but were unable to f at least a month Used much me (DRUG CATEGORY) than you used to f the effect same amount had much less effect than it once did Spent a lot of time using, getting, recovering from the effects of (DRUG CATEGORY) gave up reduced imptant activities to get use it Had withdrawal symptoms from (DRUG CATEGORY) used drugs to avoid get rid of withdrawal symptoms from (DRUG CATEGORY) Continued using (DRUG CATEGORY) after realizing it caused physical emotional problems

17 CARD 16A 1. Unintended weight loss gain 2. A seizure 3. A persistent cough 4. Eye problems 5. An injury burn 6. Heart pounding 7. Sexual difficulties 8. An overdose 9. A se throat sinus problems 10. Trembling, twitching, numbness 11. Headaches dizziness 12. Stomach problems 13. Kidney problems CIDI/SAM 1/30/01

18 CARD A doct nurse advised you to 2. Your family friends asked you to 3. It cost too much 4. You got tired of it 5. It s bad f you 6. It caused unpleasant side effects 7. Pregnancy CIDI/SAM 1/11/00

19 1. feeling depressed empty CARD 17A 2. being paranoid suspicious 3. feeling confused 4. feeling anxious tense 5. being irritable aggressive 6. feeling keyed up overactive 7. seeing, hearing, smelling feeling things that weren t there 8. laughing crying f no reason 9. being jumpy easily startled 10. feeling overconfident fearless CIDI/SAM 1/30/01

20 CARD 18 E7 made special trips planned ahead so you wouldn t run out of caffeinated beverages E8 E8A needed to drink me caffeinated beverages than you used to f the effect usual amount of a caffeinated beverages had much less effect than befe E9 often drank me caffeinated beverages than you intended E10 had a period of wanting to quit cut down on caffeinated beverages E12A me than once were unable to quit cut down on caffeinated beverages f at least one month E14A had withdrawal symptoms when you have gone without reduced caffeinated beverages E15 used a caffeinated product beverage to avoid get rid of withdrawal symptoms continued to use caffeinated beverages after realizing you: E17A had a physical problem caused by caffeine E18 had a medical condition health problem that could be made wse by caffeine E19A you had a psychological emotional problem caused by caffeine E23 avoided doing things going places because caffeine would not be available CIDI/SAM 1/22/01

21 CARD 19 E7 E23 made special trips planned ahead so you wouldn t run out of caffeinated beverages avoided doing things going places because caffeinated beverages would not be available E8 E8A needed to drink much me caffeinated beverages than you used to f the effect usual amount of caffeinated beverages had much less effect than befe E9 E10 often drank me caffeinated beverages than you intended had a period of wanting to quit cut down on caffeinated beverages E12A me than once were unable to quit cut down on caffeinated beverages f at least one month E14A had withdrawal symptoms when you have gone without reduced caffeinated beverages E15 used a caffeinated product beverage to avoid get rid of withdrawal symptoms continued to use caffeine after realizing you: E17A had a physical problem caused by caffeine E18 had a medical condition health problem that could be made wse by caffeine E19A had a psychological emotional problem caused by caffeine E22 often had a strong desire craving f caffeinated beverages CIDI/SAM 1/22/01