Addiction Assessment

General Instructions
Test Questions
Demographic Information
Your Results

General Instructions

The Brief Addiction Monitor (BAM) is a 17-item, multidimensional, progress-monitoring instrument for patients in treatment for a substance use disorder (SUD). The BAM includes items that assess risk factors for substance use , protective factors that support sobriety, and drug and alcohol use (items 4-7G). The BAM produces composite scores for the three aforementioned domains. The instrument can be used in treatment planning, progress monitoring, and group or individual psychotherapies for SUD.

Please consider each question and answer as accurately as possible.

1. In the past 30 days, how would you say your physical health has been?(Required)

Very Poor

Poor

Moderate

Good

Very Good

2. In the past 30 days, how many nights did you have trouble falling asleep or staying asleep?(Required)

0-4 Nights

5-9 Nights

10-14 Nights

15-19 Nights

20+ Nights

3. In the past 30 days, how many days have you felt depressed, anxious, angry or very upset throughout most of the day?(Required)

0-4 Days

5-9 Days

10-14 Days

15-19 Days

20+ Days

4. In the past 30 days, how many days did you drink ANY alcohol?(Required)

0-4 Days

5-9 Days

10-14 Days

15-19 Days

20+ Days

5. In the past 30 days, how many days did you have at least 5 drinks (if you are a man) or at least 4 drinks (if you are a woman)? Description: One drink is considered one shot of hard liquor (1.5 oz.) or 12-oz. can/bottle of beer or 5 oz. glass of wine.(Required)

0-4 Days

5-9 Days

10-14 Days

15-19 Days

20+ Days

6. In the past 30 days, how many days did you use any illegal or street drugs or abuse any prescription medications?(Required)

0-4 Days

5-9 Days

10-14 Days

15-19 Days

20+ Days

8. In the past 30 days, how many days were you bothered by cravings or urges to drink alcohol or use of drugs?(Required)

0-4 Days

5-9 Days

10-14 Days

15-19 Days

20+ Days

9. In the past 30 days, how many days did you use any of the following drugs (please select all that apply):(Required)

Marijuana (cannabis, pot, weed)

Sedatives and/or Tranquilizers (benzos, Valium, Xanax, Ativan, Ambien, barbs, Phenobarbital, downers, etc.)

Cocaine and/or Crack

Other Stimulants (Other Stimulants (amphetamine, methamphetamine, Dexedrine, Ritalin, Adderall, speed, crystal meth, ice, etc.

Opiates (Heroin, Morphine, Dilaudid, Demerol, Oxycontin, oxy, codeine (Tylenol 2,3,4), Percocet, Vicodin, Fentanyl, etc.)

Inhalants (Inhalants (glues, adhesives, nail polish remover, paint thinner, etc.)

Other Drugs (steroids, non-prescription sleep and diet pills, Benadryl, Ephedra, other over-the-counter or unknown? Medications

None

how many days(Required)

0-4 Days

5-9 Days

10-14 Days

15-19 Days

20+ Days

10. In the past 30 days, how many days did you attend self-help meetings like AA or NA to support your recovery?(Required)

0-4 Days

5-9 Days

10-14 Days

15-19 Days

20+ Days

11. In the past 30 days, how many days were you in any situations or with any people that might put you at any increased risk for using alcohol or drugs (i.e. around risky, "people, places or things")?(Required)

0-4 Days

5-9 Days

10-14 Days

15-19 Days

20+ Days

12. In the past 30 days, how many days did you contact or spend time with any family members or friends who are supportive of your recovery?(Required)

0-4 Days

5-9 Days

10-14 Days

15-19 Days

20+ Days

13. Are you confident that you will NOT use alcohol and drugs in the next 30 days?(Required)

Yes

14. In the past 30 days, how many days did you spend much of the time at work, school, or doing volunteer work?(Required)

0-4 Days

5-9 Days

10-14 Days

15-19 Days

20+ Days

15. Do you have enough income (from legal sources) to pay for necessities such as housing, transportation, food and clothing for yourself and your dependents?(Required)

Yes

16. In the past 30 days, how many days have you been bothered by arguments or problems getting along with any family members or friends?(Required)

0-4 Days

5-9 Days

10-14 Days

15-19 Days

20+ Days

17. How satisfied are you with your progress toward achieving your recovery goals?(Required)

Not Satisfied

Satisfied

Very Satisfied

Demographic Information

Please take a moment to answer the following optional questions. Your answers are totally anonymous—we won't be able to identify you based on this information. Your answers help us provide better information and support for people like you.

You can answer as many or as few questions as you would like. When you are done, scroll to the bottom of the survey and click "View Results" to receive your screening results.

Are you taking this test for yourself or for someone else?

For Myself

For Someone Else

About You

Age Range

Zip/Postal Code(Required)

BAM Assessment Resources developed by the VISN 4 MIRECC. P

General Instructions

Demographic Information

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