Brief Addiction Monitor (BAM)
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.
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Name
First Name
Last Name
Date
-
Month
-
Day
Year
Date
Phone Number
Please enter a valid phone number.
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1. In the past 30 days, would you say your physical health has been:
*
Excellent
Very Good
Good
Fair
Poor
2. In the past 30 days, how many nights did you have trouble falling asleep or staying asleep?
*
0
1-3
4-8
9-15
16-30
3. In the past 30 days, how many days have you felt depressed, anxious, angry, or very upset throughout most of the day?
*
0
1-3
4-8
9-15
16-30
4. In the past 30 days, how many days did you drink ANY alcohol?
*
0 (Skip to #6)
1-3
4-8
9-15
16-30
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)? (One drink is considered one shot of hard liquor (1.5 oz), 12 oz can/bottle of beer, or 5 oz glass of wine)
0
1-3
4-8
9-15
16-30
6. In the past 30 days, how many days did you use any illegal/street drugs or abuse any prescription medications?
*
0 (Skip to #8)
1-3
4-8
9-15
16-30
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7A. In the past 30 days, how many days did you use: Marijuana (cannabis, pot, weed)?
0
1-3
4-8
9-15
16-30
7B. In the past 30 days, how many days did you use: Sedatives/Tranquilizers (e.g., "benzos," Valium, Xanax, Ativan, Ambien, "barbs," Phenobarbital, downers, etc)?
0
1-3
4-8
9-15
16-30
7C. In the past 30 days, how many days did you use: Cocaine/Crack?
0
1-3
4-8
9-15
16-30
7D. In the past 30 days, how many days did you use: Other Stimulants (e.g., amphetamine, methamphetamine, Dexedrine, Ritalin, Adderall, "speed," "crystal meth," "ice," etc)?
0
1-3
4-8
9-15
16-30
7E. In the past 30 days, how many days did you use: Opiates (e.g., Heroin, Morphine, Dilaudid, Demerol, OxyContin, Codeine, Percocet, Vicodin, Fentanyl, etc)?
0
1-3
4-8
9-15
16-30
7F. In the past 30 days, how many days did you use: Inhalants (glues/adhesives, nail polish remover, paint thinner, etc)?
0
1-3
4-8
9-15
16-30
7G. In the past 30 days, how many days did you use: Other drugs (steroids, non-prescription sleep/diet pills, Benadryl, Ephedra, other OTC/unknown medications)?
0
1-3
4-8
9-15
16-30
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8. In the past 30 days, how much were you bothered by cravings or urges to drink alcohol or use drugs?
*
Not at all
Slightly
Moderately
Considerably
Extremely
9. How confident are you in your ability to be completely abstinent (clean) from alcohol and drugs in the next 30 days?
*
Not at all
Slightly
Moderately
Considerably
Extremely
10. In the past 30 days, how many days did you attend self-help meetings like AA or NA to support your recovery?
*
0
1-3
4-8
9-15
16-30
11. In the past 30 days, how many days were you in any situations or with any people that might put you at an increased risk for using alcohol or drugs (i.e., around risky "people, places, or things")?
*
0
1-3
4-8
9-15
16-30
12. Does your religion or spirituality help support your recovery?
*
Not at all
Slightly
Moderately
Considerably
Extremely
13. In the past 30 days, how many days did you spend much of the time at work, school, or doing volunteer work?
*
0
1-3
4-8
9-15
16-30
14. Do you have enough income (from legal sources) to pay for necessities such as housing, transportation, food, and clothing for yourself and your dependents?
*
No
Yes
15. In the past 30 days, how much have you been bothered by arguments or problems getting along with family members or friends?
*
Not at all
Slightly
Moderately
Considerably
Extremely
16. In the past 30 days, how many days were you in contact or spent time with any family members or friends who are supportive of your recovery?
*
0
1-3
4-8
9-15
16-30
17. How satisfied are you with your progress toward achieving your recovery goals?
*
Not at all
Slightly
Moderately
Considerably
Extremely
Risk
Use
Protective
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