10  Measures

10.1 Continuous Collection

Continuously while participants are on study, personal sensing measures in A-CHESS will capture information related to moment-to-moment changes in risk, including data from phone calls, text messages, GPS location services, and people’s use of the mHealth app features. Phone call, text message, and GPS information will be enhanced with contextual information about frequent social contacts and frequently visited places.

 

10.2 Daily Update

Each day that participants are on study, they will complete a short survey that includes items related to daily changes in risk: the drugs people have used in the past 24 hours; whether people took their daily MAT medication; and, thinking of the past 24 hours, how well they slept, their mood, their pain, urges to use, risky situations, pleasant situations, motivation to avoid using opioids, and confidence in remaining abstinent.

• See P:\\StudyData/risk2/methods/measures

 

10.3 Daily Video Check-In (NO LONGER ACTIVE AS OF FEB 2023)

Each day participants will record a short video check-in using their front-facing phone camera that shows their facial expressions and captures their voice as they reflect on how they are doing that day. We will create predictive features from these videos using natural language processing and other techniques (e.g., to characterize affective cues in people’s vocal tone and facial expression).

Check Videos SOP

Check Video SOP (the purpose of this SOP is to describe how to review daily video check-ins)

Schedule for Checking Video Check-Ins - One business day before a participants scheduled one-week check-in… o On the weekday before a participants one-week check-in, study staff should check all the videos that the participant submitted that week o Study staff should make a note if the participant… – Does not include their face in the camera – Is not facing or looking at the camera – Is not in a well-lit room – Is difficult to hear (either not speaking loudly enough or is recording in a noisy space) – Does not specify whether they will be sharing a rose, a bud, or a thorn – Does not explain what the rose, bud, or thorn is – Does not explain why they chose the rose, bud, or thorn – Says that they are having an issue with the app • Note. We explicitly tell participants that the video check-ins are NOT a way to communicate with staff so this is pretty unlikely - A couple of times a week (depends in large part on how many participants we have on study) o Study staff will have a rotating list of subids that should have a sample of their past month of videos reviewed o Each participant on study will have their videos review at least once a month

Open the R Script - Navigate to your local github repository for analysis_risk2 - Open the RISK2 R project o In R studio, open the staff_scripts folder o In staff_scripts, open the check_videos.Rmd script Step 1: Set up and Step 2: Download videos - “site” should be set to “live” - “the_subid” o Study staff will have to check each subid individually o Set “the_subid” equal to the subid you are trying to review - “period” o Set to “week_one” if completing a pre-one week check-in review o Set to “past_month_sampled” if doing a regular review - Run step 1 - Run step 2 Step 3: Play videos - Run step 3 - Use the risk2_video_checkin_checklist Qualtrics to note any issues - https://uwmadison.co1.qualtrics.com/jfe/form/SV_82oOWPrRL3X6eLs

10.4 Monthly Update

The monthly update that participants complete will differ slightly some months.

Static risk

At the beginning of the study, participants will complete a survey that includes measures of the following characteristics related to static risk: demographics; lifetime substance use history (items adapted from the World Health Organization Alcohol, Smoking, and Substance Involvement Screening Test, Version 3); opioid treatment history; opioid use disorder DSM-V diagnostic criteria for the year prior to starting MAT; distress tolerance (items selected from the Distress Tolerance Scale); pain catastrophizing (items adapted from the Pain Catastrophizing Scale and Pain Catastrophizing Scale for Children); personality traits relevant to psychopathology (Personality Interview for DSM-IV Brief Form); adverse childhood experiences (items selected from the Adverse Childhood Experiences Questionnaire); and trauma experience.

 

Dynamic risk

Each month that participants are on study, they will complete a survey that includes the following measures related to monthly changes in risk: life circumstances (e.g., employment status, living situation); social connectedness (adapted from the MOS Social Support Survey); romantic relationship quality (items selected from the Relationship Assessment Scale); psychiatric symptoms (items selected from the BASIS-32); pain and anticipated pain treatment (items adapted from the Wisconsin Brief Pain Questionnaire and the Pain, Enjoyment, General Activity Scale); stress (items selected from the Perceived Stress Scale); quality of life (items adapted from the World Health Organization Quality of Life Assessment); substance use (adapted from the World Health Organization Alcohol, Smoking, and Substance Involvement Screening Test, Version 3); opioid use; opioid recovery satisfaction and motivation; other recovery goals; questions about treatment use, adherence, and perceived efficacy including questions about MAT, self-help meetings, counseling, psychiatric medication, and detox or other inpatient residential treatment.

From the second month forward, the monthly update will include questions about social contacts and visited locations (see below for more information).

Dynamic risk - Social contacts

To contextualize social contacts data (phone call and text/SMS message logs), participants will complete a short self-report survey about contacts that are identified as potentially meaningful to the person based on the duration and frequency of voice calls and text messages. This survey will ask people about the relationship type and closeness, the valence of typical interactions, and the extent to which interactions support or undermine their recovery.

Dynamic risk – Visited Locations

To contextualize visited locations data (GPS location), participants will complete a short self-report survey about the places they frequently visit (i.e., more than twice a month). This survey will ask people about the type of place, what they typically do there, the valence of spending time there, and the extent to which spending time there supports or undermines their recovery. When available, public information (e.g., via OpenStreetMap) about locations will also be used to contextualize GPS data. This contextual information (i.e., public data and the data the participant provides) will be used to create predictive features (e.g., changes in routine movement patterns, length of time spent at a specific place or place type) from the GPS location data.

 

Burden

In the third month and the last month, participants will be asked questions about burden. Specifically, we will collect self-reported ratings on how much participants dislike a personal sensing signal and any positive or negative comments participants have about the signals. For the daily update, daily video check-in, and monthly updates, participants will also provide ratings on how much the signal interfered with their daily activities.

In the final month, the monthly update will only contain questions about burden and social contacts and visited locations.

See P:\\StudyData/risk2/methods/measures

10.4.1 Timing of the monthly update

From the CHESS team:

• The logic treats the intake survey, personalized monthly survey, and monthly survey all as “monthly” surveys so if a person completes the intake survey during the window, they have to wait until the next window take the regular or personalized monthly survey.

 

• Then the following logic applies for deciding which survey to take is:

1. If they haven’t taken the intake survey, take the intake survey now.
2.  If they completed the intake survey and they have a personalized monthly survey to take, take the personalized monthly survey now.
3. If they completed the intake survey and they do NOT have a personalized monthly survey to take, take a regular monthly survey.

 

10.4.2 Social contacts

Criteria for identifying a phone number as a frequent contact:

• A number not identified as spam AND

• At least one phone call (outgoing or incoming) more than 2 minutes long on two different days in a month OR

• A phone call (outgoing or incoming) of 15 minutes or more OR

• A one-on-one (not group) exchange of text messages (at least two outgoing texts and two incoming texts) during the month

 

10.4.3 Visited locations

Criteria for identifying a visited location: GPS observation with a next time of  > 3 minutes or GPS observations within 60 meters of a GPS observation with a next time of > 3 minutes

If people report that they do not recognize a location or were just passing by, we will ask them about it if it reappears on a future survey, but only one time (i.e., people will only need to report that they don’t recognize a location or they were passing by twice

10.5 Original Survey Questions

General Formatting Notes

• Brackets are used to describe skip and branching logic

• Response options in circles are forced choice, response options in check boxes are select all that apply

• < page break > is used to denote page breaks in STAR surveys

• Bolding is used to for emphasis or to highlight discrepancies (e.g., items with timeframes that conflict with the instruction text)

Instruction Text

• For surveys with items that are questions, instructions start with “The next set of questions ask about…”

• For surveys with items that are statements, instructions start with “Listed below are….” In addition, instructions describe how to select responses (e.g., “Select how much you agree with each statement”)

• By default, instruction text is on its own page

Survey Headers

• Survey headers are texts that are displayed on the top of every page in a survey and that specify times or qualifiers that apply to all questions (e.g., “In the past month…”)

• Ellipses end all survey headers

Item text

• Parentheses are used to list examples

• First person is only used in statements (i.e., not questions)

Response Option Defaults

• Response options are in ascending order (e.g., No -> Yes, 0 -> 10, None -> Extreme)

• Likert scales have 5 response options and use the following options for each type of response:

  • Frequency response options are: Never> Rarely> Sometimes> Most of the time> Always

  • Quantity response options are: Not at all> Slightly> Moderately> Considerably> Extremely

  • Agreement scale: Strongly Disagree > Mildly Disagree > Equally Agree and Disagree > Mildly Agree > Strongly Agree ### Daily Update (Content) Instructions

This survey asks about your recent drug use, medication assisted treatment, mood, and daily experiences. Several questions ask about using drugs “for non-medical reasons” which means using drugs to feel intoxicated or high. It is possible to use a drug you are prescribed for non-medical reasons, for example, by taking more than prescribed.

< page break > 1. Have you used any opioids for non-medical reasons that you have not yet reported?

o   No 

o   Yes 

< page break >

2. Please select the time(s) that you have not yet reported when you used opioids for non-medical reasons: [Display if Q1 is Yes]

   [TIME PICKER, MULTI-SELECT]

< page break >

Thinking about the past 24 hours…

3. Which of these drugs have you used for non-medical reasons? Select all that apply.

? Alcohol

? Cannabis (marijuana, pot, grass, hash, K2, spice, etc.)

? Stimulants (cocaine, meth, speed, ecstasy, molly, Adderall, etc.)

? Inhalants (nitrous, glue, petrol, paint thinner, etc.)

? Sedatives or sleeping pills (Valium, Serepax, Rohypnol, etc.)

? Hallucinogens (LSD, acid, mushrooms, PCP, special K, etc.)

? None of the above

Thinking about the past 24 hours…

4. Did you take your daily medication for opioid use (e.g., Suboxone, Methadone, Buprenorphine, etc.). as prescribed?

   o Yes

   o No, I missed a dose

   o No, I am using a monthly medication (e.g., Vivitrol)

   o No, I am no longer prescribed medication for opioid use

< page break >

Thinking about the past 24 hours…

5. Think about the worst pain you experienced. How painful was it?

   No pain Mildly Moderately Considerably Extremely

6. Think about the greatest urge you had to use opioids. How strong was it?

   No urge; Mildly; Moderately ; Considerably; Extremely

7. Think about the riskiest situation you experienced (people, places, or things that interfere with your recovery). How risky was it?

   No risky situation; Mildly; Moderately; Considerably; Extremely

8. Think of the biggest hassle or most stressful event you experienced. How stressful was it?

   No hassle/stressful event; Mildly; Moderately; Considerably; Extremely

9. Think of the most pleasant or positive event you experienced. How pleasant was it?

   No pleasant/positive event; Mildly; Moderately; Considerably; Extremely

< page break >

Thinking about the past 24 hours…

10. How did you sleep?

    Very badly; Badly; Neutral; Well; Very well

Thinking about the past 24 hours…

11. How depressed have you felt?

    Not at all; Mildly; Moderately; Considerably; Extremely

12. How angry have you felt?

    Not at all; Mildly; Moderately; Considerably; Extremely

13. How anxious have you felt?

    Not at all Mildly Moderately Considerably Extremely

14. How relaxed have you felt?

    Not at all Mildly Moderately Considerably Extremely

15. How happy have you felt?

    Not at all Mildly Moderately Considerably Extremely

    < page break >

Now thinking forward to the next week…

16. How motivated are you to completely avoid using opioids for non-medical reasons?

    Not at all Mildly Moderately Considerably Extremely

17. How confident are you in your ability to completely avoid using opioids for non-medical reasons?

    Not at all Mildly Moderately Considerably Extremely

    < page break >

End of Survey Message Thank you! You have now completed the daily update.

10.5.1 Intake Survey (Content)

Global Instructions

This is the first monthly update. It consists of different surveys that ask about aspects of your life and your recovery including your age, income, household, history of opioid and other drug use, drug treatment services, life events, and emotions. This first monthly update is longer than other monthly updates because it asks questions about your background.

Completing this survey will take about 30 minutes and you will receive a $10 payment for completing it.

Please read through all questions carefully and answer them honestly. All of your responses will be kept completely private.

< page break >

The term “opioid” in these surveys refers to prescription opioids (like Oxycontin or Vicodin), synthetic opioids (fentanyl), and heroin. Below is a list of commonly used terms for these substances:

Oxycodone (Oxycontin, Percocet, oxy, percs, O.C., rims, tires, greenies)

Hydrocodone (Vicodin, Lortab, Norco, vike, bananas, fluff, hydros)

Morphine (Kadian, Duramorph, MS Contin, miss Emma, monkey, white stuff, M)

Codeine (lean, captain Cody, little C, schoolboy)

Buprenorphine (Suboxone, Subutex, buse, sobos, strips, oranges)

Hydromorphone (Dilaudid, Exalgo, smack, dillies, footballs, juice)

Methadone (Methadose, Dolophine, tootsie roll, red rock, mud, dolls)

Oxymorphone (Opana, biscuits, mrs. O, O bomb, octagon)

Tramadol (Ultram, chill pills, trammies, ultras)

Fentanyl (Sublimaze, Actiq, apache, goodfella, TNT)

Heroin (black tar, black pearl, black, china white, dope, white lady, smack, snow, speedball)

< page break >

When we ask about your use of opioids or other drugs, we often use the term “non-medical reasons” When you see this term, please think about your use of drugs to feel intoxicated or high. This includes taking more of a drug than you were prescribed, taking it more frequently than prescribed, or using a drug for reasons other than it was prescribed for.

< page break >

? #### Demographics [Instructions:] The first set of questions asks for some general information about you. 1. What is your age (in years)?

o   18 - 21

o   22 - 25

o   26 - 35

o   36 - 45

o   46 - 55

o   56 - 65

o   Over 65

2. What is your gender identity?

   o Woman

   o Man

   o Non-binary

   o Prefer not to say

   o Not listed above ______

3. What do you think of yourself as?

   o Lesbian or gay

   o Straight, that is, not gay or lesbian

   o Bisexual

   o Not sure

   o Not listed above ________

4. What is your race or origin? Select all that apply.

? American Indian/Alaska Native

? Asian

? Native Hawaiian/Other Pacific Islander

? Black/African American

? White/Caucasian

? Hispanic, Latino, or Spanish origin

? Not listed above _______

< page break >

5. What is your highest level of education completed?

   o 8th grade or less

   o Some high school, but did not graduate

   o High school graduate or GED

   o Some college or 2-year degree

   o 4-year college graduate

   o More than 4-year or advanced degree

6. What is your yearly household income?

   o Less than $25,000

   o $25,000 - $34, 999

   o $35,000 - $49,999

   o $50,000 - $74, 999

   o $75, 000 - $99, 999

   o $100,000 - $149,999

   o $150, 000 - $199,999

   o $200, 000 or more

7. Which of the following best describes your religious affiliation?

   o Christian

   o Jewish

   o Buddhist

   o Muslim

   o Hindu

   o Atheist (God does not exist)

   o Agnostic (not sure if God exists or not)

   o Spiritual, but not religious

   o Not listed above____________

8. How important is religion in your life?

   Not at all; Mildly; Moderately; Considerably; Extremely

9. How important is spirituality in your life?

   Not at all; Mildly; Moderately; Considerably; Extremely

< page break >

10.5.1.1 Demographics - Monthly

[Instructions:] The next set of questions asks for some general information about your current life. < page break >

1. Are you currently enrolled in school?

   o No
   o Yes

2. What is your current employment status?

   o Employed, working 1-39 hours per week

   o Employed, working 40 or more hours per week

   o Not employed, looking for work

   o Not employed, NOT looking for work

   o Retired

   o Disabled, not able to work

< page break >

3. Are you currently in a committed romantic relationship?

   o No
   o Yes

[If no option is selected, Relationship Assessment Scale is skipped]

< page break >

4. What is your current living arrangement?

   o Living alone [Skip to end of demographic survey]

   o Living with family/others

   o Homeless shelter

   o Homeless unsheltered

   o Recovery community (Sober living/halfway house)

   o Other

[If no option is selected, Q5 is displayed]

< page break >

5. Who do you live with? Select all that apply.

   ? Spouse/significant other
   ? Child/grandchild
   ? Parent
   ? Other relative
   ? Non-relative

[If no option is selected, display Q6-Q9]

< page break >

Do you live with anyone who…

6. Uses opioids for medical reasons (uses opioids as prescribed by their doctor)?

   o No
   o Yes

7. Uses opioids for non-medical reasons (uses opioids to feel intoxicated or high)?
   o No
   o Yes

8. Uses drugs other than opioids for non-medical reasons (do not include tobacco or alcohol)?

   o No
   o Yes

9. Uses alcohol excessively (very frequently or in large amounts)?

   o No
   o Yes

< page break >

? #### Relationship Assessment Scale

[This scale will be skipped by participants who indicate they are not in a relationship on Q3 of the monthly demographics survey and by participants who do not answer Q3]

[Instructions:] The next set of questions asks you to think about your relationship with your partner in the past month.

< page break >

In the past month…

1. How satisfied have you been with your relationship?

   Not at all; Mildly; Moderately; Considerably; Extremely

2. How often have there been problems in your relationship?

   Never; Rarely; Sometimes; Often; Always

3. How often have you wished you hadn’t gotten into this relationship?

   Never Rarely Sometimes Often Always

< page break >

10.5.1.2 Lifetime Drug Use History

[Instructions:] The next set of questions asks about your experience using drugs for non-medical reasons across your lifetime.

< page break >

Across your lifetime…

1. Which of the following drugs have you ever used for non-medical reasons? Select all that apply.

   ? Alcohol

   ? Combustible tobacco products (cigarettes, cigars, cigarillos, little cigars, pipe, hookah, bidis)

   ? Electronic cigarettes (e-cigarette, e-vaporizer, vape pen, e-hookah, hookah pen)

   ? Opioids (heroin, fentanyl, oxy, etc.)

   ? Cannabis (marijuana, pot, grass, hash, K2, spice, etc.)

   ? Stimulants (cocaine, meth, speed, ecstasy, molly, Adderall, etc.)

   ? Inhalants (nitrous, glue, petrol, paint thinner, etc.)

   ? Sedatives or sleeping pills (Valium, Serepax, Rohypnol, etc.)

   ? Hallucinogens (LSD, acid, mushrooms, PCP, special K, etc.)

   ? None of the above [If selected, skip to Q5]

< page break >

Across your lifetime…

2_1. Have you ever tried and failed to control, cut down, or stop using Alcohol? [display if Alcohol is selected in Q1]

o No
o Yes

3_1. Has a friend, relative, or anyone else ever expressed concern about your use of Alcohol? [display if Alcohol is selected in Q1]

Never Once or twice Monthly Weekly Almost daily or daily

4_1. Has your use of Alcohol led to health, social, legal or financial problems? [display if Alcohol is selected in Q1]

o No
o Yes

< page break >

Across your lifetime…

2_2. Have you ever tried and failed to control, cut down, or stop using Combustible tobacco products? [display if Combustible tobacco products is selected in Q1]

o No
o Yes

3_2. Has a friend, relative, or anyone else ever expressed concern about your use of Combustible tobacco products? [display if Combustible tobacco products is selected in Q1]

Never; Once or twice; Monthly Weekly; Almost daily; or daily

4_2. Has your use of Combustible tobacco products led to health, social, legal or financial problems? [display if Combustible tobacco products is selected in Q1]

o No

o Yes

< page break >

Across your lifetime…

2_3. Have you ever tried and failed to control, cut down, or stop using Electronic cigarettes? [display if Electronic cigarettes is selected in Q1]

o No
o Yes

3_3. Has a friend, relative, or anyone else ever expressed concern about your use of Electronic cigarettes? [display if Electronic cigarettes is selected in Q1]

Never; Once or twice; Monthly; Weekly; Almost daily or daily

4_3. Has your use of Electronic cigarettes led to health, social, legal or financial problems? [display if Electronic cigarettes is selected in Q1]

o No

o Yes

< page break >

Across your lifetime…

2_4. Have you ever tried and failed to control, cut down, or stop using Opioids? [display if Opioids is selected in Q1]

o No
o Yes

3_4. Has a friend, relative, or anyone else ever expressed concern about your use of Opioids? [display if Opioids is selected in Q1]

Never; Once or twice; Monthly; Weekly; Almost daily or daily

4_4. Has your use of Opioids led to health, social, legal or financial problems? [display if Opioids is selected in Q1]

o No

o Yes

< page break >

Across your lifetime…

2_5. Have you ever tried and failed to control, cut down, or stop using Cannabis? [display if Cannabis is selected in Q1]

o No
o Yes

3_5. Has a friend, relative, or anyone else ever expressed concern about your use of Cannabis? [display if Cannabis is selected in Q1]

Never; Once or twice; Monthly; Weekly; Almost daily or daily

4_5. Has your use of Cannabis led to health, social, legal or financial problems? [display if Cannabis is selected in Q1]

o No

o Yes

< page break >

Across your lifetime…

2_6. Have you ever tried and failed to control, cut down, or stop using Stimulants? [display if Stimulants is selected in Q1]

o No
o Yes

3_6. Has a friend, relative, or anyone else ever expressed concern about your use of Stimulants? [display if Stimulants is selected in Q1]

Never; Once or twice; Monthly; Weekly; Almost daily or daily

4_6. Has your use of Stimulants led to health, social, legal or financial problems? [display if Stimulants is selected in Q1]

o No

o Yes

< page break >

Across your lifetime…

2_7. Have you ever tried and failed to control, cut down, or stop using Inhalants? [display if Inhalants is selected in Q1]

o No

o Yes

3_7. Has a friend, relative, or anyone else ever expressed concern about your use of Inhalants? [display if Inhalants is selected in Q1]

Never; Once or twice; Monthly; Weekly; Almost daily or daily

4_7. Has your use of Inhalants led to health, social, legal or financial problems? [display if Inhalants is selected in Q1]

o No

o Yes

< page break >

Across your lifetime…

2_8. Have you ever tried and failed to control, cut down, or stop using Sedatives or sleeping pills? [display if Sedatives or sleeping pills is selected in Q1]

o No

o Yes

3_8. Has a friend, relative, or anyone else ever expressed concern about your use of Sedatives or sleeping pills? [display if Sedatives or sleeping pills is selected in Q1] Never; Once or twice; Monthly; Weekly; Almost daily or daily

4_8. Has your use of Sedatives or sleeping pills led to health, social, legal or financial problems? [display if Sedatives or sleeping pills is selected in Q1]

o No

o Yes

Across your lifetime…

2_9. Have you ever tried and failed to control, cut down, or stop using Hallucinogens? [display if Hallucinogens is selected in Q1]

o No

o Yes

3_9. Has a friend, relative, or anyone else ever expressed concern about your use of Hallucinogens? [display if Hallucinogens is selected in Q1] Never; Once or twice; Monthly; Weekly; Almost daily or daily

4_9. Has your use of Hallucinogens led to health, social, legal or financial problems? [display if Hallucinogens is selected in Q1]

o No

o Yes

Across your lifetime…

5. Which of the following types of opioids have you ever used for non-medical reasons? Select all that apply.

   ? Fentanyl (Sublimaze, Actiq, apache, goodfella, TNT)

   ? Heroin (black tar, black pearl, black, china white, dope, white lady, smack, snow, speedball)

   ? Medication for opioid treatment (e.g., Suboxone, Methadone, etc.)

   ? Prescription opioid not for opioid treatment (OxyContin, Vicodin, Percocet, Opana)

6. Which of the following ways have you ever taken opioids? Select all that apply.

   ? Oral (swallow, chew)

   ? Smoke (chase)

   ? Sniff or snort

   ? Injection (IV, muscle, under skin)

   ? Other: ______

7. Have you ever overdosed while taking opioids (passed out and/or you were given Naloxone, an ambulance was called, or you were taken to a hospital)?

   o No

   o 1 time

   o 2 - 3 times

   o 4 - 5 times

   o More than 5 times

8. In the past, if all of the following opioids were available, which would you have chosen?

   o Fentanyl (Sublimaze, Actiq, apache, goodfella, TNT)

   o Heroin (black tar, black pearl, black, china white, dope, white lady, smack, snow, speedball)

   o Medication for opioid treatment (e.g., Suboxone, Methadone, etc.)

   o Prescription opioid not for opioid treatment (OxyContin, Vicodin, Percocet, Opana)

9. Which of the following ways have you most frequently taken opioids?

   o Oral (swallow, chew) o Smoke (chase) o Sniff or snort o Injection (IV, muscle, under skin) o Other _______

? #### Drug Use

[Instructions:] The next set of questions asks about your experience using drugs for non-medical reasons in the past month.

< page break >

In the past month…

1. Which of the following drugs have you used for non-medical reasons? Select all that apply.

   ? Alcohol

   ? Combustible tobacco products (cigarettes, cigars, cigarillos, little cigars, pipe, hookah, bidis)

   ? Electronic cigarettes (e-cigarette, e-vaporizer, vape pen, e-hookah, hookah pen)

   ? Opioids (heroin, fentanyl, oxy, etc.)

   ? Cannabis (marijuana, pot, grass, hash, K2, spice, etc.)

   ? Stimulants (cocaine, meth, speed, ecstasy, molly, Adderall, etc.)

   ? Inhalants (nitrous, glue, petrol, paint thinner, etc.)

   ? Sedatives or sleeping pills (Valium, Serepax, Rohypnol, etc.)

   ? Hallucinogens (LSD, acid, mushrooms, PCP, special K, etc.)

   ? None of the above

In the past month…

2_1. How often have you used alcohol? [display if alcohol is selected in Q1]

Never; Once or twice; Weekly; Almost daily or daily

3_1. How often have you had a strong desire or urge to use Alcohol? [display if alcohol is selected in Q1]

Never; Once or twice; Weekly; Almost daily or daily

4_1. Have you failed to do what was normally expected of you because of your use of Alcohol? [display if alcohol is selected in Q1]

o No

o Yes

In the past month…

2_2. How often have you used Combustible tobacco products? [display if Combustible tobacco products is selected in Q1]

Never; Once or twice; Weekly; Almost daily or daily

3_2. How often have you had a strong desire or urge to use Combustible tobacco products? [display if Combustible tobacco products is selected in Q1] Never; Once or twice; Weekly; Almost daily or daily

4_2. Have you failed to do what was normally expected of you because of your use of Combustible tobacco products? [display if Combustible tobacco products is selected in Q1]

o No

o Yes

< page break >

In the past month…

2_3. How often have you used Electronic cigarettes? [display if Electronic cigarettes is selected in Q1]

Never; Once or twice; Weekly; Almost daily or daily

3_3. How often have you had a strong desire or urge to use Electronic cigarettes? [display if Electronic cigarettes is selected in Q1]

Never; Once or twice; Weekly; Almost daily or daily

4_3. Have you failed to do what was normally expected of you because of your use of Electronic cigarettes? [display if Electronic cigarettes is selected in Q1]

o No

o Yes

< page break >

In the past month…

2_4. How often have you used Opioids? [display if Opioids is selected in Q1]

Never; Once or twice; Weekly; Almost daily or daily

3_4. How often have you had a strong desire or urge to use Opioids? [display if Opioids is selected in Q1]

Never; Once or twice; Weekly; Almost daily or daily

4_4. Have you failed to do what was normally expected of you because of your use of Opioids? [display if Opioids is selected in Q1]

o No

o Yes

< page break >

In the past month…

2_5. How often have you used Cannabis? [display if Cannabis is selected in Q1]

Never; Once or twice; Weekly; Almost daily or daily

3_5. How often have you had a strong desire or urge to use Cannabis? [display if Cannabis is selected in Q1]

Never; Once or twice; Weekly; Almost daily or daily

4_5. Have you failed to do what was normally expected of you because of your use of Cannabis? [display if Cannabis is selected in Q1]

o No

o Yes

< page break >

In the past month…

2_6. How often have you used Stimulants? [display if Stimulants is selected in Q1]

Never; Once or twice; Weekly; Almost daily or daily

3_6. How often have you had a strong desire or urge to use Stimulants? [display if Stimulants is selected in Q1]

Never; Once or twice; Weekly; Almost daily or daily

4_6. Have you failed to do what was normally expected of you because of your use of Stimulants? [display if Stimulants is selected in Q1]

o No

o Yes

< page break >

In the past month…

2_7. How often have you used Inhalants? [display if Inhalants is selected in Q1]

Never; Once or twice; Weekly; Almost daily or daily

3_7. How often have you had a strong desire or urge to use Inhalants? [display if Inhalants is selected in Q1]

Never; Once or twice; Weekly; Almost daily or daily

4_7. Have you failed to do what was normally expected of you because of your use of Inhalants? [display if Inhalants is selected in Q1]

o No

o Yes

< page break >

In the past month…

2_8. How often have you used Sedatives or sleeping pills? [display if Sedatives or sleeping pills is selected in Q1]

Never; Once or twice; Weekly; Almost daily or daily

3_8. How often have you had a strong desire or urge to use Sedatives or sleeping pills? [display if Sedatives or sleeping pills is selected in Q1]

Never; Once or twice; Weekly; Almost daily or daily

4_8. Have you failed to do what was normally expected of you because of your use of Alcohol? [display if alcohol is selected in Q1]

o No

o Yes

< page break >

In the past month…

2_9. How often have you used Hallucinogens? [display if Hallucinogens is selected in Q1]

Never; Once or twice; Weekly; Almost daily or daily

3_9. How often have you had a strong desire or urge to use Hallucinogens? [display if Hallucinogens is selected in Q1]

Never; Once or twice; Weekly; Almost daily or daily

4_9. Have you failed to do what was normally expected of you because of your use of Hallucinogens? [display if alcohol is selected in Q1]

o No

o Yes

< page break >

In the past month…

5. Which of the following types of opioids have you used? Select all that apply. [Display if opioids selected in 1]

   ? Fentanyl (Sublimaze, Actiq, apache, goodfella, TNT)

   ? Heroin (black tar, black pearl, black, china white, dope, white lady, smack, snow, speedball)

   ? Medication for opioid treatment (e.g., Suboxone, Methadone, etc.)

   ? Prescription opioid not for opioid treatment (OxyContin, Vicodin, Percocet, Opana)

6. Which of the following ways have you taken opioids? Select all that apply. [display if opioids selected in 1]

   ? Oral (swallow, chew)

   ? Smoke (chase)

   ? Sniff or snort

   ? Injection (IV, muscle, under skin)

   ? Other _______

7. Have you overdosed while taking opioids (passed out and/or you were given naloxone, an ambulance was called, or you were taken to a hospital)?

   o No

   o 1 time

   o 2 - 3 times

   o 3 - 4 times

   o More than 5 times

< page break >

10.5.1.3 Lifetime Opioid Use History

[Instructions:] The next set of questions asks about your history of using opioids (heroin, fentanyl, oxy, etc.) for non-medical reasons.

< page break >

Thinking about your use of opioids for non-medical reasons…

1. How old were you when you first used opioids?

[Scroll bar: Under 10, 10 - 13, 14 - 17, 18 - 21, 22 - 25, 26 - 35, 36 - 45, 46 - 55, 56 - 65, Over 65]

2. How old were you when you first began using opioids once a week for a month in a row?

[Scroll bar: Under 10, 10 - 13, 14 - 17, 18 - 21, 22 - 25, 26 - 35, 36 - 45, 46 - 55, 56 - 65, Over 65]

3. How old were you when you first believed that your use of opioids was a problem?

[Scroll bar: Under 10, 10 - 13, 14 - 17, 18 - 21, 22 - 25, 26 - 35, 36 - 45, 46 - 55, 56 - 65, Over 65]

4. How old were you when you first tried to quit using opioids?

[Scroll bar: Under 10, 10 - 13, 14 - 17, 18 - 21, 22 - 25, 26 - 35, 36 - 45, 46 - 55, 56 - 65, Over 65]

< page break >

Thinking about your use of opioids for non-medical reasons…

5. How many times have you tried to quit using opioids?

   [Scroll bar: 0 - 20+]

6. Before you began treatment for your opioid use how many days per week did you typically use opioids?

   [Scroll bar: Less than weekly, 1, 2, 3, 4, 5, 6, 7]

7. What types of programs or services have you used in the past to help your recovery from opioids? Select all that apply.

   ? Detox

   ? Short-term residential treatment (less than 6 months)

   ? Outpatient treatment-individual counseling

   ? Outpatient treatment-group counseling

   ? Self-help group (Ex: Narcotics Anonymous, SMART Recovery)

   ? Methadone

   ? Buprenorphine (e.g. Bunavail, Suboxone, Zubsolv)

   ? Naltrexone (e.g. Vivitrol, Revia)

< page break >

10.5.1.4 Opioid Use DSM Self-Report

[Instructions:] The next set of questions asks about your use of opioids for non-medical reasons. When answering each question, think about the 12 months before you started taking medication for opioid use (e.g., Suboxone, Methadone, Buprenorphine, etc.).

< page break >

In the year before you started taking medication for opioid use, did you…

1. Often use larger amounts of opioids than you were planning on using?

   No Yes

2. Often use opioids for longer periods of time than you were planning on using?

   No Yes

3. Often want or try to control your opioid use without success?

   No Yes

4. Spend a lot of time using opioids?

   No Yes

< page break >

In the year before you started taking medication for opioid use, did you…

5. Spend a lot of time trying to find/get opioids?

   No Yes

6. Spend a lot of time recovering from the effects of using opioids?

   No Yes

7. Experience strong desires, urges, or cravings to use opioids?

   No Yes

8. Fail to fulfill requirements at work, school, or home because of your opioid use? (e.g., repeatedly missing work/school, performing poorly at work or school, neglecting responsibilities at home)

   No Yes

< page break >

In the year before you started taking medication for opioid use, did you…

9. Give up or reduce your involvement in social, work/school, or recreational activities that were important to you because of your use of opioids?

   No Yes

10. Continue to use opioids even though it often caused or worsened problems with friends, family, or other people? (e.g., arguments with friends about your use, physical fights)

    No Yes

11. Continue to use opioids even though it often caused or worsened problems with your mental or physical health?

    No Yes

12. Often use opioids in situations that were physically dangerous? (e.g., when driving a car, operating machinery)

    No Yes

< page break >

In the year before you started taking medication for opioid use, did you…

13. Need to increase the amount of opioids you used to get high?

    No Yes

14. Find you got much less of an effect by using the same amount of opioids as in the past?

    No Yes

15. Experience withdrawal symptoms when you tried to cut down or stop using opioids? (e.g., nausea, vomiting, abdominal cramping, diarrhea, runny nose, watery eyes, widespread joint and muscle pain)

    No Yes

16. Use opioids to relieve or avoid withdrawal symptoms? (e.g., nausea, vomiting, abdominal cramping, diarrhea, runny nose, watery eyes, widespread joint and muscle pain)

    No Yes

< page break > ? #### Medication & Treatment Adherence

[Instructions:] The next set of questions asks about medications, counseling, or other forms of treatment that you have used to help your recovery from opioids in the past month.

< page break >

1. What type of medication for opioid use are you currently taking?

   o Medication taken daily (e.g., Suboxone, Methadone)

   o Medications taken monthly (e.g., Vivitrol)

   o I am not taking any medications for opioid use [If selected, skip to Q14]

   o Medication taken daily (e.g., Suboxone, Methadone) and medication taken monthly (e.g., Vivitrol)

[If no option is selected, skip to Q14]

< page break >

2. What type of medication will you continue to take after this month as your primary medication? [Display if “daily and monthly” selected in Q1]

   o Medications that are to be used daily (e.g., Suboxone, Methadone)

   o Medications that are to be used monthly (e.g., Vivitrol)

< page break >

3.Which daily medication are you taking? [Display if “Daily” selected in Q1 or Q2]

o Buprenorphine (Bunavail, Suboxone, Zubsolv, Subutex)

o Methadone (Methadone Intensol, Methadose, Diskets)

o Naltrexone (Revia)

o Other:____

< page break >

4. Which monthly medication are taking? [Display if “Monthly” selected in Q1 or Q2]

   o Buprenorphine injection (Sublocade)

   o Naltrexone injection (Vivitrol)

   o Other:

< page break >

5_1. Did you take Buprenorphine injection (Sublocade) in the past month? [Display if “Buprenorphine injection” selected in Q4]

o No

o Yes

5_2. Did you take Naltrexone injection (Vivitrol) in the past month? [Display if “Naltrexone injection” selected in Q4]

o No

o Yes

5_3. Did you take your monthly medication in the past month? [Display if “Other” selected in Q4] o No

o Yes

< page break >

6_1. How often did you take Buprenorphine (Bunavail, Suboxone, Zubsolv, Subutex) in the past month? [Display if “Buprenorphine” selected in Q3]

Never; Rarely; Sometimes; Most days; Every day

6_1. How often did you take Methadone (Methadone Intensol, Methadose, Diskets) in the past month? [Display if “Methadone” selected in Q3]

Never; Rarely; Sometimes; Most days; Every day

6_3. How often did you take Naltrexone (Revia) in the past month? [Display if “Naltrexone” selected in Q3]

Never; Rarely; Sometimes; Most days; Every day

6_4. How often did you take your daily medication in the past month? [Display if “Other” selected in Q3]

Never; Rarely; Sometimes; Most days; Every day

< page break >

7. It can be hard to take medication for opioid use. What has made it hard for you? Select all that apply.

   ? I forget to take it

   ? I lose my medication

   ? It’s too expensive/it’s not covered under my insurance

   ? Trouble getting it due to a lack of reliable transportation

   ? I do not like how the medication makes me feel

   ? The side-effects are unpleasant

   ? I do not think I need it anymore

   ? I want to be able to get high

   ? I do not like my doctor/clinic/treatment provider

   ? Other___________________

< page break >

In the past month…

8. How much have you experienced side-effects while taking your medication for opioid use? [Skip if monthly or daily is not selected in Q1 or]

   Not at all; Mildly; Moderately; Considerably; Extremely

9. How effective do you think your medication for opioid use is? [Skip if monthly or daily is not selected in Q1]

   Not at all; Mildly; Moderately; Considerably; Extremely

10. How likely are you to continue taking your medication for opioid use? [Skip if monthly or daily is not selected in Q1]

    Not at all; Mildly; Moderately; Considerably; Extremely

< page break >

In the past month…

11. How much have you experienced opioid withdrawal symptoms?

    Not at all; Mildly; Moderately; Considerably; Extremely

12. How often have you attended self-help meetings like AA or NA? [If no options are selected, Q13 and Q14 are displayed]

    Never; Less than weekly; Weekly/near weekly; Daily/near daily

< page break >

13. How effective do you think your self-help meetings (NA/AA) are? [Skip if never is selected for Q12]

    Not at all; Mildly; Moderately; Considerably; Extremely

14. How likely are you to continue attending your self-help meetings (NA/AA)? [Skip if never is selected for Q12]
    Not at all; Mildly; Moderately; Considerably; Extremely

< page break >

In the past month…

15. How often have you attended other individual or group counseling sessions (not including AA or NA meetings)? [If no options are selected, Q16 and Q17 are displayed]

    Never; Less than weekly; Weekly/near weekly; Daily/near daily

< page break >

16. How effective do you think your counseling is? [Skip if never is selected for Q15]

    Not at all; Mildly; Moderately; Considerably; Extremely

17. How likely are you to continue attending your counseling sessions? [Skip if never is selected for Q15]

Not at all; Mildly; Moderately; Considerably; Extremely

< page break >

In the past month…

18. Have you taken psychiatric medication for depression, anxiety, or other mental health symptoms?

    No Yes

19. Have you attended a detox program or other inpatient residential treatment for opioid use(e.g., short or long-term residential treatment, hospitalization, rehab)?

    No Yes

< page break > ? #### Abstinence Confidence/Efficacy Questions

[Instructions:] The next set of questions asks about your recovery goals over the past month and in the next month.

< page break >

Thinking about the **past month…

1. How satisfied are you with your progress toward achieving your opioid recovery goals?

   Not at all; Mildly Moderately; Considerably; Extremely < page break > Thinking forward to the **next month…

2. How motivated are you to completely avoid using opioids for non-medical reasons?

Not at all Mildly Moderately Considerably Extremely

3. How confident are you in your ability to completely avoid using opioids for non-medical reasons?

Not at all Mildly Moderately Considerably Extremely

4. Do you intend to completely avoid using any other drugs (besides opioids)?

   o No [If selected, skip to end of survey] o Yes

[If no option selected, skip to end of survey]

< page break >

In the **next month…

5. Select the drugs below that you are trying to completely avoid using. Select all that apply. ? Alcohol ? Combustible tobacco products (cigarettes, cigars, cigarillos, little cigars, pipe, hookah, bidis) ? Electronic cigarettes (e-cigarette, e-vaporizer, vape pen, e-hookah, hookah pen) ? Cannabis (marijuana, pot, grass, hash, etc.) ? Stimulants (cocaine, meth, speed, ecstasy, molly, Adderall, etc.) ? Inhalants (nitrous, glue, petrol, paint thinner, etc.) ? Sedatives or sleeping pills (Valium, Serepax, Rohypnol, etc.) ? Hallucinogens (LSD, acid, mushrooms, PCP, special K, etc.) ? Other________ < page break >

10.5.1.5 Pain Catastrophizing Scale

[Instructions:] Listed on the next page are thoughts and feelings you may have when you experience pain. For each statement, select the response that best describes you.

< page break >

When I’m in pain…

1. I can’t stand it.

   Never Rarely Sometimes Often Always

2. I am afraid that the pain will get worse. Never Rarely Sometimes Often Always

3. I keep thinking about how much I want the pain to stop. Never Rarely Sometimes Often Always

? < page break >

10.5.1.6 Mid-Survey Message

You are more than half-way done with the first monthly update! Complete it to receive a $10 payment. < page break >

10.5.1.7 Brief Pain Inventory (Short Form, Modified)

[Instructions:] The next set of questions asks about any pain you have experienced in the past month.

< page break >

In the **past month…

1. How bad has your pain been on average?

   Not at all Mildly Moderately Considerably Extremely

2. How much has pain interfered with your enjoyment of life?

   Not at all Mildly Moderately Considerably Extremely

3. How much has pain interfered with your general activity?

   Not at all Mildly Moderately Considerably Extremely

< page break >

In the **next month…

4. What treatments or medications will you receive for your pain? Select all that apply. (Do not include medication you are receiving to help your opioid recovery efforts.)

   ? Opioid pain medications ? Non-opioid pain medications ? Surgical outpatient procedure (lidocaine injection, steroid injection, trigger point injection, medication pump, etc.) ? Surgeries (spinal fusion, discectomy, arthroscopic, etc.) ? Physical/occupational therapy
   ? Alternative treatments (e.g., massage, yoga, acupuncture, meditation, herbal supplements, etc.)
   ? No treatments or medications ? Other

< page break >

10.5.1.8 Behavior and Symptom Identification Scale (BASIS-32)

[Instructions:] Listed on the next page are problems that some people may experience. Select the response that best describes how much difficulty you have been having in each problem area. Think about your experiences in the past month.

< page break >

In the past month, how much difficulty have you had with…

1. Depression, feeling hopeless

   None at all; Mild; Moderate; Considerable; Extreme

2. Fear, anxiety, or panic

   None at all Mild Moderate Considerable Extreme

3. Confusion, loss of memory

   None at all Mild Moderate Considerable Extreme

4. Disturbing thoughts or beliefs
   None at all Mild Moderate Considerable Extreme

5. Hearing voices, seeing things
   None at all Mild Moderate Considerable Extreme

< page break >

In the past month, how much difficulty have you had with…

6. Manic, bizarre behavior

   None at all Mild Moderate Considerable Extreme

7. Mood swings, unstable moods

   None at all Mild Moderate Considerable Extreme

8. Uncontrollable, repetitive behavior (e.g., eating disorder, hand washing, hurting yourself)

   None at all Mild Moderate Considerable Extreme

9. Sexual activity or preoccupation

   None at all Mild Moderate Considerable Extreme

10. Controlling temper, outburst of anger, violence None at all Mild Moderate Considerable Extreme

< page break >

10.5.1.9 Distress Tolerance Questionnaire

[Instructions:] Listed on the next page are statements that describe how people may feel about being distressed or upset. We are interested in how you would describe yourself. There are no right or wrong answers. For each statement, select how much you agree that the statement describes you.

< page break >

1. I can’t handle feeling distressed or upset.

   Strongly disagree Mildly disagree Agree and disagree equally Mildly agree Strongly agree

2. My feelings of distress are so intense that they completely take over.

   Strongly disagree Mildly disagree Agree and disagree equally Mildly agree Strongly agree

3. There’s nothing worse than feeling distressed or upset.

   Strongly disagree Mildly disagree Agree and disagree equally Mildly agree Strongly agree

4. My feelings of distress or anger are not acceptable.

   Strongly disagree Mildly disagree Agree and disagree equally Mildly agree Strongly agree

5. When I feel distressed or upset, I cannot help but concentrate on how bad I feel.

   Strongly disagree Mildly disagree Agree and disagree equally Mildly agree Strongly agree

< page break > ? #### Perceived Stress Scale

[Instructions:] The next set of questions asks about your feelings and thoughts in the past month.

< page break >

In the **past month…

1. How often have you felt that you were unable to control the important things in your life?

   Never Rarely Sometimes Often Always

2. How often have you felt confident about your ability to handle your personal problems?

   Never Rarely Sometimes Often Always

3. How often have you felt that things were going your way?

   Never Rarely Sometimes Often Always

4. How often have you felt difficulties were piling up so high that you could not overcome them?

   Never Rarely Sometimes Often Always

< page break >

10.5.1.10 World Health Organization Quality of Life (WHOQOL-BREF 2)

[Instructions:] The next set of questions asks about your quality of life in the past month.

< page break >

In the past month, how satisfied are you with…

1. Your overall quality of life

   Very dissatisfied Dissatisfied Neither satisfied nor dissatisfied Satisfied Very satisfied

2. Your physical health

   Very dissatisfied Dissatisfied Neither satisfied nor dissatisfied Satisfied Very satisfied

3. Your mental health

   Very dissatisfied Dissatisfied Neither satisfied nor dissatisfied Satisfied Very satisfied

4. Your sleep

   Very dissatisfied Dissatisfied Neither satisfied nor dissatisfied Satisfied Very satisfied

< page break >

In the past month, how satisfied are you with…

5. Your daily living activities

   Very dissatisfied Dissatisfied Neither satisfied nor dissatisfied Satisfied Very satisfied

6. Your capacity for work

   Very dissatisfied Dissatisfied Neither satisfied nor dissatisfied Satisfied Very satisfied

7. Yourself

   Very dissatisfied Dissatisfied Neither satisfied nor dissatisfied Satisfied Very satisfied

8. Your personal relationships

   Very dissatisfied Dissatisfied Neither satisfied nor dissatisfied Satisfied Very satisfied

< page break >

In the past month, how satisfied are you with…

9. Your sex life

   Very dissatisfied Dissatisfied Neither satisfied nor dissatisfied Satisfied Very satisfied

10. Your opportunities for leisure activities

    Very dissatisfied Dissatisfied Neither satisfied nor dissatisfied Satisfied Very satisfied

11. The support you get from your friends

    Very dissatisfied Dissatisfied Neither satisfied nor dissatisfied Satisfied Very satisfied

12. The conditions of your living place (e.g., your house, apartment)

    Very dissatisfied Dissatisfied Neither satisfied nor dissatisfied Satisfied Very satisfied

< page break >

In the past month, how satisfied are you with…

13. The conditions of your neighborhood

    Very dissatisfied Dissatisfied Neither satisfied nor dissatisfied Satisfied Very satisfied

14. Your access to health services

    Very dissatisfied Dissatisfied Neither satisfied nor dissatisfied Satisfied Very satisfied

15. Your access to transportation

    Very dissatisfied Dissatisfied Neither satisfied nor dissatisfied Satisfied Very satisfied

16. Your ability to concentrate

    Very dissatisfied Dissatisfied Neither satisfied nor dissatisfied Satisfied Very satisfied

17. Your energy for everyday life

    Very dissatisfied Dissatisfied Neither satisfied nor dissatisfied Satisfied Very satisfied

< page break > ? #### Social Connectedness

[Instructions:] The next set of questions asks about social support. Think about support you have given and received in person, on the phone, or online (e.g., over text, phone, email, Facebook, Twitter, etc.) in the past month.

< page break >

In the past month, how often was there someone …
1. …who you could count on to listen to you when you needed to talk?

Never       Rarely      Sometimes       Often       Always

2. …who gave you information to help you understand a situation?

   Never Rarely Sometimes Often Always

3. How often did you get support from someone in person (not using your phone or a computer)?

   Never Rarely Sometimes Often Always

< page break >

In the past month, how often did others …

4. . …count on you to listen when they needed to talk?
   Never Rarely Sometimes Often Always

5. …get information from you to help them understand a situation?

   Never Rarely Sometimes Often Always

6. How often did you give support to someone in person (not using your phone or a computer)?

   Never Rarely Sometimes Often Always

< page break >

10.5.1.11 Personality Inventory for DSM-5 Brief Form

[Instructions:] Listed on the next page are a number of things people might say about themselves. We are interested in how you would describe yourself. There are no right or wrong answers. For each statement, select how much you agree that the statement describes you.

< page break >

1. People would describe me as reckless.

   Strongly disagree Mildly disagree Agree and disagree equally Mildly agree Strongly agree

2. I feel like I act totally on impulse.

   Strongly disagree Mildly disagree Agree and disagree equally Mildly agree Strongly agree

3. Even though I know better, I can’t stop making rash or careless decisions.

   Strongly disagree Mildly disagree Agree and disagree equally Mildly agree Strongly agree

4. Others see me as irresponsible.

   Strongly Disagree Mildly Disagree Agree and Disagree Equally Mildly Agree Strongly agree

< page break >

5. I’m not good at planning ahead.

   Strongly disagree Mildly disagree Agree and disagree equally Mildly agree Strongly agree

6. I steer clear of romantic relationships.

   Strongly disagree Mildly disagree Agree and disagree equally Mildly agree Strongly agree

7. I’m not interested in making friends.

   Strongly disagree Mildly disagree Agree and disagree equally Mildly agree Strongly agree

< page break >

8. I don’t like to get close to people.

   Strongly disagree Mildly disagree Agree and disagree equally Mildly agree Strongly agree

9. It’s no big deal if I hurt other peoples’ feelings.

   Strongly disagree Mildly disagree Agree and disagree equally Mildly agree Strongly agree

10. I rarely get enthusiastic about anything.

    Strongly disagree Mildly disagree Agree and disagree equally Mildly agree Strongly agree

11. I crave attention.

    Strongly disagree Mildly disagree Agree and disagree equally Mildly agree Strongly agree

12. I often have to deal with people who are less important than me.

    Strongly disagree Mildly disagree Agree and disagree equally Mildly agree Strongly agree

< page break >

13. I use people to get what I want.

    Strongly disagree Mildly disagree Agree and disagree equally Mildly agree Strongly agree

14. It is easy for me to take advantage of others.

    Strongly disagree Mildly disagree Agree and disagree equally Mildly agree Strongly agree

< page break >

10.5.1.12 Adverse Childhood Experience Questionnaire

[Instructions:] The next set of questions asks about difficult or stressful things that sometimes happen to children. Think about your entire childhood (the first 18 years of your life) as you respond.

< page break >

During your childhood…

1. Did a parent or other adult in the household swear at you, insult you, or put you down more than once?

   o No

   o Yes

2. Did a parent or other adult in the household push, grab, slap, or throw something at you more than once?

   o No

   o Yes

3. Did you live with anyone who had problems with alcohol or other drugs?

   o No

   o Yes

< page break > ? #### Trauma Experience

< page break >

1. Across your lifetime, have you ever experienced an event that put you or close others at risk of serious harm or death?

   o No

   o Yes

< page break >

10.5.1.13 End of Survey Message

You have now completed the first monthly update! You will receive an additional $10 in your next study payment. Thank you! ### Monthly Survey

10.5.1.14 Global Instructions

This is the monthly update. It consists of different surveys that ask about aspects of your life and your recovery including the people you talk to and the places you go, your household, personal support network, opioid use, other drug use, drug treatment services, life events, and emotions.

Completing this will take about 20 minutes and you will receive a $10 payment for completing it.

Please read through all questions carefully and answer them honestly. All of your responses will be kept completely private.

< page break >

The term “opioid” in these surveys refers to prescription opioids (like Oxycontin or Vicodin), synthetic opioids (fentanyl), and heroin. Below is a list of commonly used terms for these substances:

Oxycodone (Oxycontin, Percocet, oxy, percs, O.C., rims, tires, greenies)

Hydrocodone (Vicodin, Lortab, Norco, vike, bananas, fluff, hydros)

Morphine (Kadian, Duramorph, MS Contin, miss Emma, monkey, white stuff, M)

Codeine (lean, captain Cody, little C, schoolboy)

Buprenorphine (Suboxone, Subutex, buse, sobos, strips, oranges) Hydromorphone (Dilaudid, Exalgo, smack, dillies, footballs, juice)

Methadone (Methadose, Dolophine, tootsie roll, red rock, mud, dolls)

Oxymorphone (Opana, biscuits, mrs. O, O bomb, octagon)

Tramadol (Ultram, chill pills, trammies, ultras)

Fentanyl (Sublimaze, Actiq, apache, goodfella, TNT)

Heroin (black tar, black pearl, black, china white, dope, white lady, smack, snow, speedball)

< page break >

When we ask about your use of opioids or other drugs, we often use the term “non-medical reasons.” When you see this term please think about your use of drugs to feel intoxicated or high. This includes taking more of a drug than you were prescribed, taking it more frequently than prescribed, or using a drug for reasons other than it was prescribed for.

< page break >

10.5.1.15 Demographics

[Instructions:] The next set of questions asks for some general information about your current life.

< page break >

1. Which of the following have changed in your life in the past month? Select all that apply.

   ? School enrollment (enrolled, dropped out, or graduated) ? Employment status (changed jobs or hours, retired, or lost job) ? Living arrangement (changed where you live or who you live with) ? None of the above [if selected, jump to question 4]

< page break >

2. Are you currently enrolled in school? [Display if “school enrollment” selected in Q1] o No
   o Yes

< page break >

3. Which of the following categories best describes your employment status? [Display if “employment status” selected in Q1]

   o Employed, working 1-39 hours per week

   o Employed, working 40 or more hours per week

   o Not employed, looking for work

   o Not employed, NOT looking for work

   o Retired

   o Disabled, not able to work

   < page break >

4. Are you currently in a committed romantic relationship?

   o No [Skip RAS go to WHOASSIST]
   o Yes

< page break >

5. What is your current living arrangement? [Display if “living arrangement” selected in Q1]

   o Living alone [Skip to end of demographic survey]

   o Living with family/others

   o Homeless shelter

   o Homeless unsheltered

   o Sober living/halfway house

   o Other

< page break >

6. Who do you live with? Select all that apply. [Display if “living arrangement” selected in Q1 and “living alone” not selected in Q6]

   ? Spouse/significant other

   ? Child/grandchild

   ? Parent

   ? Other relative

   ? Non-relative

< page break >

Do you live with anyone who…

[Display Q7-Q10 if “living arrangement” selected in Q1 and “living alone” not selected in Q6]

7. Uses opioids for medical reasons (uses opioids as prescribed by their doctor)?

   o No
   o Yes

8. Uses opioids for non-medical reasons (uses opioids to feel intoxicated or high)?

   o No
   o Yes

9. Uses drugs other than opioids for non-medical reasons (do not include tobacco or alcohol)?

   o No
   o Yes

10. Uses alcohol excessively (very frequently or in large amounts)?

    o No
    o Yes

< page break > ? #### Relationship Assessment Scale

[This scale will be skipped by participants who indicate they are not in a relationship across Q4 of the monthly demographics survey]

[Instructions:] The next set of questions asks you to think about your relationship with your partner in the past month.

< page break >

In the past month…

1. How satisfied have you been with your relationship?

   Not at all Mildly Moderately Considerably Extremely

2. How often have there been problems in your relationship?

   Never Rarely Sometimes Often Always

3. How often have you wished you hadn’t gotten into this relationship?

   Never Rarely Sometimes Often Always

< page break >

10.5.1.16 Drug Use - Monthly

[Instructions:] The next set of questions asks about your experience using drugs for non-medical reasons in the past month.

< page break >

In the past month…

1. Which of the following drugs have you used for non-medical reasons? Select all that apply.

   ? Alcohol

   ? Combustible tobacco products (cigarettes, cigars, cigarillos, little cigars, pipe, hookah, bidis)

   ? Electronic cigarettes (e-cigarette, e-vaporizer, vape pen, e-hookah, hookah pen)

   ? Opioids (heroin, fentanyl, oxy, etc.)

   ? Cannabis (marijuana, pot, grass, hash, K2, spice, etc.)

   ? Stimulants (cocaine, meth, speed, ecstasy, molly, Adderall, etc.)

   ? Inhalants (nitrous, glue, petrol, paint thinner, etc.)

   ? Sedatives or sleeping pills (Valium, Serepax, Rohypnol, etc.)

   ? Hallucinogens (LSD, acid, mushrooms, PCP, special K, etc.)

   ? None of the above [If selected, skip to Q5]

< page break >

In the past month…

2_1. How often have you used alcohol? [display if alcohol is selected in Q1]

Never Once or twice Weekly Almost daily or daily

3_1. How often have you had a strong desire or urge to use Alcohol? [display if alcohol is selected in Q1]

Never Once or twice Weekly Almost daily or daily

4_1. Have you failed to do what was normally expected of you because of your use of Alcohol? [display if alcohol is selected in Q1]

o No

o Yes

In the past month…

2_2. How often have you used Combustible tobacco products? [display if Combustible tobacco products is selected in Q1]

Never Once or twice Weekly Almost daily or daily

3_2. How often have you had a strong desire or urge to use Combustible tobacco products? [display if Combustible tobacco products is selected in Q1]

Never Once or twice Weekly Almost daily or daily

4_2. Have you failed to do what was normally expected of you because of your use of Combustible tobacco products? [display if Combustible tobacco products is selected in Q1]

o No

o Yes

< page break >

In the past month…

2_3. How often have you used Electronic cigarettes? [display if Electronic cigarettes is selected in Q1]

Never Once or twice Weekly Almost daily or daily

3_3. How often have you had a strong desire or urge to use Electronic cigarettes? [display if Electronic cigarettes is selected in Q1]

Never Once or twice Weekly Almost daily or daily

4_3. Have you failed to do what was normally expected of you because of your use of Electronic cigarettes? [display if Electronic cigarettes is selected in Q1]

o No

o Yes

< page break >

In the past month…

2_4. How often have you used Opioids? [display if Opioids is selected in Q1]

Never Once or twice Weekly Almost daily or daily

3_4. How often have you had a strong desire or urge to use Opioids? [display if Opioids is selected in Q1]

Never Once or twice Weekly Almost daily or daily

4_4. Have you failed to do what was normally expected of you because of your use of Opioids? [display if Opioids is selected in Q1]

o No

o Yes

< page break >

In the past month…

2_5. How often have you used Cannabis? [display if Cannabis is selected in Q1]

Never Once or twice Weekly Almost daily or daily

3_5. How often have you had a strong desire or urge to use Cannabis? [display if Cannabis is selected in Q1]

Never Once or twice Weekly Almost daily or daily

4_5. Have you failed to do what was normally expected of you because of your use of Cannabis? [display if Cannabis is selected in Q1]

o No

o Yes

< page break >

In the past month…

2_6. How often have you used Stimulants? [display if Stimulants is selected in Q1]

Never Once or twice Weekly Almost daily or daily

3_6. How often have you had a strong desire or urge to use Stimulants? [display if Stimulants is selected in Q1]

Never Once or twice Weekly Almost daily or daily

4_6. Have you failed to do what was normally expected of you because of your use of Stimulants? [display if Stimulants is selected in Q1]

o No

o Yes

< page break >

In the past month…

2_7. How often have you used Inhalants? [display if Inhalants is selected in Q1]

Never Once or twice Weekly Almost daily or daily

3_7. How often have you had a strong desire or urge to use Inhalants? [display if Inhalants is selected in Q1]

Never Once or twice Weekly Almost daily or daily

4_7. Have you failed to do what was normally expected of you because of your use of Inhalants? [display if Inhalants is selected in Q1]

o No

o Yes

< page break >

In the past month…

2_8. How often have you used Sedatives or sleeping pills? [display if Sedatives or sleeping pills is selected in Q1]

Never Once or twice Weekly Almost daily or daily

3_8. How often have you had a strong desire or urge to use Sedatives or sleeping pills? [display if Sedatives or sleeping pills is selected in Q1]

Never Once or twice Weekly Almost daily or daily

4_8. Have you failed to do what was normally expected of you because of your use of Alcohol? [display if alcohol is selected in Q1]

o No

o Yes

< page break >

In the past month…

2_9. How often have you used Hallucinogens? [display if Hallucinogens is selected in Q1]

Never Once or twice Weekly Almost daily or daily

3_9. How often have you had a strong desire or urge to use Hallucinogens? [display if Hallucinogens is selected in Q1]

Never Once or twice Weekly Almost daily or daily

4_9. Have you failed to do what was normally expected of you because of your use of Hallucinogens? [display if alcohol is selected in Q1]

o No

o Yes

< page break >

In the past month…

5. Which of the following types of opioids have you used? Select all that apply. [display if opioids selected in 1]

   ? Fentanyl (Sublimaze, Actiq, apache, goodfella, TNT)

   ? Heroin (black tar, black pearl, black, china white, dope, white lady, smack, snow, speedball)

   ? Medication for opioid treatment (e.g., Suboxone, Methadone, etc.)

   ? Prescription opioid not for opioid treatment (OxyContin, Vicodin, Percocet, Opana)

6. How did you take opioids for non-medical reasons? Select all that apply. [display if opioids selected in 1]

   ? Oral (swallow, chew) ? Smoke (chase) ? Sniff or snort ? Injection (IV, muscle, under skin) ? Other _______

7. Have you overdosed while taking opioids (passed out and/or given naloxone, treated by EMT, or went to a hospital)? [display if opioids selected in Q1] o No o 1 time o 2 - 3 times o 4 - 5 times o More than 5 times

< page break > ? #### Medication & Treatment Adherence

[Instructions:] The next set of questions asks about medications, counseling, or other forms of treatment that you have used to help your recovery from opioids in the past month.

< page break >

1. What type of medication for opioid use are you currently taking?

   o Medication taken daily (e.g., Suboxone, Methadone)

   o Medication taken monthly (e.g., Vivitrol)

   o I am not taking any medications for opioid use [If selected, skip to Q11 (withdrawal, self-help)]

   o Medication taken daily (e.g., Suboxone, Methadone) and medication taken monthly (e.g., Vivitrol)

< page break >

2. What type of medication will you continue to take after this month as your primary medication? [Show if “daily and monthly” selected in Q1]

   o Medications that are to be used daily (e.g., Suboxone, Methadone)

   o Medications that are to be used monthly (e.g., Vivitrol)

< page break >

3.Which daily medication are you taking? [display if “Daily” selected in Q1 or Q2]

o Buprenorphine (Bunavail, Suboxone, Zubsolv, Subutex)

o Methadone (Methadone Intensol, Methadose, Diskets)

o Naltrexone (Revia)

o Other: _____

< page break >

4. Which monthly medication are you taking? [Show if “Monthly” selected in Q1 or Q2]

   o Buprenorphine injection (Sublocade)

   o Naltrexone injection (Vivitrol)

   o Other: ______

< page break >

5_1. Did you take Buprenorphine injection (Sublocade) in the past month? [Display if “Buprenorphine injection” selected in Q4]

o No

o Yes

5_2. Did you take Naltrexone injection (Vivitrol) in the past month? [Display if “Naltrexone injection” selected in Q4]

o No

o Yes

5_3. Did you take your monthly medication in the past month? [Display if “Other” selected in Q4]

o No

o Yes

< page break >

6_1. How often did you take Buprenorphine (Bunavail, Suboxone, Zubsolv, Subutex) in the past month? [Display if “Buprenorphine” selected in Q3]

Never Rarely Sometimes Most days Every day

6_1. How often did you take Methadone (Methadone Intensol, Methadose, Diskets) in the past month? [Display if “Methadone” selected in Q3]

Never Rarely Sometimes Most days Every day

6_3. How often did you take Naltrexone (Revia) in the past month? [Display if “Naltrexone” selected in Q3]

Never Rarely Sometimes Most days Every day

6_4. How often did you take your daily medication in the past month? [Display if “Other” selected in Q3]

Never Rarely Sometimes Most days Every day

< page break >

7. It can be hard to take medication for opioid use. What has made it hard for you? Select all that apply.

   ? I forget to take it

   ? I lose my medication

   ? It’s too expensive/it’s not covered under my insurance

   ? Trouble getting it due to a lack of reliable transportation

   ? I do not like how the medication makes me feel

   ? The side-effects are unpleasant

   ? I do not think I need it anymore

   ? I want to be able to get high

   ? I do not like my doctor/clinic/treatment provider

   ? Other______

< page break >

In the past month…

8. How much have you experienced side-effects while taking your medication for opioid use?

   Not at all Mildly Moderately Considerably Extremely

< page break >

9. How effective do you think your medication for opioid use is? [Skip if monthly or daily is not selected in Q1]

   Not at all Mildly Moderately Considerably Extremely

10. How likely are you to continue taking your medication for opioid use? [Skip if monthly or daily is not selected in Q1]

    Not at all Mildly Moderately Considerably Extremely

< page break >

In the past month…

11. How much have you experienced opioid withdrawal symptoms?

    Not at all Mildly Moderately Considerably Extremely

< page break >

In the past month…

12. How often have you attended self-help meetings like AA or NA?

    Never Less than weekly Weekly/near weekly Daily/near daily

< page break >

14. How effective do you think your self-help meetings (NA/AA) are? [Skip if Never is selected for Q15]

    Not at all Mildly Moderately Considerably Extremely

15. How likely are you to continue attending your self-help meetings (NA/AA)? [Skip if Never is selected for Q15]
    Not at all Mildly Moderately Considerably Extremely

< page break >

In the past month…

16. How often have you attended other individual or group counseling sessions (not including AA or NA meetings)?

    Never Less than weekly Weekly/near weekly Daily/near daily

< page break >

17. How effective do you think your counseling is? [Skip if Never is selected for Q18]

    Not at all Mildly Moderately Considerably Extremely

18. How likely are you to continue attending your counseling sessions? [Skip if Never is selected for Q18]

    Not at all Mildly Moderately Considerably Extremely

< page break >

In the past month…

19. Have you taken psychiatric medication for depression, anxiety, or other mental health symptoms?

    o No

    o Yes

20. Have you attended a detox program or other inpatient residential treatment for opioid use(e.g., short or long-term residential treatment, hospitalization, rehab)? o No

    o Yes

< page break >

10.5.1.17 Mid-Survey Message

You are about half-way done with the monthly update! Complete it to receive a $10 payment.

< page break >

10.5.1.18 Abstinence Confidence/Efficacy Questions

[Instructions:] The next set of questions asks about your recovery goals over the past month and in the next month.

< page break >

Thinking about the past month…

1. How satisfied are you with your progress toward achieving your opioid recovery goals?

   Not at all Mildly Moderately Considerably Extremely

< page break >

Thinking forward to the next month…

2. How motivated are you to completely avoid using opioids for non-medical reasons?

   Not at all Mildly Moderately Considerably Extremely

3. How confident are you in your ability to avoid using opioids for non-medical reasons?

   Not at all Mildly Moderately Considerably Extremely

< page break >

In the next month…

4. Do you intend to completely avoid using any other drugs (besides opioids)?

   o No

   o Yes

< page break >

In the next month…

5. Select the drugs below that you are trying to completely avoid using. Select all that apply. [Skip if Never is selected for Q4]

   ? Alcohol

   ? Combustible tobacco products (cigarettes, cigars, cigarillos, little cigars, pipe, hookah, bidis) [If selected; skip to end of survey]

   ? Electronic cigarettes (e-cigarette, e-vaporizer, vape pen, e-hookah, hookah pen) [If selected; skip to end of survey]

   ? Cannabis (marijuana, pot, grass, hash, etc.)

   ? Stimulants (cocaine, meth, speed, ecstasy, molly, Adderall, etc.)

   ? Inhalants (nitrous, glue, petrol, paint thinner, etc.)

   ? Sedatives or sleeping pills (Valium, Serepax, Rohypnol, etc.)

   ? Hallucinogens (LSD, acid, mushrooms, PCP, special K, etc.)

   ? Other __________

< page break >

10.5.1.19 Brief Pain Inventory (Short Form, Modified)

[Instructions:] The next set of questions asks about any pain you have experienced in the past month.

< page break >

In the past month…

1. How bad has your pain been on average?

   Not at all Mildly Moderately Considerably Extremely

2. How much has pain interfered with your enjoyment of life?

   Not at all Mildly Moderately Considerably Extremely

3. How much has pain interfered with your general activity?

   Not at all Mildly Moderately Considerably Extremely

< page break >

In the next month…

4. What treatments or medications will you receive for your pain? Select all that apply. (Do not include medication you are receiving to help your opioid recovery efforts)

   ? Opioid pain medications

   ? Non-opioid pain medications

   ? Surgical outpatient procedure (lidocaine injection, steroid injection, trigger point injection, medication pump, etc.)

   ? Surgeries (spinal fusion, discectomy, arthroscopic, etc.)

   ? Physical/occupational therapy

   ? Alternative treatments (e.g., massage, yoga, acupuncture, meditation, herbal supplements, etc.)

   ? No treatments or medications

   ? Other

< page break >?

10.5.1.20 Behavior and Symptom Identification Scale (BASIS-32)

[Instructions:] Listed on the next page are problems that some people may experience. Select the response that best describes how much difficulty you have been having in each problem area. Think about your experiences in the past month.

< page break >

In the past month, how much difficulty have you had with…

1. Depression, feeling hopeless

   None at all Mild Moderate Considerable Extreme

2. Fear, anxiety, or panic
   None at all Mild Moderate Considerable Extreme

3. Confusion, loss of memory

None at all Mild Moderate Considerable Extreme

4. Disturbing thoughts or beliefs
   None at all Mild Moderate Considerable Extreme

5. Hearing voices, seeing things

   None at all Mild Moderate Considerable Extreme

< page break >

In the past month, how much difficulty have you had with…

6. Manic, bizarre behavior

   None at all Mild Moderate Considerable Extreme

7. Mood swings, unstable moods

   None at all Mild Moderate Considerable Extreme

8. Uncontrollable, repetitive behavior (e.g., eating disorder, hand washing, hurting yourself)

   None at all Mild Moderate Considerable Extreme

9. Sexual activity or preoccupation

   None at all Mild Moderate Considerable Extreme

10. Controlling temper, outburst of anger, violence

    None at all Mild Moderate Considerable Extreme

< page break >

10.5.1.21 Perceived Stress Scale

[Instructions:] The next set of questions ask about your feelings and thoughts in the past month.

< page break >

In the past month…

1. How often have you felt that you were unable to control the important things in your life?

   Never Rarely Sometimes Often Always

2. How often have you felt confident about your ability to handle your personal problems?

   Never Rarely Sometimes Often Always

3. How often have you felt that things were going your way?

   Never Rarely Sometimes Often Always

4. How often have you felt difficulties were piling up so high that you could not overcome them?

   Never Rarely Sometimes Often Always

< page break >

10.5.1.22 World Health Organization Quality of Life (WHOQOL-BREF 2)

[Instructions:] The next set of questions asks about your quality of life in the past month.

< page break >

In the past month, how satisfied are you with…

1. Your overall quality of life

   Very dissatisfied Dissatisfied Neither satisfied nor dissatisfied Satisfied Very satisfied

2. Your physical health

   Very dissatisfied Dissatisfied Neither satisfied nor dissatisfied Satisfied Very satisfied

3. Your mental health

   Very dissatisfied Dissatisfied Neither satisfied nor dissatisfied Satisfied Very satisfied

4. Your sleep

   Very dissatisfied Dissatisfied Neither satisfied nor dissatisfied Satisfied Very satisfied

< page break >

In the past month, how satisfied are you with…

5. Your daily living activities

   Very dissatisfied Dissatisfied Neither satisfied nor dissatisfied Satisfied Very satisfied

6. Your capacity for work

   Very dissatisfied Dissatisfied Neither satisfied nor dissatisfied Satisfied Very satisfied

7. Yourself

   Very dissatisfied Dissatisfied Neither satisfied nor dissatisfied Satisfied Very satisfied

8. Your personal relationships

   Very dissatisfied Dissatisfied Neither satisfied nor dissatisfied Satisfied Very satisfied

< page break >

In the past month, how satisfied are you with…

9. Your sex life

   Very dissatisfied Dissatisfied Neither satisfied nor dissatisfied Satisfied Very satisfied

10. Your opportunities for leisure activities

    Very dissatisfied Dissatisfied Neither satisfied nor dissatisfied Satisfied Very satisfied

11. The support you get from your friends

    Very dissatisfied Dissatisfied Neither satisfied nor dissatisfied Satisfied Very satisfied

12. The conditions of your living place (e.g., your house, apartment)

    Very dissatisfied Dissatisfied Neither satisfied nor dissatisfied Satisfied Very satisfied

< page break >

In the past month, how satisfied are you with…

13. The conditions of your neighborhood

    Very dissatisfied Dissatisfied Neither satisfied nor dissatisfied Satisfied Very satisfied

14. Your access to health services

    Very dissatisfied Dissatisfied Neither satisfied nor dissatisfied Satisfied Very satisfied

15. Your access to transportation

    Very dissatisfied Dissatisfied Neither satisfied nor dissatisfied Satisfied Very satisfied

16. Your ability to concentrate

    Very dissatisfied Dissatisfied Neither satisfied nor dissatisfied Satisfied Very satisfied

17. Your energy for everyday life

    Very dissatisfied Dissatisfied Neither satisfied nor dissatisfied Satisfied Very satisfied

< page break >

? #### Social Connectedness

[Instructions:] The next set of questions asks about social support. Think about support you have given and received in person or online (e.g., over email, Facebook, Twitter, etc.) in the past month.

< page break >

In the past month, how often was there someone …
1. …who you could count on to listen to you when you needed to talk?

Never       Rarely      Sometimes       Often       Always

2. …who gave you information to help you understand a situation?

   Never Rarely Sometimes Often Always

3. How often did you get support from someone in person (not over email, Facebook, Twitter, etc.)?

   Never Rarely Sometimes Often Always

< page break > In the past month, how often did others …

4. . …count on you to listen when they needed to talk?
   Never Rarely Sometimes Often Always

5. . …get information from you to help them understand a situation?

   Never Rarely Sometimes Often Always

6. How often did you give support to someone in person (not over email, Facebook, Twitter, etc.)?

   Never Rarely Sometimes Often Always

< page break >

10.5.1.23 End of Survey Message

You have now completed the monthly update! You will receive an additional $10 in your next study payment. Thank you!

10.5.2 Social Contacts Survey

[Instructions:] The first questions ask you about the people you talked to or texted with on your phone over the past month.

Our automated system has identified phone numbers that you interacted with frequently. The system is not perfect; it may have identified phone numbers that you do not recognize. You will be able to tell us if the system has made an error.

[Display for each phone number identified as a frequent contact for the month]

You texted or spoke to a person whose phone number is $number several times in the past month. Recently, you $type with them on \(date. This person is saved in your contacts as **\)contact_name**. [Display last sentence only if the number is saved in contacts]

[Repeat context information on every page that asks about this person.]

1. Which of the following best describes who this phone number belongs to?

   o Spouse or significant other o Person I take care of (e.g., my child) o Parent o Other family member (e.g., grandparent, sibling, cousin) o Friend o Mental health-related (e.g., a therapist or counselor, crisis line) o Work-related (e.g., a co-worker, my place of work) o Healthcare-related (e.g., a doctor or doctor’s office, a pharmacy) o Law-related (e.g., probation or parole officer, legal advocate, lawyer) o Financial-related (e.g., unemployment office, bank, debt collector) o Unknown number [If selected skip to end of survey] o None of the above [If selected skip to end of survey]

< page break >

You texted or spoke to a person whose phone number is $number several times in the past month. Recently, you $type with them on \(date. This person is saved in your contacts as **\)contact_name**. [Display last sentence only if the number is saved in contacts]

2. How close are you with the person or people who you call and/or text with at this contact number?

   Not at all Mildly Moderately Considerably Extremely

3. In general, how often are calls and/or text messages with this contact number pleasant?

   Never Rarely Sometimes Most of the time Always

4. In general, how often are calls and/or text messages with this contact number unpleasant?

   Never Rarely Sometimes Most of the time Always

5. In general, how much do calls and/or text messages with this contact number help your recovery from opioids?

   Not at all Mildly Moderately Considerably Extremely

6. In general, how much do calls and/or text messages with this contact number harm your recovery from opioids?

   Not at all Mildly Moderately Considerably Extremely

[Instructions:] The next questions ask you about the places you have gone more than once or spent the night at in the past month.

Our automated system has identified these places using the data you share with us. The system is not perfect; it may have identified places that you have not been. You will be able to tell us if the system has made an error.

You visited the place shown below, near $address, several times in the past month. Recently, you visited this place on $date. [display on map, repeat on every page]

1. Which of the following best describes this place?

   o My home [If selected, skip to end of survey]

   o Someone else’s home

   o A shelter, group home, hotel, or other temporary place I stayed [If selected, skip to end of survey] o A restaurant, business, public place, or other non-residential place o I do not recognize this location or was just passing by [If selected, skip to end of survey]

< page break >

You visited the place shown below, near $address, several times in the past month. Recently, you visited this place on $date. [display on map]

2. What do you do at this place? Select all that apply.

   ? Work ? Take classes ? Religious or spiritual activities ? Volunteer or do community service ? Exercise or play sports ? Spend time with friends ? Spend time with family ? Socialize with new people ? Relax ? Drink alcohol ? Get mental health care (e.g., counseling, talk therapy, group therapy, support group) ? Get medication for opioid treatment (e.g., Suboxone, Methadone, etc.) ? Get physical health care ? None of the above

< page break >

You visited the place shown below, near $address, several times in the past month. Recently, you visited this place on $date. [display on map]

3. In general, how often is going to this place pleasant?

   Never Rarely Sometimes Most of the time Always

4. In general, how often is going to this place unpleasant?

   Never Rarely Sometimes Most of the time Always

5. In general, how much does going to this place help your recovery from opioids?

   Not at all Mildly Moderately Considerably Extremely

6. In general, how much does going to this place harm your recovery from opioids?

   Not at all Mildly Moderately Considerably Extremely

10.5.3 Burden Survey

[Instructions:] Listed on the next page are statements that describe how people may feel about their experience with the STAR app and other study technology over the past month. For each statement, select how much you agree or disagree that the statement describes you.

< page break >

Thinking about the daily update…

1. Completing the daily update interfered with my daily activities.

   Strongly disagree Mildly disagree Agree and disagree equally Mildly agree Strongly agree

2. I disliked completing the daily update.

   Strongly disagree Mildly disagree Agree and disagree equally Mildly agree Strongly agree

3. Please share any positive or negative comments you have about the daily update.

   [Text]

< page break >

Thinking about the daily video check-in…

4. Completing the daily video check-in interfered with my daily activities.

   Strongly disagree Mildly disagree Agree and disagree equally Mildly agree Strongly agree

5. I disliked completing the daily video check-in.

   Strongly disagree Mildly disagree Agree and disagree equally Mildly agree Strongly agree

6. Please share any positive or negative comments you have about the daily video check-in.

   [Text]

< page break >

Thinking about the monthly update…

7. Completing the monthly update interfered with my daily activities.

   Strongly disagree Mildly disagree Agree and disagree equally Mildly agree Strongly agree

8. I disliked completing the monthly update.

   Strongly disagree Mildly disagree Agree and disagree equally Mildly agree Strongly agree

9. Please share any positive or negative comments you have about the monthly update.

   [Text]

< page break >

Thinking about sharing your GPS location data…

10. I disliked sharing my GPS location data.

    Strongly disagree Mildly disagree Agree and disagree equally Mildly agree Strongly agree

11. Please share any positive or negative comments you have about sharing your GPS location data.

    [Text]

< page break >

Thinking about sharing your phone call logs…

12. I disliked sharing my phone call logs.

    Strongly disagree Mildly disagree Agree and disagree equally Mildly agree Strongly agree

13. Please share any positive or negative comments you have about sharing your phone call logs.

    [Text]

< page break >

Thinking about sharing your SMS logs and message text…

14. I disliked sharing my SMS logs and message text.

    Strongly disagree Mildly disagree Agree and disagree equally Mildly agree Strongly agree

15. Please share any positive or negative comments you have about sharing your SMS logs and message text.

    [Text]