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| Thinking about your PAST WEEK: | Number of Days (mark with an X) | |||||||
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| 0 | 1 | 2 | 3 | 4 | 5 | 6 | 7 | |
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| 13. How many days did you drink any alcohol? | ||||||||
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| 14. How many days did you use opiates? | ||||||||
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| 15. How many days did you use cocaine or crack? | ||||||||
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| 16. How many days did you use marijuana? | ||||||||
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| 17. How many days did you use other drugs? | ||||||||
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| 18. How many days did you experience any cravings for drugs or alcohol? | ||||||||
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| 19. How many days did you attend AA or NA? | ||||||||
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