Comparison of Buprenorphine vs Buprenorphine/Naloxone on the Effects of Maternal Symptomatology
Phase: PHASE4
Conditions: Opioid-use Disorder
Sponsor: Stony Brook University

ID #: _________________________ 
Date:  ___ ___ / ___ ___ / ___ ___ ___ ___ 
ADAI Sound Data Source—3/7/2007 
{Project information} 
http://adai.washington.edu/sounddatasource 
 
Page 1 
 
{Module Name} Module 
Brief Substance Craving Scale 
STAFF USE ONLY 
A.  Identify the primary substance dependence for which the participant is being treated at this clinic. 
  Downers or Sedatives (Barbiturates, etc.) 1  
Benzos (Valium, Xanax, etc.) 2  
Hallucinogens (including ecstasy) 3  
Alcohol 4  
Heroin or other Opiates (Morphine, etc.) 5  
Marijuana 6  
Stimulants (cocaine, amphetamine) 7  
Other (specify): _________________________________ 8 
Please answer the following questions with regard to your craving for the primary drug. 
1.  The INTENSITY of my craving, that is, how much I desired this drug in the past 24 hours was: 
 
   
None at all 0  
Slight 1 
Moderate 2  
Considerable 3  
Extreme 4 
2.  The FREQUENCY of my craving, that is, how often I desired this drug in the past 24 hours was:                                                                     
 Never 0 
Almost never 1 
Several times 2 
Regularly 3 
Almost constantly 4  
3.  The LENGTH of time I spent in craving this drug during the past 24 hours was: 
 
 
None at all 0 
Very short 1 
Short 2 
Somewhat long 3 
Very long 4  
4.  Write in the NUMBER of times you think you had craving for  this drug during the past 24 hours.                                                                   
___ ___ 
Agency Name: __________________________________ 
Site Name: ______________________________ 
ID #: _________________________ 
Date: __ __ / __ __ / __ __ __ __ 
 
 
 
 
 

ID #: _________________________ 
Date:  ___ ___ / ___ ___ / ___ ___ ___ ___ 
ADAI Sound Data Source—3/7/2007 
{Project information} 
http://adai.washington.edu/sounddatasource 
 
Page 2 
 
B.  A second craved substance during the past 24 hours was: 
Choose only ONE from the following.  If NONE, please do not answer Questions 5-8.                                         
None (STOP) 0  
                Downers or Sedatives (Barbiturates, etc.) 1  
Benzos (Valium, Xanax, etc.) 2  
Hallucinogens (including ecstasy) 3  
Alcohol 4  
Heroin or other Opiates (Morphine, etc.) 5  
Marijuana 6  
Stimulants (cocaine, amphetamine) 7  
Other (specify): _________________________________ 8 
Please answer the following questions with regard to a second craved drug.  
5.  The INTENSITY of my craving, that is, how much I desired this drug in the past 24 hours was: 
 
 
None at all 0  
Slight 1 
Moderate 2  
Considerable 3  
Extreme 4 
6.  The FREQUENCY of my craving, that is, how often I desired this drug in the past 24 hours was:                                                                     
 Never 0 
Almost never 1 
Several times 2 
Regularly 3 
Almost constantly 4  
7.  The LENGTH of time I spent in craving this drug during the past 24 hours was: 
None at all 0 
Very short 1 
Short 2 
Somewhat long 3 
Very long 4 
8.  Write in the NUMBER of times you think you had craving for  this drug during the past 24 hours.                                                                   
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Reference: Somoza, E., Dyrenforth, S., Goldsmith, J., Mezinskis, J., & Cohen, M., 1995. In search of a universal drug craving 
scale. Paper presented at the Annual Meeting of the American Psychiatric Association, Miami Florida.