National Institute on Alcohol Abuse and Alcoholism

Project MATCH Monograph Series

Volume 5

FORM 90

A Structured Assessment Interview 

for Drinking and Related Behaviors

Test Manual

William R. Miller, Ph.D.

University of New Mexico

Project MATCH Monograph Series: 

Margaret E. Mattson, Ph.D., Editor

Lisa A. Marshall, Ph.D. Candidate, Assistant Editor

U.S. Department of Health and Human Services

Public Health Service

National Institutes of Health

National Institute on Alcohol Abuse and Alcoholism 

6000 Executive Boulevard

Rockville, Maryland 20892–7003
Project MATCH is supported by grants under a cooperative agreement 

funded by the National Institute on Alcohol Abuse and Alcoholism 

(NIAAA) and implemented by nine clinical research units and a data 

coordinating center. The project was initiated and is administered 

by the Treatment Research Branch, NIAAA.

Research on Form 90 was supported in part by grants U10–

AA08435 and K05–AA00133. The contents of this manual are solely 

the responsibility of the author and do not necessarily represent the 

official views of NIAAA.

All material appearing in this volume is in the public domain and 

may be reproduced or copied without permission from the Institute 

or the author. Citation of the source is appreciated.

NIH Publication No. 96–4004 

Printed 1996
iii

Acknowledgments

The author gratefully acknowledges the collaboration of the Project 

MATCH Research Group in the development of the Form 90 instruments and preparation of this manual. Thanks are particularly due 

to Thomas Babor, Frances Del Boca, and Bonnie McRee of the Project 

MATCH Coordinating Center at the University of Connecticut Medical 

School for their attention to detail in refining the manual and interview 

procedures.

Project MATCH Research Group and

Other Contributors

William Miller, Ph.D.

J. Scott Tonigan, Ph.D.

Center on Alcoholism, Substance Abuse and Addictions

University of New Mexico

Albuquerque, NM

Gerard Connors, Ph.D.

Robert Rychtarik, Ph.D.

Research Institute on Alcoholism 

Buffalo, NY

Carrie Randall, Ph.D.

Raymond Anton, M.D.

Medical University of South Carolina and 

Veterans Affairs Medical Center

Charleston, SC

Ronald Kadden, Ph.D.

Mark Litt, Ph.D.

University of Connecticut School of Medicine 

Farmington, CT

Ned Cooney, Ph.D.

West Haven Veterans Affairs Medical Center and 

Yale University School of Medicine

New Haven, CT

Principal and 

Coinvestigators 

at the Sites
iv

Form 90

Carlo DiClemente, Ph.D. 

Joseph Carbonari, Ed.D. 

University of Houston 

Houston, TX

Allen Zweben, D.S.W.

University of Wisconsin—Milwaukee

Milwaukee, WI

Richard Longabaugh, Ed.D. 

Robert Stout, Ph.D.

Brown University

Providence, RI

Dennis Donovan, Ph.D.

University of Washington and Seattle VA Medical Center 

Seattle, WA

Coordinating 

Center

Principal and 

Coinvestigators

Thomas Babor, Ph.D. 

Frances Del Boca, Ph.D. 

University of Connecticut 

Farmington, CT

Kathleen Carroll, Ph.D. 

Bruce Rounsaville, M.D. 

Yale University

New Haven, CT

NIAAA Staff John P. Allen, Ph.D.

Project Officer for Project MATCH 

Chief, Treatment Research Branch

Margaret E. Mattson, Ph.D.

Staff Collaborator for Project MATCH 

Treatment Research Branch

Lisa A. Marshall, Ph.D. Candidate

Research Assistant, Treatment Research Branch 

(Gallaudet University Cooperative Education Program)

Consultants Larry Muenz, Ph.D. 

Gaithersburg, MD

Philip Wirtz, Ph.D.

George Washington University 

Washington, DC

Contractor Jane K. Myers

Janus Associates 

Bethesda, MD
v

 FOREWORD

This volume of the National Institute on Alcohol Abuse and Alcoholism 

(NIAAA) Project MATCH Monograph Series should prove of particular 

value to the alcoholism treatment and research communities since it 

introduces Form 90, a series of well-constructed instruments to assess 

alcohol consumption. Although alcoholism is characterized by additional factors such as adverse physical and psychological effects of 

drinking as well as dependence on alcohol, the cardinal feature of 

the problem involves excessive or inappropriate use. Hence, accurate 

measurement of drinking behavior is of vital interest. Further, precise 

measurement of ethanol consumption itself is important, since many 

medical and legal consequences of drinking are specifically associated 

with use patterns. Finally, assessment of alcohol consumption is of 

primary importance in evaluating treatment efficacy.

While there are many ways to assess alcohol consumption, and each 

may be particularly appropriate for a specific purpose, the strategy 

employed by Form 90 offers unique advantages. Continuous recording of alcohol use provides more objective and sensitive indices of 

behavioral change than do summary measures of drinking or scores 

associated with most other dimensions of the problem. In light of this, 

the two primary outcome variables for Project MATCH were derived 

from Form 90 data. In addition, the software supporting Form 90 computes a wide variety of statistical data that can be employed in a range 

of clinical and research settings.

Form 90 is a family of related instruments that generate both baseline and followup information as well as gather data from informants. 

Beyond incorporating sequential drinking information, Form 90 collects data on other important facets of patient functioning. These 

include concurrent use of drugs, experience with medical and psychological treatments, and lifestyle activities such as work and school 

involvement, religious participation, and residential status. The large 

multisite sample enrolled in Project MATCH allowed derivation of 

robust, stable psychometric indices for Form 90.

In short, Form 90 has played a major role in Project MATCH; dissemination of the information in this volume will facilitate transfer of 

Form 90 to other research projects as well as to treatment endeavors. 

The sincere appreciation of NIAAA, the alcohol research community,
vi

Form 90

and alcoholism treatment practitioners go to all those from the MATCH 

investigational team who developed Form 90. Their contribution will 

doubtless enrich the field and ultimately enhance outcomes from interventions designed to treat alcoholism.

John P. Allen, Ph.D.

Treatment Research Branch

National Institute on Alcohol Abuse and Alcoholism
vii

Contents

Acknowledgments ..................................................................... iii

Foreword ................................................................................... v

Overview..................................................................................... 1

History and Description ........................................................ 1

Limitations............................................................................ 3

Statistics Available From Form 90 ........................................ 4

Psychometric Properties of Form 90 ...................................... 5

Alternate Forms .................................................................... 5

Supporting Software ............................................................. 6

General Instructions .................................................................. 9

Calendar ............................................................................... 9

Standard Drink Units ......................................................... 12

Conducting the Interview ................................................... 14

Missing Followup Periods ................................................... 16

Quick Form ........................................................................ 18

Instructions for 90–AI and 90–AF ............................................. 19

Preparing for the Interview ................................................. 19

Conducting the Interview ................................................... 21

Completing the Interview .................................................... 38

Remote Reconstruction ............................................................ 41

Telephone Interviews 90–AT and 90–AQ ................................... 43

The Client Telephone Assessment of Drinking and

Related Behaviors .......................................................... 43

Quick Drinking Assessment Interview ................................ 44

Collateral Interview on Drinking................................................ 45

Preparing for the Interview ................................................. 45

Conducting the Interview ................................................... 46

References ............................................................................... 49

Appendices .............................................................................. 51

1

Overview

Form 90 is a family of assessment interview instruments designed 

to provide primary dependent measures of alcohol consumption and 

related variables. It is a structured interview procedure that yields 

quantitative indices of alcohol consumption during a specified period 

of time. The same interview format is used for pretreatment evaluation 

and for followup assessment, although instructions vary slightly and 

separate forms are used at intake and followup.

The retrospective assessment “window” being queried is variable at 

both intake and followups. At intake, the window begins 89 days before 

the client’s last drink (with the last day of drinking being the 90th day) 

and extends through the day before the interview for outpatients, or 

through the day before admission for inpatients. At followup, the window extends from the day of the preceding interview to the day before 

the current interview, allowing for variations in assessment windows 

due to scheduling.

The desired result is a continuous daily record of drinking and documentation of related variables from a 90-day baseline period through 

the last followup point.* An experienced interviewer will be able to 

complete this interview in less than 45 minutes on average, though 

complicated drinking patterns, talkative respondents, and larger 

assessment windows can take longer. A totally abstinent client at followup, on the other hand, may require only 10–15 minutes. Across 

1,726 intake interviews conducted in a major clinical trial, the average 

length of time required for administration of the full Form 90–AI (client 

intake interview) was 41 minutes.

History and 

Description

The Form 90 family of instruments was originally developed for use in 

Project MATCH, a multisite clinical trial of three psychological treatments for alcohol abuse and dependence, funded by the National 

Institute on Alcohol Abuse and Alcoholism. This team of 23 collaborat-

*For other applications, it may be desirable to sample a fixed period of time (e.g., 

the prior 90 days) at all assessment points. This simplifies data entry and analysis 

but leaves gaps of varying length between (or in some cases, overlapping) records. 

Form 90 is adaptable to either approach, and choice of strategy should be guided 

by the types of analyses anticipated (e.g., time-to-event analyses).
2

Form 90

ing investigators, known as the Project MATCH Research Group (1993), 

set out to develop a hybrid approach combining the strengths of several prior strategies (Miller and Del Boca 1994).

A calendar base is used as in the timeline followback method (Sobell 

et al. 1980; Sobell and Sobell 1992), but a broader range of behavior 

is quantified in greater detail than in prior timelines. To streamline 

the detailed reconstruction of drinking, recurrent weekly and episodic 

patterns are quantified in grid format, as in the Drinker Profile (Miller 

and Marlatt 1984), and these grids are then folded into the calendar. 

Finally, other variables of interest (treatment services, medications, 

work and education, self-help group attendance, and other drug use) 

were selected from and defined in a manner similar to the Addiction 

Severity Index and Treatment Services Review of McLellan et al. (1990).

A parallel form was constructed for collateral interviews to obtain corroborating data. Both client and collateral interviews can be conducted 

by telephone as well as in person, although telephone interviews pose 

special challenges. The difficulties involved in telephone reconstruction 

of a calendar make it highly desirable that as many client interviews as 

possible be conducted in person. In cases where only brief telephone 

contact may be possible at followup, a much abbreviated form is used 

to obtain the most crucial outcome information before attempting the 

longer interview. The Form 90 family thus comprises five instruments:

■ 90–AI Client intake interview (in person)

■ 90–AF Client followup interview (in person)

■ 90–AT Client followup interview (by telephone)

■ 90–AQ Quick client followup interview

■ 90–ACS Collateral interview (intake or followup, usually by 

telephone)

This version of the Form 90 manual and instruments has been modified based on experience in Project MATCH. An archival version of 

the instruments and manual, exactly as used in Project MATCH, is 

available.* MATCH-specific instructions have been removed from the 

current version in order to provide instruments appropriate for more 

general use. Changes in format have also been made to facilitate administration, reduce time demands, and improve data management.

*Contact Thomas Babor, Ph.D., University of Connecticut Health Center, 

Department of Psychiatry, 263 Farmington Avenue, Farmington, CT 06030-1410.
3

Overview

Because interviewer computations are error prone, we have shifted the 

protocols away from hand calculations. Available software packages 

for data entry and automatic variable calculation are described at the 

end of this chapter. The collateral interview (Form 90–ACS) contained 

in this manual is a simplified version developed for 3-year followups in 

Project MATCH. This was substituted because the more detailed 90–AC 

was found to be unduly laborious for both interviewers and collaterals, 

and the simpler global questions suffice for most purposes.

Other changes could be made, but we elected to retain the original format to maintain comparability with the national data base collected in 

Project MATCH, which offers a large treatment sample against which 

other samples can be compared (Tonigan et al. 1997). One such change 

that was considered but rejected was replacing the steady pattern grid 

with a simpler timeline calendar (e.g., Sobell and Sobell 1994). The grid 

was retained as an option because completion of a timeline calendar 

frequently involves ascertaining consistent patterns, and the grid offers 

a structured method for doing so. Interviewers may choose to bypass 

the grid method depending upon the nature of the client’s drinking 

behavior. In either approach, the desired end product is a continuous 

calendar. The Form 90 procedures provide a degree of flexibility as the 

interviewer adapts to varying drinking styles and, as reported below 

and elsewhere (e.g., Tonigan et al. 1997), yield reliable estimates of 

drinking variables.

Limitations Some caveats are important to consider regarding the Form 90. Both 

the primary strengths and the weaknesses of Form 90 have to do 

with its complexity. A range of detailed information is collected, which 

necessarily increases the likelihood of measurement error. Although 

current psychometric data generally reflect excellent reliability and 

validity of Form 90, these data were obtained by interviewers who were 

highly trained, certified, and closely supervised throughout the Project 

MATCH trial. It has been our experience that without such training, 

the reliability of Form 90 data is likely to be seriously compromised.

Before embarking on the use of an extensive and time-intensive interview such as this, it is prudent to ask whether information of this 

complexity is required. Alternative reliable and straightforward alcohol-focused timeline instruments are available (e.g., Sobell and Sobell 

1994). A simpler quantity-frequency approach may yield sufficiently 

comparable global measures to meet some assessment needs (Grant 

et al. 1995). It seems unlikely, for example, that an interview of this 

complexity would be optimal for routine clinical assessment purposes. 

Form 90 was designed for use in complex clinical research to yield a 

range of outcome and mediating variables amenable to a variety of 

data analytic strategies. When data with this degree of breadth and 

resolution are needed, use of the Form 90 family of instruments is 

recommended.
4

Form 90

Statistics

Available

From Form 90

A wide variety of statistical variables can be derived from the Form 90 

interview. For example, the following variables can be computed from 

the drinking calendar:

■ Total number of standard drinks (SECs) consumed (Note: U.S. 

ounces of absolute ethanol consumed can be calculated by halving the number of SECs)

■ Total number and percentage of abstinent days and drinking days

■ Average number of SECs per drinking day

■ Total number and percentage of days in specific consumption categories such as:

— 0.1–2.0 SECs

— 2.1–4.0 SECs

— 4.1–6.0 SECs

— Over 6.0 SECs

■ The peak intoxication (BAC) level for each assessment period, or 

average BAC level throughout the assessment period

■ Time to events such as the first drink or first heavy drinking day

■ Longest span of abstinence

When the Form 90 interview is properly administered, sufficiently 

complete information will be obtained to compute these summary statistics. In Project MATCH, of 1,726 interviews completed at intake, 

only 5 protocols yielded insufficient data to calculate summary data of 

weekly alcohol consumption. Other variables commonly of interest can 

also be derived from Form 90, including:

■ Days and categories of health care utilization

■ Days of additional treatment received for alcohol/drug problems

■ Days of 12-step group (e.g., Alcoholics Anonymous) attendance and 

religious attendance
5

Overview

■ Days employed or in school

■ Lifetime and recent use of other drugs in 11 categories

■ Days of medication use

Psychometric 

Properties of 

Form 90

The design and findings of psychometric evaluations of Form 90 in 

Project MATCH have been reported in detail elsewhere (Del Boca et al. 

1994; Tonigan et al. 1997). Test-retest reliability in three samples was 

found to be excellent for core alcohol variables including total consumption (r = 0.91 to 0.97), drinks per drinking day (r = 0.88 to 0.93), 

percent days abstinent (r = 0.96 to 0.98), and percent heavy drinking 

days (r = 0.92 to 0.97).

Test-retest correlations across a 2-day interval were also reasonably 

high for days worked (0.85 to 0.98), in school (0.93 to 0.99), in own 

residence (0.74 to 0.99), days of religious attendance (0.79 to 0.98), 

and days of medical care (0.91 to 0.99). Somewhat greater variability 

was found for days of psychological treatment (0.63 to 0.99) and days 

of 12-step group attendance (0.62 to 0.92).

Despite the less precise procedure used to obtain estimates of lifetime 

drug use in Form 90–AI and 90–AF, test-retest stability was generally 

high for days of use of the more common categories, including nicotine 

(r = 0.94 to 0.97), cannabis (0.74 to 0.93), cocaine (0.80 to 0.96), tranquilizers (0.89 to 0.96), sedatives (0.92 to 0.98), and inhalants (0.94 

to 0.99). Greater instability of reports across interviews was found for 

days of hallucinogen (0.68 to 0.82), stimulant (0.47 to 0.95), steroid 

(0.30 to 0.97), and opiate use (0.02 to 0.93), owing in part to the less 

frequent use of drugs in these categories. Test-retest reliability for estimates of recent (past 90 days) drug use were generally higher than 

those for lifetime use.

Drinking measures obtained via Form 90 converge with simpler indices of alcohol consumption. In the Project MATCH (1993) sample, 

for example, clients’ reports of the percentage of drinking days during the prior 90 days (on Form 90) were consistent with their reports 

of drinking days during the prior week on a frequency item from the 

paper-and-pencil Alcohol Use Disorders Identification Test (AUDIT) for 

both outpatients (n = 624, r = 0.67) and inpatients (n = 152, r = 0.71). 

This finding is consistent with reported correlations between calendarbased interview data and quantity-frequency questionnaire data (e.g., 

Grant et al. 1995).

Alternate 

Forms

For some applications, it may be desirable to obtain more detailed 

calendar-based data for drugs other than alcohol. The 90–AF (client 

followup) format does not permit, for example, time-to-event analyses
6

Form 90

for any drug except alcohol. In clinical and research settings where 

“relapse” is judged not only by alcohol use but by other drug use as 

well, equal weight may be given to substance use across categories. 

Studies of the temporal convergence of alcohol and other drug use 

would also require a more detailed calendar-based approach for all 

drugs.

Alternate drug-use forms (Form 90–D instruments) were developed 

for such purposes, and samples are appended. The amount of detail 

regarding drinking has been curtailed relative to 90–AI and 90–AF. 

Given the greater difficulty of specifying the quantity of use for drugs 

other than alcohol and nicotine, emphasis has been placed on days of 

use as the calendar-based variable across drug categories. Ancillary 

procedures similar to those in 90–AI and 90–AF are used to measure 

quantity of drug use and routes of administration. The steady and episodic pattern grids have been deleted from the 90–D versions, given the 

complexity of their use with multiple drug categories. Two 90–D forms 

are included as examples in the appendix:

■ 90–DI Alcohol/drug use at baseline

■ 90–DF Alcohol/drug use at followup

Supporting

Software

Four separate software packages are available to support applications 

of Form 90. All are offered at minimal cost, with the provision that the 

originators cannot provide warranty of accuracy, and consultation/ 

support services are not provided (though may be available on a contractual basis).

■ The Blood Alcohol Concentration Calculation System (BACCuS)1 

was prepared prior to the development of Form 90 (Markham et al. 

1993; Matthews and Miller 1979). It runs in IBM-compatible systems and aids in the calculation of standard drink units and the 

estimation of BAC peaks.

■ The Form 90 Database (F90DB)2 was designed by the Project 

MATCH Coordinating Center to combine BACCuS with SPSS 

components of Form 90 data entry into one package. As a Superbase program, it is divided into 13 separate data bases that allow 

the user to enter the entire set of respondent data from all versions of the ounce conversion tables, which can be referenced, 

1 Available from Dr. William Miller, Department of Psychology, The University of 

New Mexico, Albuquerque, New Mexico, 87131–1161.

2 For information contact Dr. Thomas Babor, Department of Psychiatry, University of 

Connecticut Health Center, 263 Farmington Avenue, Farmington, CT 06030–1410.
7

Overview

edited, and revised to fit local standards. This software corresponds to the version of Form 90 that was used in Project MATCH.

■ Data entry software3 for Form 90 was written in the M data base 

programming language (formerly the MUMPS language). Since the 

M language is highly portable, this software should run with modest modification on a variety of hardware platforms. It allows for 

full-screen data entry and verification. It retains drinking pattern 

information as well as standard drink units.

■ An IBM-compatible Form 90 software package4 was developed by 

the Research Division of the University of New Mexico’s Center on 

Alcoholism, Substance Abuse and Addictions (CASAA). It implements an electronic graphical user interface version of the Form 

90 interview. The software is capable of tracking an individual’s 

drinking on a daily basis from up to 1 year prior to intake through 

approximately 10 years of followup. The hardware required is a 

minimum of a 486–66 DX2 processor with 16 MB of memory. A 

90–MHz Pentium with 16 MB is recommended. CASAA’s Form 90 

software requires installation of SAS for Windows version 6.08 or 

higher, including the BASE module.

3 Contact Robert Stout, Ph.D., Center for Alcohol and Addiction Studies, Brown 

University, Providence, RI 02906.

4 For information contact David Waldron, Research Data Services, Center on 

Alcoholism, Substance Abuse and Addictions, The University of New Mexico, 

Albuquerque, NM 87131.

9

General Instructions

This chapter provides a general orientation to the Form 90 interviews 

and includes charts and definitions that apply to all instruments. More 

detailed instructions for specific instruments are provided in the next 

chapter. Copies of all the forms and questionnaires cited here are in 

the appendix.

The calendar (fig. 1) is a key component of the Form 90 interview and 

should be carefully managed while completing the interview. The ultimate goal of using the calendar is to gather detailed and accurate data 

about self-reported drinking behavior over a specified time period. This 

involves gathering information about the quantity and potency of the 

beverages consumed as well as the actual dates on which drinking 

occurred. These particular dates on which drinking occurred are especially important when time-to-event statistical approaches are used to 

analyze followup data.

When conducting a Form 90 client interview, it is necessary to have 

a calendar form for recording data. This could be a regular blank calendar page (with holidays marked) or a computer-generated calendar. 

Project MATCH used the IBM–PC software CALENDAR CREATOR PLUS 

(CC+) for this purpose.*

The CC+ software program generates blank calendar grids for any 

specified period of months and inserts a standard set of holidays and 

additional specified events onto the printed calendar. Thus, the calendar software can be updated with important news headlines and 

memorable local (e.g., sports) events.

If entries of this kind are logged into the master calendar datafile regularly, they can then be accessed (by calendar file printing) whenever an 

interviewer needs a retrospective calendar. Note that only more memorable events should be entered in order to avoid a confusing amount of 

detail on the calendar. The purpose is to aid, not confuse, the client.

Calendar

* Version 2 is currently available from Softkey International, 201 Broadway, 

Cambridge, MA 02139–1901.
10

Form 90

FIGURE 1. Example of a filled-in calendar

April

1995

Sunday Monday Tuesday Wednesday Thursday Friday Saturday

1

A

0

2 Daylight 

Savings Begins

A

0

3

0

4

0

5

P1

5.6

6

5.6

7

6.91

8

6.91

9 PALM

 SUNDAY

4.8

10

5.6

11

5.6

12

5.6

13

5.6

14 GOOD

 FRIDAY

6.91

15

In 12.32

16 EASTER

out of jail

A

0

17

A

0

18

Bowling

E1

9.60

19 Oklahoma 

Bombing

A

0

20

0

21

0

22 EARTH

 DAY

0

23

1.92

24

A

0

25

Bowling

E1

9.6

26

A

0

27 28 ARBOR 

 DAY

29

30

Brother ’s

Birthday

Party

7 beer 10oz

7 whiskey 1oz

3-11 AM (.283)

Anniv.

2 wine 4oz

6-8 PM (.032)

Today
11

General Instructions

An efficient approach is to make multiple copies of the calendar grid 

for each month and keep them in stock. Interviewers can then easily 

assemble a Form 90 calendar by taking copies of the needed months. 

At the end of each month, a final blank calendar form for that month 

(containing its unique events) should be generated and added to the 

file.

Individual Day 

Boxes

Each portion of a calendar day box is used for a particular kind of 

information (fig. 1).

Upper left: Date (may be automatically inserted by calendar 

software)

Upper right: Special day information (e.g., holiday, memorable 

event, which also may be automatically inserted by 

calendar software)

Center: Drinking information

Lower left: Institutionalization codes (see below)

Lower right: Information (when needed) about hours of drinking

Institutional 

Codes

When clients are institutionalized for any of the following reasons, the 

matching code should be entered in the lower left corner of each appropriate day box:

Hm: Medical hospitalization

Htox: Hospital/medical detoxification

Rtox: Other residential, nonmedical detoxification

Ra: Alcohol treatment hospitalization

Rd: Drug treatment hospitalization

Rp: Emotional/psychological hospitalization

In: Incarcerated in jail or prison

Ambulatory detox days have no code and need not be recorded on the 

calendar.
12

Form 90

FIGURE 2. Anchor dates for Form 90 interviews

Type of interview Starting date Ending date

Intake (90–AI) 89 days before the last drink 

(not including the day of 

interview)

Outpatients: Yesterday 

Inpatients: Day before 

admission

First followup (90–AF) for 

outpatients

Date of first completed treatment 

session, or (if no treatment) 5 

days after completion of the 

intake interview

Yesterday

First followup (90–AF) for 

inpatients

Date of discharge Yesterday 

Later followups (90–AF) Date of last 90–AF (if done in 

the last 179 days) or target date 

for last missed 90–AF interview 

(if >179 days)

Yesterday 

Reconstruction of a missed 

90–AF interview

Date of last completed 90–AF Date before target day of 

missed 90–AF interview

Assessment 

Window

A specific period known as the “assessment window” (fig. 2) is accounted 

for at each Form 90 interview. The interviewer must make an entry 

in the center of every day box of this assessment window during the 

interview.

Standard 

Drink Units

Drinking information obtained through the Form 90 interview is converted into standard drink units The conventional drink unit used in 

all applications to date is the standard ethanol content (SEC) unit as 

defined by Miller, Heather, and Hall (1991; cf. Miller 1978), which is 

0.5 oz (15 mL) of absolute alcohol. A simple way of calculating SEC 

units is the formula:

(x oz)(% alcohol)(2) = y standard drinks

Examples: Beer: (48 oz)(.05)(2) = 4.8 standard drinks

Wine: (16 oz)(.12)(2) = 3.8 standard drinks

80 proof spirits: (6 oz)(.40)(2) = 4.8 standard drinks

86 proof spirits: (6 oz)(.43)(2) = 5.2 standard drinks

100 proof spirits: (6 oz)(.50)(2) = 6.0 standard drinks
13

General Instructions

Halving of the number of SEC units yields the number of ounces of 

absolute ethanol consumed. Conversely, ounces of absolute ethanol 

can easily be converted (by doubling) into standard drink (SEC) units. 

It is equally feasible to use standard drink units other than the SEC. 

The software currently available for Form 90 computations accommodates metric units and other standard drinks of various sizes, as 

described by Miller et al. (1991).

Most alcoholic beverages are labeled as to their alcohol content. A significant U.S. exception is beer, which can range from under 2 percent 

to over 11 percent alcohol. The average content of normal U.S. lager 

beers has remained fairly constant over the years at just under 5 percent (Leake and Silverman 1971). Even most “light” beers are between 

4 and 5 percent alcohol, except for those explicitly labeled “LA” (low 

alcohol), which average between 2 and 3 percent. Malt liquors average 

around 6 percent, and “ice beers” and imported beers tend to be over 

5 percent as well.

Bracketing The Form 90 interview specifies actual numbers of standard drinks 

for each day, rather than using ranges or categories (e.g., light days, 

heavy days). It is necessary to arrive at the most reasonable estimate 

of number of drinks on each drinking day.

A behavioral assessment procedure known as “bracketing” is often 

quite useful in conducting the interview. This can be employed, for 

example, when a client is having difficulty providing a precise number of drinks or hours for a specific occasion. The basic approach is 

to ascertain a range within which the actual value falls, starting with 

values that are too high and too low.

“Did you have more than two beers? Was it more than 50? What is the 

least you would have had? And what is the most you would have had?”

These outer bounds are then tightened until a narrow range is obtained. 

When the range cannot be constricted further, the midpoint of the 

range is used as the estimated value.

When a smaller range is offered by the client (e.g., “I had 3 or 4 beers”), 

use a “closer to” question to decide on the actual value to be entered 

(“Was it closer to 3 or closer to 4?”).

Table 1 may be helpful in recording event frequency during a 90-day 

period. Be aware, however, that the assessment window for Form 90 is 

rarely exactly 90 days, so that these should be used only as examples 

of how to convert verbal descriptions of occurrence into actual frequencies for an assessment window.
14

Form 90

For longer periods, convert client reports into actual number of days 

within the followup window. For a “once a week” occurrence, divide the 

number of days in the period by 7. Thus, for a 112-day followup window, a self-report of “once a week” throughout the whole period would 

equal 16 days.

TABLE 1. Conversion of verbal descriptions to 90-day scale (number of occurrences/90 days)

Once a month 3

Twice a month 6

Three days a month 9

Four days a month 12

Once a week 13

Twice a week 26

Three days a week 39

Four days a week 51

Five days a week 64

Six days a week 77

Every day 90

Conducting

the Interview

The biggest clinical interviewing challenge is filling in drinking information for each of the days in the calendar form. The recommended 

progression for accomplishing this follows six general steps.

Step 1 

Introduce 

Form 90

The interviewer should explain to clients that the interview involves 

mainly reconstructing their drinking history during a specified timeframe and that their assistance is needed in completing this task. How 

a calendar will be used to recover drinking patterns (defined as quantity and frequency) by linking memory aids to drinking behavior should 

also be explained.

Step 2 

Identify 

Memory Aids

To facilitate clients’ recall about their drinking, it is important to gather 

other information before turning to the drinking questions on the Form 

90. Notations about what was occurring in the clients’ lives are entered 

on the calendar to invoke the clients’ retrospective recall of daily consumption of alcohol beverages. In order to establish these memorable 

anchor points, it is important to give clients a variety of probes, ideas, 

or suggestions and then allow them enough time to search their memory. The regularities in the client’s life (e.g., work schedule, payday) 

can and should be used to provide a context for filling in the calendar 

with memory aids.
15

General Instructions

Anchor points common to most clients would include holidays, birthdays, major news or sporting events, paydays, and weekends. Negative 

events that may have occurred in the client’s life are as important 

as the positive or festive occasions. More idiosyncratic events would 

include dates of hospitalizations, illness or accidents, arrests or incarcerations, court appearances, beginning or termination of employment, 

vacations, marital arguments, separations and reconciliations, anniversaries, and birthdays of family members or friends. Reports of such 

events also make it possible to estimate how much alcohol has been 

consumed during periods of alcohol availability (e.g., excluding days in 

jail or treatment).

The interviewer then proceeds by asking several questions about the 

client’s treatment and incarceration experiences during the assessment period. All periods of hospitalization, detoxification, residential 

treatment, and incarceration are recorded on the calendar. Each day 

is also accounted for in terms of where the client was living, but this 

information is usually not recorded on the calendar but on the form 

itself in total numbers of days in various living situations. Outpatient 

treatment and 12-step group experiences are also queried but are 

recorded on the calendar only if they may be helpful memory aids for 

later reconstruction of drinking. Use of prescription medications is 

determined as well as status with regard to work, education, and religious attendance.

Step 3

Note Abstinent 

Days

The Form 90 interviewer then proceeds to quantify the client’s drinking. 

At intake (90–AI), spans of abstinence are queried first and recorded 

on the calendar. Consumption should be asked about even on days of 

hospitalization or incarceration because clients may do some drinking 

on such days.

At followup (90–AF), where the predominant pattern may be abstinence, it may be most efficient to inquire first about periods of drinking 

and to log these on the calendar before entering abstinent days.

Step 4

Steady Pattern 

Grids

Next the interviewer determines whether the client has any predictable 

patterning for periods of drinking For those who have a reasonably 

consistent pattern of drinking over several weeks, a steady pattern grid 

(items 38–41) may be used to specify that pattern. This pattern can 

then be used to fill in blocks of the calendar. If the client has only variable episodes of drinking, and no pattern that is reasonably consistent 

across weeks, the steady pattern grid is omitted.

A second steady pattern grid is available in Form 90 for cases where 

it is useful to define two different but consistent weekly patterns that 

occurred during the same assessment window. For example, one 
16

Form 90

steady pattern may characterize the first portion of a followup window, whereas a different steady pattern predominates during the latter 

portion.

If appropriate, complete one or more steady pattern grids and fill in 

periods accounted for by these patterns. Note on the calendar those 

periods when the drinking pattern applied.

Step 5 

Episodic 

Pattern Charts

Form 90 also has an option (items 42–47) for recording recurrent 

episodic drinking patterns that are either above or below the usual 

drinking pattern. Each episode type is quantified as to usual kind(s) of 

beverage, amounts, and timeframes of consumption. Days of such episodes can then be designated on the calendar. Episodes that occurred 

only once during the assessment window are entered directly on the 

calendar.

Step 6 

Daily Alcohol 

Consumption

Drinking days that cannot be accounted for by either steady or recurrent episodic patterns are reconstructed individually using a modified 

timeline approach. On completion of this step, there should be drinking data entries in every day of the entire assessment window. Always 

obtain sufficient information so that SECs and BAC may be calculated.

Throughout the interview, the interviewer should continually focus 

the client’s attention on the calendar and the events depicted on the 

calendar. It is useful to break the calendar into months or weeks to 

facilitate recall of patterns and specific episodes. Even for clients with 

very consistent patterns, the interviewer should probe regarding the 

special events on the calendar that may have triggered an idiosyncratic 

episode. The interviewer also should add events to the calendar that 

may be revealed after the actual drinking history interview begins.

The interviewer should also pay close attention to inconsistencies in 

the client’s description of drinking and ask questions to resolve these 

differences and to make sure that accurate information is collected. 

Interviewers should probe in cases where SECs seem unreasonably 

high, especially if clients report drinking lethal amounts of alcohol for 

extended periods of time (e.g., a gallon of spirits a day for a period of a 

month).

Missing 

Followup 

Periods

Although followup interviews are usually scheduled at regular intervals (e.g., every 90 days), few will occur on exactly the right day. This 

means that the time between the current and prior followup interviews 

will be variable. Rather than always using a retrospective 90-day block, 

the recommended procedure is to attempt to reconstruct the entire

uncharted period between interviews.
17

General Instructions

In this approach, there are no “dead” periods in Form 90 followup 

during which interviewers make no attempt to reach a client who is 

overdue for a followup. The interviewer should try continuously to 

complete each followup interview, from the target date until 179 days 

after the due date for the prior interview. After that day, it should be 

regarded as a missed followup, and the client enters the next followup 

period.

When the client is reached, the missing period is then reconstructed 

(see below). Thus, for example, if the target date for the 9-month followup interview is 9 months after the first treatment session, it may be 

conducted on any day from there until 179 days after the 6-month due 

date (though it is highly desirable for the interview to occur as close to 

9 months as possible). The regular Form 90 calendar-based procedure 

is used to reconstruct drinking for the entire span (up to 179 days) 

back to the date of the prior interview (or, if that interview was not 

completed, to the target date for the missed interview).

Reconstruction If a previous followup has been missed, the interviewer completes a 

separate Form 90–AF or 90–AT to reconstruct the missed interval. 

Items 1–5 and 48–58 should be completed for the missed interval 

whenever possible, again aided by a retrospective calendar. The remote 

reconstruction of drinking behavior (steady pattern grids, episodic pattern charts, and the calendar) is often a more challenging task. If the 

pattern is relatively simple (e.g., client abstained throughout the period 

except for a few days), it may be possible to complete the calendar grid 

as usual.

When the client has been drinking in a more variable fashion throughout the missed period, however, a day-by-day reconstruction is usually 

beyond the patience and ability of a client, particularly just after 

completing Form 90–AF for the current period. In this case, an approximation can be obtained by comparing the missed period with the 

followup window just reconstructed (Gorenstein 1985). Procedures for 

this situation are provided by items 59–66 of the Form 90–AF interview 

protocol. These items are used only when a missed interval is being 

reconstructed, and day-by-day calendar reconstruction is not feasible.

In the event that a followup interview is completed close to the due date 

for the next followup, a period of at least 30 days should pass before 

the next followup interview is conducted. Thus a single Form 90–AF 

may be used to assess periods ranging from 30 to 179 days.
18

Form 90

Quick Form When clients are unwilling either to come for an in-person (90–AF) 

interview or to cooperate with a full telephone interview (90–AT), the 

interviewer should always attempt to complete the 1-page quick form, 

90–AQ. This provides the minimal essential outcome variables for a 

followup point. If the client’s cooperation and endurance are doubtful, 

90–AQ should be completed before proceeding with 90–AT.
19

Instructions for 90–AI and 90–AF

Preparing for 

the Interview

To conduct an in-person Drinking Assessment Interview—Intake (Form 

90–AI) or Followup Interview Assessment of Drinking and Related 

Behaviors (90–AF), you will need a table to work on and a drug card 

sort set. For in-person followup interviews, you should have a copy of 

the Treatment Experiences Questionnaire (TEQ) available to administer if the client has received additional alcohol/drug treatment (see 

items 23–24). Additional TEQ items might be useful depending upon 

the specific applications of Form 90–AF.

It is helpful to have a clipboard to keep your Form 90 interview protocol out of the client’s line of vision. It is best not to lay Form 90 on the 

table during your interview (with the exception of the steady pattern 

and calendar grids) where the client can follow your instructions and 

the information you record. Finally, it can be helpful to have glasses, a 

pitcher, and a measuring cup available to help with drink quantification (see section on steady pattern grids).

FIGURE 3. Items needed for conducting Form 90 interviews

• The proper Form 90 interview blank 

• Calendar forms to cover the assessment window

• The Form 90 Drug Card Sort

• A copy of the Treatment Experiences Questionnaire

• A set of glasses, a pitcher of water, and a measuring cup (optional)

Define 

Assessment 

Window

Generate calendar forms to cover the assessment window to be constructed. A calendar software program should automatically insert 

holidays and other memorable local events.

The period for drinking inquiry on Form 90–AI will always be 90 days, 

plus whatever span of days elapsed between the last drink and the 

intake interview or admission date. This will almost always require at 

least 4 monthly grids. Days not included in the assessment window 
20

Form 90

should be crossed out on the calendar with X’s to avoid confusion. For 

outpatients, print “TODAY” on the date of interview and place an X 

over subsequent dates. For inpatients, print “ADMITTED” on the date 

of inpatient admission and place an X over subsequent dates.

At intake, the assessment window begins 89 days before the client’s 

last drink, with the last day of drinking being the 90th day. An easy 

way to locate the point 89 days before the last drink is to place your 

finger on the day of the last drink, then count back 13 weeks, staying 

on the same day of the week as the day of the last drink. When you get 

back 13 weeks, cross out (X) that day and the next day. The following 

day is your starting point for the 90-day period.

At followup points, the interval will generally be at least 90 days, but 

usually longer, encompassing the period from the last interview (or 

target date) to the current interview date. Again, X’s should be placed 

on the calendar before and after the assessment window to indicate the 

period being queried. Because the day of interview is not a complete 

day, the last day of any Form 90 assessment window is the day before 

the interview.

If the followup interview is to be conducted by telephone, mail a copy of 

this calendar to the client in advance of the interview along with a brief 

letter of explanation. Keep a copy of the mailed materials in the file for 

your own use during the interview. For further details, see the chapter 

on telephone interviewing.

Items 1–7 Before the interview begins, the first seven items can be filled in. At item 

1, specify the starting and ending dates of the period being queried. 

(For remote reconstruction periods, this is the followup period being 

reconstructed, not the current period.) At item 2, indicate the number of days in this period. If this is not determined automatically by 

software, take great care in counting the number of days in the assessment window and verifying your count before and after the interview, 

because an error can cause vexing problems later during data entry. At 

item 3, indicate which evaluation period is being queried (on 90–AI this 

is always 0–Pretreatment). Again, for remote reconstruction periods, 

this is the followup period being reconstructed, not the current period.

Indicate the client’s gender at item 4. The client’s current body weight 

in pounds is recorded at item 5 to facilitate estimates of BAC levels. 

This is best obtained by weighing the client at each followup interview, although self-report may be accepted. Indicate at item 6 whether 

weight was obtained by weighing or by self-report. At item 7, indicate 

whether the interview is being done in person on site, by telephone, in 

person during a home visit, or at another location.
21

Instructions for 90–AI and 90–AF

Conducting the Interview

Style The style of interviewing is important. A warm empathic tone will 

encourage more honest reporting. Use reflective listening to respond 

to client statements. Maintain eye contact and memorize instructions 

in order to avoid excessive reliance on the form. Patience and positive 

reinforcement are also vital, given the amount of detail the client is 

being asked to provide.

When a client voices frustration, it is often helpful to offer an empathic 

reflection of the feeling and then to reassure or refocus the interviewee 

[e.g., “It is difficult to say, and I’m sure that your drinking does vary 

from week to week, but were there some times here when your drinking 

was fairly consistent from week to week?”] It is also wise to thank and 

reinforce the client for persisting with a sometimes difficult process.

Starting the 

Interview

Below is a script that can be used or paraphrased before beginning 

the Form 90 to help the interviewer obtain more useful and accurate 

information. This script may be worked into the opening introduction 

provided on the Form 90 interview form.

“I’d like to begin this session by asking you questions about your drinking and other experiences you’ve had during the period of time from 

about 3 months before your last drink up until yesterday/the day prior to 

admission (or for about the past 90 days for followup).”

Place calendar in front of client.

“We will be reconstructing this period by using points on the calendar 

to help you remember things that have happened to you as well as to 

help you remember what and how much you’ve had to drink on each 

of these 90 days. You will be able to use the calendar throughout the 

interview to help you remember this period of time.”

Continue using the script on the Form 90 interview form.

The length and content of this statement will vary depending on the 

client’s familiarity with the procedure. For the client’s first Form 90 

(90–AI), however, follow the instructions as printed on the interview 

form.

When asking for memorable events to serve as calendar prompts, 

read the list of possible events slowly and allow clients time to search 

their memory. Write any mentioned memorable events on the calendar 
22

Form 90

across the top of the day boxes. Clients often volunteer information 

here about abstinent or drinking days. Note these briefly and then proceed with the instructions printed on the interview form.

Treatment/ 

Incarceration/ 

Living Experiences 

Record numbers for all items 8–26. If there were no countable days in 

a category, always enter 0 on that item.

“During this period, how many days did you spend in a hospital or treatment program where you stayed overnight?”

For inpatients, be sure they understand that this is for the period 

before their admission and does not include their current hospitalization. At first followup, be sure that inpatients understand this is for 

the period after their discharge. If, in response to this question, clients 

indicate that they had no hospital/residential days, do not proceed to 

ask item by item for each category. Instead verify the answer by saying:

“So you had no overnight stays in a program for detox or treatment of 

any kind?”

Even if the client indicates no days of hospital or residential treatment, 

do ask specifically about outpatient/ambulatory detoxification:

“Did you receive any detoxification treatment at all during this time?”

For each reported hospitalization or residential treatment, record all 

days with any period of residential stay by printing the appropriate code 

in the lower left corner of each day box. Partial hospitalizations (e.g., 

day treatment) and emergency room visits do not count as hospitalized 

days. To count, the client must have been admitted for a residential 

stay and have stayed overnight. Halfway house stays do not count at 

hospital days and are recorded separately (item 20). Classify admissions (items 8–14) according to the primary problem being treated, as 

follows.

Item 8 

Medical

The person was admitted to a medical hospital to be treated for injuries, illnesses requiring hospitalization, medical tests, etc. If the injury 

or illness is alcohol related, the admission is still counted as medical if 

the purpose of treatment was to remedy the medical condition rather 

than to detoxify or to treat the alcohol problem.

■ Record on the calendar as Hm.
23

Instructions for 90–AI and 90–AF

Items 9–11 

Detoxification

The person received treatment for detoxification from alcohol and/or 

other drugs. These are days specifically for detoxification, not treatment. Count any days admitted for detox only, or detox in one facility 

in preparation for treatment at another. If the person was admitted to 

a treatment program where detoxification is merely the first phase and 

blends into treatment and if the person stayed at the facility for subsequent days of treatment, count all days as treatment days rather than 

detox days. Note that detoxification experiences are classified separately as hospital, nonhospital residential, or ambulatory.

■ Hospital/medical detox days are recorded as item 9 and also indicated on the calendar as Htox.

■ Days spent in residential but nonmedical detox are recorded as 

item 10 and recorded on the calendar as Rtox.

■ Days receiving specific ambulatory/outpatient treatment for detox 

are recorded as item 11.

Among the three types of detox days, only hospital and residential nonmedical detox days (items 9 and 10) contribute to the total number of 

residential treatment days (item 15), and only these must be recorded 

on the calendar.

There should be no double counting of days as both detox (items 9–11) 

and treatment. Treatment always takes precedence. Detox days are 

those in which only detox services were received with nothing more 

than minimal advice. For inpatients at intake, do not count detox 

received as part of the client’s current admission. Self-detoxification, 

detoxing by family or friends, and involuntary detox (e.g., during incarceration) do not count unless the client specifically received assistance 

(e.g., prescribed medication) from a qualified professional or program.

Item 12 

Alcohol

The person was admitted to an inpatient or residential program to 

be treated primarily for alcohol problems. This includes admission 

to a psychiatric unit when the purpose included treatment of alcohol problems. If both alcohol and other drug problems were involved, 

the interviewer must decide which constituted the primary reason for 

admission.

■ Record on the calendar as Ra.

Item 13 

Drug

The person was admitted to an inpatient or residential program to be 

treated primarily for drug problems other than drinking This includes 

admission to a psychiatric unit when the purpose included treatment 

of drug problems.

■ Record on the calendar as Rd.
24

Form 90

Item 14 

Psychiatric

The person was admitted to a psychiatric facility for psychological 

problems other than alcohol/drug. If treatment was for a combination 

of alcohol/drug and other psychological problems, it should be classified as an alcohol or drug admission. No hospital/residential day may 

be classified in more than one category.

■ Record on the calendar as Rp.

Item 15 

Total

Record the total number of days in each category of items 8–14 and 

the total (excluding item 11) as item 15. To be counted as a hospital or 

residential day, the client must have been admitted to the hospital or 

other residential facility for an overnight stay. Visits to the emergency 

room, for example, do not count as hospital days if they did not result 

in an admission. The number of “days” is the number of overnight 

stays. The total (item 15) is the simple sum of items 8, 9, 10, 12, 13, 

and 14. (We do not recommend hand calculation of totals. They are 

electronically calculated by Form 90 software programs.)

Item 16 

Incarceration

“During this period, did you spend any time in jail or prison?”

Focus client’s attention on the anchor points on the calendar. Record 

the total number of days as item 16.

■ Record on the calendar as In.

Item 17 

Total Institutional

Add items 15 and 16 to yield the total number of days in institutions 

and enter the total as item 17. (This can also be electronically calculated by software.)

Item 18 

Residence

Begin item 18 with this question:

“During this period, where did you live? How many days did you live in 

the following?”

Record the total number of days during this period when the client was 

living in his/her own house, apartment, or room. Days count in this 

category if the client (or client’s spouse/partner) owned or paid rent 

or mortgage payments. Days away from home (e.g., camping, military 

reserve duty, staying in a hotel while on vacation or a trip, visiting 

friends or relatives) still count on item 18 if the place of residence was 

maintained. Any days paying rent in a hotel/motel also count here. DO 

NOT COUNT on item 18 any days already included in item 17 (i.e., days 

in institutions).
25

Instructions for 90–AI and 90–AF

Item 19 Record the total number of days living with others (except a spouse/

partner) and not paying rent. This includes living with parents, children, or friends who offer the client free lodging.

Item 20 Record all days living in a halfway house. Count days as overnights living in a halfway facility. Do not count days spent in homeless shelters, 

missions, etc. The facility must be identified as a halfway house.

Item 21 Record all days when the client was homeless, “on the road,” or living 

in shelters or missions. Note that the sum of items 17 through 21 must 

equal the total number of days in the assessment window (item 2).

Item 22 “During this period, how many days were there (not including hospital 

or detox days) when you saw a doctor, nurse, nurse practitioner, or 

physician’s assistant for any kind of medical care?”

Record the total number of days as item 22. DO NOT COUNT medical 

care given on hospital, detox, or incarcerated days. Do not count dental visits, eye care (e.g., ophthalmologist or optometrist), chiropractic 

treatment, physical or occupational therapy visits, etc. The intent here 

is to assess primary medical care.

Items 23–25 “During this period, on how many days did you have a session with a 

counselor or therapist?”

Record separately visits for alcohol, drug, and emotional/psychological 

problems as items 23, 24, and 25, respectively. Partial hospitalization services (e.g., day treatment) are counted here as outpatient days. 

Family counseling visits also count here. Briefly describe the type of 

setting, provider, and treatment.

If the client received any alcohol or other drug treatment, also administer the Treatment Experiences Questionnaire (TEQ) for any treatment 

received, even if only a single session. Use only one TEQ for all treatment services received during the assessment window, not a separate 

TEQ for each. [NOTE: The particular TEQ form provided in the appendix was developed for Project MATCH to study attributes of additional 

treatment received. For other applications, it may be desirable to 

amend the content of the TEQ or to omit it altogether.]
26

Form 90

Item 26 “During this period, on how many days did you attend a meeting of 

Alcoholics Anonymous or another 12-step meeting?”

Focus client’s attention on the calendar to aid in memory.

Multiple meetings on one day still count as only one day. NA, CA, ACoA, 

Alanon, and any other 12-step groups all count.

Other Activities Ask these three questions.

Item 27

Work

“How many days have you been paid for working during this period?”

Use calendar to assist in counting.

INCLUDE any part-time or temporary employment. Full-time work 

normally equals 5 days per week unless otherwise specified. In normal 

work weeks, however, count only paid work days (e.g., not weekends if 

they are not worked). Self-employed people should be asked the number of days they worked. Days paid for working (e.g., paid holidays, sick 

leave, vacation time) count, even if the person did not actually work. 

Any period of paid work (e.g., 2 hours of hourly pay to clean house, or 

do yard work, or baby-sit) on a given day counts as a work day.

DO NOT COUNT unpaid volunteer work, or financial gain from illegal 

activities. Paid retirement, disability, or unemployment compensation 

days do not count as work days.

Item 28

Education

“How many days have you been in school or training during this period?”

INCLUDE degree as well as nondegree education as long as it is an 

organized class activity. Any class attendance (or on-the-job training) 

counts as an education day. Do not count correspondence courses 

where no class attendance is required. Note that any given day can be 

both a work day and an education day.

Item 29

Religious 

Attendance

“On how many days during this time did you attend a worship service 

or other religious celebration?”

Count days on which the client attended at least one worship service 

or other religious observance. Attending more than one event in a day 
27

Instructions for 90–AI and 90–AF

counts as only one day. Weddings and funerals are counted only if they 

were conducted in a context of religious worship (e.g., not if a wedding 

is conducted as a civil ceremony). Other examples of events that would 

be counted are prayer meeting, bris, any event including communion/

eucharist, Passover observance, vigil, evensong, and revival meeting. 

Do not count events that are primarily civil/secular/social but may 

include minor religious elements (e.g., an opening and closing prayer), 

such as university commencement, potluck dinner, church administrative meeting, or social cause rally. Do not count any AA or other 

12-step meetings as religious attendance days.

Items 30–35

Medications

Here record only medications that the client took by prescription during the assessment window. Ask:

“During this period, on how many days did you take any medication 

prescribed by a physician?”

Inquire separately for each group of medications. For each, record the 

estimated number of days on which the client took medication by prescription and specify the medications used. DO NOT COUNT vitamins 

or birth control pills. DO NOT COUNT nonprescription drugs (e.g., 

aspirin, over-the-counter medications) recommended by a physician 

but not requiring a prescription. Be sure you make clear the difference 

between medications to maintain/stabilize drug use (e.g., methadone) 

and antagonists intended to block drug effects (e.g., naltrexone), using 

explanatory language that the client will understand. When in doubt 

about the type of medication, record medication information and consult with medical staff.

Periods of 

Abstinence

If the client has not already provided this information, ask:

“Now I’d like to ask you about your drinking during this same period. 

The things already recorded on the calendar here may help you to 

remember better. First of all, were there any periods of days when you 

had nothing to drink at all?”

If the client was continuously and completely abstinent throughout 

the assessment window, complete items 1–35. Leave items 36 and 37 

blank and go to Other Drug Use (items 48–58). It is not necessary in 

this case to add further details to the calendar or to complete items 

38–47, but it is still important to go through the regular routine for 

memorable events, both to confirm abstinence and in preparation for 

other information that is reconstructed from the calendar. If a prior 

followup interval is missing, complete a new Form 90–AF (or 90–AT) for 

the missed period.
28

Form 90

If there were periods of abstinent days but not complete abstinence for 

the entire assessment window, proceed to record drinking and abstinent days on the calendar according to the sequence outlined earlier. 

Make full use of the information already recorded on the calendar to 

help the client recall dates and periods of abstinence and drinking. 

The first step is simply to distinguish days of complete abstinence from 

those in which any alcohol was consumed.

Print an “A” in the center of every day box for days of nondrinking. 

(For prolonged periods of abstinence, an “A” in the first day of each 

week and an arrow through the rest of the week will suffice.) Be sure to 

inquire about drinking during periods of hospitalization (H), residential 

treatment (R), and incarceration (In) as well. Do not assume abstinence 

on H, R, and In days.

Items 36–37 For all clients who drank, ascertain the date of the first drink during the assessment window (item 36) and the date of the most recent 

drink during the window (item 37). For clients drinking throughout the 

period, these will be the first and last days of the assessment window, 

respectively.

Items 38–41

Steady Pattern 

Grids

Clients frequently have periods of reasonably consistent drinking. 

Although drinking weeks are rarely identical, there is commonly a 

repeating pattern from week to week, for at least part of the assessment window. Identifying and quantifying such consistency via the 

steady pattern grid can be helpful in completing the calendar efficiently.

To determine whether to use the steady pattern grid, first examine the 

calendar. If the pattern is mostly abstinence, with only sporadic days 

of drinking, the steady pattern grid is not appropriate. If, on the other 

hand, there are at least several weeks of drinking, inquire:

“During this period of time, when you were drinking, I’d like to see if 

your pattern was at all similar from one week to the next, at least for 

a few of these weeks. I realize that drinking will vary from day to day 

and from week to week, but I want to know if there was any similarity 

among weeks. Was there any consistency to your drinking from week 

to week?”

Allow enough time for the client to study the memorable events on the 

calendar to assist in recall. It is also helpful if the interviewer allows 

the client to see a steady pattern grid in relation to the calendar so that 

he or she may assist with the task. If no consistency can be found, 

skip to item 42 and ask about episodic patterns, using the calendar to 

assist in the client’s recall of the episodes.
29

Instructions for 90–AI and 90–AF

If the client has had a reasonably consistent pattern of consumption 

from week to week when drinking, at least for part of the assessment 

window, complete the first steady pattern grid. Note that this grid divides 

a regular drinking week into 21 parts: morning, afternoon, and evening 

for each of the seven days. Fill in each of the 21 boxes by recording the 

type and amount of alcohol typically consumed (including the proof 

or percentage strength of alcohol content whenever possible), and the 

approximate time span (e.g., beginning and ending hours) over which 

it is consumed. Begin with weekdays, working through mornings, then 

afternoons, then evenings Use these instructions to start:

“Could you describe for me a usual or typical week of drinking? In a 

typical week, let’s start with weekdays—Monday through Friday. What 

did you normally drink in the morning, from the time you got up until 

about lunch time?”*

Focus client’s attention on the grid.

The latter phrasing is intended to provide permission for reporting 

morning drinking. Alternative phrasings such as “Did you ever drink in 

the morning?” may encourage falsification or minimization of morning 

drinking information. Use past tense to inquire about drinking (e.g., 

“What did you drink,” not “What would you drink’?” or “What do you 

drink?”).

You can help the client to be more specific by first asking which beverages were consumed and then how much of each. It helps to know 

ordinary drink sizes (e.g., standard bar draft of beer = 10 oz; ordinary 

wine glass = 4 oz). To clarify actual drink sizes, use a set of glasses of 

different sizes, a pitcher of water, and a measuring cup. Often clients 

have no idea what volume they are consuming. In this case, the client 

can be asked to select a glass that is about the size of the glass usually 

used. The client may pour water into the glass, to the level normally 

poured with the preferred beverage. You can then measure this volume. 

We have found that clients’ estimates of the amount poured can be off 

by a factor of 3 or more, usually in the direction of underestimation.

Be careful not to assume drink sizes. “One drink” of whiskey may 

mean an 8-oz tumbler for one client but a 1-oz shot for another. Ask 

for details. Also inquire about the size of a bottle, a can, and so forth. 

After each reported type of drink for a given time block, ask

“... and what else?”

Another precaution is to clarify whether the client, when drinking with 

others, drank the full quantity being described or shared this quantity 

• Adapted from Miller and Marlatt 1984.
30

Form 90

with drinking companions. Seek clear estimates of the amount consumed by the client alone.

In certain situations, it is more difficult to obtain a good estimate of 

the amount of alcohol consumed. This is so, for example, when the client had drinks mixed by others or of unknown quantity (e.g., a party 

punch), or when the client suffered a memory blackout. Nevertheless 

an estimate is better than no data, and there are often clues to help 

in arriving at a reasonable guess (e.g., amount of money spent, empty 

bottles and cans, friends’ reports, apparent strength of drinks from 

their effects).

Remember to ask about the time period over which the alcohol is usually consumed. This is needed for BAC estimations:

“About what time did you normally have your first drink? . . . And when 

did you usually finish the last one?”

Because drinking is often consistent from day to day, do not begin by 

asking about days one at a time. The “weekdays” approach described 

above often works well. If drinking varies from day to day (e.g., “Two 

mornings a week I may have a glass of beer before lunch”), this can be 

specified. If there are particular days when this occurs (e.g., Tuesdays 

and Thursdays), record it on those days.

After constructing morning drinking, proceed to afternoons:

“Now how about weekday afternoons, including what you drank with 

lunch up through the afternoon until dinner time—what did you normally 

drink on weekday afternoons, Monday through Friday?”*

Again, if the pattern varies from one afternoon to the next, record this 

variation. Use probing questions.

“Would that be on the same days when you had a beer in the morning?”

Again it is important to use the calendar to assist with identifying the 

actual days drinking occurred rather than arbitrarily picking days to 

fill up the grid. (This is important for future time-to-event statistical 

analyses.) The grid is then continued by inquiring about evenings:

“And how about weekday evenings? What did you normally drink with 

dinner, up through the rest of the evening, until the time you went to 

sleep?”*

• Adapted from Miller and Marlatt 1984.
31

Instructions for 90–AI and 90–AF

The grid is completed by repeating this entire process for weekend 

days. Separate inquiries are recommended for weekdays and weekends because drinking patterns on these days often differ widely. 

Repeat the query regarding morning drinking even if the client, when 

asked about morning drinking on weekdays, reported never drinking 

in the morning.

For any time block where no drinking is reported, enter a zero (0). Do 

not leave any blank boxes. Entries should be made in all 21 boxes of 

the grid. This prevents errors through omission of time periods. Be 

careful not to make restrictive assumptions (for example, that a client 

does not drink while driving or during working hours).

These procedures must be modified to accommodate clients with certain lifestyles or schedules (e.g., working night shifts, different meal 

patterns). Remember that the purpose of this grid is to obtain a wellspecified estimate of consumption during a repetitive drinking week.

If the client indicates two distinct drinking periods during the assessment window and there seems to be a second discrete steady pattern, 

you may complete a second steady pattern grid (items 40-41) in the 

same manner.

For each steady pattern ask,

“Now which are the weeks on this calendar when your drinking was like 

this?”

Remember to fill in the calendar as you go with the steady pattern. 

The steady pattern grid and the calendar should be completed hand 

in hand, not independently of each other. It is recommended that the 

interviewer keep the steady pattern grid(s) in plain view of the client 

so that he/she can remember what pattern is being matched to the 

calendar (especially when two steady pattern grids are being used). For 

weeks or portions of weeks described by pattern 1, write “P1” on the 

first day of the week and draw an arrow through the remainder of that 

week. Do the same for P2, if there is a second steady pattern. If abstinent days are part of a steady pattern, also mark these as “A” on the 

calendar so that they are not missed as abstinent days.

A Form 90 data base software program will calculate the BAC according to the way that data are entered. It may be necessary for some days 

to calculate BAC in several different ways (e.g., from first to last drink 

of day; for an episode within the day) using different periods of hours 

to determine the peak BAC. In this case, always use the highest BAC 

estimate obtained. Drinking that continues through the night without 

sleep into the next morning is counted in SEC and BAC totals for the 

day on which it started, unless drinking extends past noon of the next 

day.
32

Form 90

If no steady pattern is apparent in the client’s self-report, go on to item 

42. If the client’s drinking did not deviate significantly from the steady 

pattern, items 42–47 can be omitted, and the calendar can be completed with only P1 (and P2).

Use of the steady pattern grids and episodic pattern charts is at the 

interviewer’s discretion. If it appears that the client’s drinking pattern 

does not lend itself to quantification via pattern charts, these may be 

bypassed, and the entire assessment window reconstructed day by day 

(see Idiosyncratic Days.)

Items 42–47 

Episodic Pattern 

Charts 

If a steady pattern grid has been completed, determine whether some 

periods were not well described by the steady pattern(s). Here is a transition instruction:

“Now that we have your regular pattern, I’d like you to tell me about 

times during this period when your drinking was different from this. 

Look at the calendar again, and think back over this period. When were 

times that you had more or less than your regular amount to drink?”

Because the steady pattern will already be recorded on the calendars, 

it is easy to see which days are not covered by the patterns.

If no steady pattern grid was completed, introduce the episodic pattern 

section in this way:

“If you didn’t have a regular pattern from week to week, tell me about 

times when you did drink during the period on this calendar.”

If there are repetitive drinking episodes in addition to (or instead of) 

the steady pattern drinking, the description of these is your next task. 

Determine whether any types of episodes recurred, that is, where the 

amount and pattern of drinking was reasonably similar from one episode to the next. These commonly occur at particular places or times 

(e.g., on Friday nights; when I go out with coworkers). If you identify a 

type of episode that occurred more than once, use the episodic pattern 

chart to describe it.

The episodic pattern chart should not be used to reconstruct individual, nonrecurring drinking episodes. Rather, the intent is to describe 

specific types of heavier drinking episodes that have recurred. One 

particular type of episode (e.g., staying out on a Saturday night) may 

have occurred several times during the assessment window. Up to 

three types of episodes may be provided. (If a particular case requires 

more than three episodes, additional sheets can be used.) Again, the 

clients must be focused on the calendar so that they can accurately 

recall the information.
33

Instructions for 90–AI and 90–AF

An episode may extend for more than one day. Thus, an episodic pattern might be a 3-day binge.

“Did that happen more than once during this period?”

For each type of episode, ascertain:

■ the specific beverage(s) typically consumed

■ the average amount(s) of beverage(s) consumed and

■ the typical beginning and ending times (for BAC estimation)

If a recurrent episode type is identified, record it as episode type 1 (E1), 

documenting the types and amounts of beverages consumed and the 

time of first and last drinks. Then ask:

“Now, using the calendar, which were the days when your drinking was 

about like that’?”

The calendar should be used throughout the process to define and 

locate these episodes. For days when episode type 1 is descriptive, 

print “E1” in the middle of the box. Follow a similar procedure for any 

additional recurring episode types (E2, E3).

The total SECs (items 42, 44, and 46) and estimated BAC peaks for 

each episode (items 43, 45, and 47) are to be computed following 

the interview, typically by using a data base software package. If no 

repeated episode types can be identified, proceed to fill in the calendar 

day by day.

Idiosyncratic 

Days

The combination of A, P, and E days should in many cases account for 

the majority of days during the assessment window. What remains is 

to reconstruct, day by day, the client’s drinking on days not covered 

by the procedures above. It is conceivable, however, that a given client 

would report no consistent steady (P) or episodic patterns (E), in which 

case the entire assessment window would be constructed one day at 

a time.

Interviewers may also elect to use a day-by-day approach rather than P 

and E grids. Sometimes a modified timeline approach is more efficient 

and less frustrating for both. interviewer and client than the sequence 

of questions presented on the Form 90 questionnaire These situations 

occur when a client is unable to generalize about “steady patterns” or 

“typical weeks” of drinking. Before this frustration occurs, the interviewer should abandon this line of questioning and direct the client’s 
34

Form 90

attention to the calendar. Again, the client should be clear about the 

task at hand. The interviewer might say,

“We are going to work on filling in the calendar with your drinking information. Each calendar day will be filled in with your best estimate of 

the amount you drank that day. Although it sounds like a difficult task, it 

really can be done. We will do this task by focusing on what you were 

doing in your life during this 90-day period.”

Begin by focusing on the longest spans of invariant behavior, such as 

abstinence and/or heavy daily drinking. For example the interviewer 

might say,

“Looking at the calendar and thinking about these events in your life 

that are written on the calendar, what is the longest number of days 

you went without drinking anything at all, not even one (favorite drink)?”

“When did that occur?”

Fill in the calendar days as indicated, and then focus on the days 

immediately following this salient period by asking:

“What happened then? How did your drinking pattern change?”

Continue by focusing on the days immediately preceding the invariant period, using any anchor points that are in close proximity to 

these days. Then ask about other times during the window when the 

client remembers an extended number of days in a regular pattern. 

Throughout the interview, make use of the anchor points provided by 

the client, especially those of regularities in the client’s life (work schedule, payday) to prompt the client in detailing his/her drinking pattern.

For every idiosyncratic day, be sure to record (in the middle of the day 

box) the specific beverage(s) consumed, the amount of each beverage 

consumed, and the number of hours (or beginning and ending times) 

of drinking

Coding Alcohol 

Information

When you have finished, there should be a drinking entry in each and 

every one of the calendar boxes for the assessment window. The entry 

can be an A (for abstinent days), a P code for steady drinking pattern 

days (items 38–41), an E code for recorded episodic patterns (items 

42–47), or a specific amount of consumption for all other days. In the 

latter case (idiosyncratic days), record the specific beverage(s) and the 

specific amounts) of each beverage consumed. Always record sufficient 

information and specificity to permit calculation of the number of standard drinks (SECs) consumed and estimation of the BAC peak on each 

day. The information should be recorded clearly and neatly in such 
35

Instructions for 90–AI and 90–AF

a way that another staff member can easily understand and enter or 

verify the record.

Again, remember that institutional H, R, and In codes (lower left of 

box) do NOT constitute drinking status codes. You must inquire about 

drinking on these days, too, and record drinking status in the middle 

of each box.

At times, clients will report quantities of consumption that seem logically impossible. Whenever the volume of consumption that a client 

reports seems unrealistically high, probe to be sure you have the correct information. Is there possible confusion about bottle size (e.g., 

quarts versus pints) or case size (12 versus 24 bottles)? Did the client 

share the reported amount with others? Do not passively accept drinking information that seems implausible.

Items 48–58 

Other Drug Use

Lifetime Use

Intake The Form 90 interview ends with an assessment of other drug use during the assessment window. To facilitate this, a set of cards has been 

prepared, describing 11 major drug classes (see appendix). For in-person interviews, the client is given this set of cards, always arranged 

in numerical order, and asked to sort them into two piles. At intake 

(90–AI), both lifetime and recent use are reconstructed. Use these 

instructions:

“Now I’m going to show you this set of cards. Each card names a kind 

of drug that people sometimes use. I’d like you to sort them into two 

piles for me. In one pile here (indicate position) I’d like you to place 

those cards that name a kind of drug that you have tried at least once 

in your life. In the other pile here (indicate position), place the cards that 

name types of drugs that you have never tried at all.”*

Use the header cards that are provided (“Drugs I have used at least 

once” and “Drugs I have not used”) to mark where the two piles are to 

be placed. Emphasize that you are asking about drug use ever in the 

client’s lifetime.

Give the cards to the client in numerical order with nicotine on top, 

cannabis next, and so on. When sorting has been completed, take the 

NO pile and check “No” for each of these categories in the LIFETIME 

USE column on the Other Drug Use Chart (items 48–58). Then for all 

categories indicated as “YES,” inquire about the type of drug(s) used 

• Adapted from Miller and Marlatt 1984.
36

Form 90

and the route(s) of administration. Record both the type of drug and the 

route of administration in the space on the form following “specify:”.

For all drug use meeting the criteria in table 2, check “YES” in the 

LIFETIME USE column. If a card placed by the client in the “Yes” pile 

does not meet the use criteria, check “No.”

Proceed to inquire about frequency of use for all drugs checked “YES” 

in the lifetime use column:

“Now for each of these types of drugs, I’d like you to give me an estimate of how long you have used them in your lifetime. What I want to 

know is: during how many weeks during your lifetime have you used 

each type of drug at least once.”

TABLE 2. Criteria for qualifying lifetime drug use (YES)

DO NOT COUNT:

• Over-the-counter medications taken to treat circumscribed illnesses (e.g., colds, allergies)

• Illegal remedies taken for nonpsychoactive, hoped-for curative properties (e.g., for cancer)

• Medications prescribed and taken for 30 days or less if taken as directed for prescribed purposes 

(e.g., Seconal prescribed and taken for 5 days for postsurgical pain; benzodiazepines prescribed during alcohol withdrawal)

• Nonpsychoactive controlled medications that are not included in the card sort drug categories (e.g., 

antibiotics), even if not taken as prescribed

• Psychoactive drugs unlikely to be abused and not falling into one of the card sort drug categories 

(e.g., anticonvulsants, lithium, antidepressants)

DO COUNT:

• All nicotine use

• Any use of controlled psychoactive drugs without prescription

• Any use of illegal drugs of abuse

• Any use of prescribed psychoactive drugs above prescribed doses

• Any use of psychoactive drugs specifically to “get high”

• Any regular (e.g., daily or almost daily) use of prescribed psychoactive drugs for more than 30 

consecutive days, even if within prescribed limits and for prescribed purposes. This includes psychoactive medication prescribed for pain relief, muscle relaxation, weight loss, insomnia, attention deficit 

disorder, etc.

• Any use of multiple prescriptions from different physicians for the same psychoactive medication in 

order to exceed prescribed limits

• Any psychoactive drug prescribed or otherwise used as a maintenance or substitution medication to 

treat alcohol or other drug abuse (e.g., methadone—but not disulfiram).
37

Instructions for 90–AI and 90–AF

Interviewers should gather information that will allow them to code the 

number of weeks in the client’s lifetime that the drug has been used.

“Let’s start with ________________.”

Use nicotine, or first YES card from numerical sequence.

“How many weeks during your lifetime would you say that you used 

_________ at least once?”

Use followup questions such as

“How long did (have) you use(d) ________ at least once a week?”

“How often did you use ________ at least once a week?” 

Remember that the goal is to approximate the number of lifetime weeks 

during which each drug was used. The client should not have the burden of calculating weeks of use.

Clients who have had long periods of use are likely to respond in spans 

of months or years. In such cases, be sure that the client means that 

for this span of time (e.g., 5 years) he/she used a drug from the category at least once per week. Be cautious; for example, do not count 

LSD use twice a year for 5 years as 5 years (260 weeks) of use! Rather 

this would count as 10 weeks of use.

Record response in lifetime weeks on items 48–58. Repeat for each YES 

drug card. Then give YES pile back to client.

Recent Use

“Now I’d like you to sort these again to say which kinds of drugs you 

have used at least once during the period we’ve been talking about on 

this calendar, from ________ up through ________. If you used the 

drug at least once during this time, put it in a pile here (indicate “Drugs 

I have used at least once” pile), and if you never used it at all during this 

period, put it here (indicate “Drugs I have have not used” pile).”

Alternatively, if there are few cards, simply ask:

“Which of these have you used at least once during this period we’ve 

been talking about . . .?”

Be clear that you are now asking about recent use during a specified 

calendar period.
38

Form 90

For each of the YES cards, now ask:

“During this period, on how many days would you say you used 

__________?”

Record as items 48 through 58, respectively, and repeat for all YES 

cards.

Followup At followup (Form 90–AF), the instructions differ slightly. Lifetime use 

is not queried, only drug use during the assessment window:

“Now I’m going to show you this set of cards, which you have seen 

before. Each card names a kind of drug that people sometimes use. 

I’d like you to sort them into two piles for me. In one pile here (indicate 

position and use marker card) I’d like you to place those cards that 

name a kind of drug that you have used at least once during this period. 

In the other pile here (indicate position and use marker card), place the 

cards that name types of drugs that you have not used at all, not even 

once, during this period.”

Always give cards to the client in numerical order, with nicotine on top, 

cannabis next, and so on. When the sorting has been completed, place 

a zero (0) next to all drug categories placed in NO pile.

Then inquire about each of the remaining (YES) categories to determine qualifying use (see table 2). If use does not qualify, mark zero (0) 

for that category. Do not record days of use that fail to qualify (e.g., 

Seconal given by prescription for 3 days for postsurgical pain; Librium 

during detoxification).

If use does qualify, ask the number of days during the assessment window when this drug class was used.

“During this period, on how many days would you say you used 

__________?”

Record on items 48–58, Other Drug Use Chart, and repeat for all YES 

cards.

Completing

the Interview

Review the calendar and other drinking information before the client 

leaves the interview setting in order to ensure that the information is 

accurate and codable. This may be done while the client is completing 

other questionnaires. To complete the calendar data, enter zero (0) for 

all abstinent days.
39

Instructions for 90–AI and 90–AF

Be sure that P1 (and P2) days are clearly marked on the calendar and 

that the data entered on the steady pattern grids are clear and easily 

readable for computer entry. This includes the number of ounces and 

percent alcohol or brand name of alcohol, as well as time to consume.

For episodic days, enter E1, E2, or E3 on the calendar, and check the 

information recorded on the episodic pattern charts for accuracy and 

completeness.

For idiosyncratic days, check the calendar for readability, amount, and 

percentage alcohol. No days may be omitted.

It is not necessary to record SECs on the calendar if, as recommended, 

you are using computer software to perform these calculations. If a 

Form 90 record is to be double-checked by another coder, however, it 

is very helpful to have the SEC units and the computer-estimated BAC 

levels for idiosyncratic days recorded in the lower left hand corner of 

each day box so that discrepancies can be easily located.

41

Remote Reconstruction

Items 59–66 

Followup Only

If the client missed a prior followup period, continue with a new Form 

90–AF (or 90–AT) to reconstruct the missed period. It is desirable to 

complete items 1–37 and 48–58, but highest priority should be given to 

quantifying drinking during the missed period. At items 1–3, indicate 

the followup period being reconstructed.

Item 59 At item 59, indicate the present followup point, from which reconstruction is being done (not the period being reconstructed). It is vital to fill 

in item 59 for all reconstructions, because it is the item that signals 

data analysts that this Form 90 is a retrospective reconstruction.

Always use a calendar to remind the client about the missing period. 

In some cases, it will be possible to complete the calendar in a straightforward manner. For example, a client may clearly recall abstaining 

throughout the missing period except for 2 days at a holiday. In such 

a case, complete the calendar form as usual. If, on the other hand, a 

day-by-day reconstruction of drinking is not viable, fill in memorable 

events to aid with memory and then use the following procedure.

First, obtain an approximate date of the first drink (item 36) and the 

last drink (item 37) during the missing interval. If drinking was continuous, these will be the first and last days of the interval, respectively.

Items 60–61 Second, ask for an estimate of the number of abstinent (A) days that 

occurred during the missing followup period. Again, show the client 

a calendar for the period. It may also be helpful to ask the client to 

compare the missing period with the most recent followup window, 

just discussed. Record the estimated number of abstinent days as item 

60. The remaining days in the followup window (item 2 minus item 60) 

constitute the number of drinking days during the missing period (item 

61).

Item 62 Third, ask for an estimate of the number of days during this period 

when the client had 6 or more drinks. Use the standard drink (SEC)
42

Form 90

definition. An illustrative graphic is provided with the form, which may 

be helpful here.

Items 63–66 The final important task is to ask clients to compare their drinking 

during the missing period with their drinking during the period just 

described. Rather than attempting a full reconstruction, ask the client 

how the missing followup period would compare with the window you 

just finished discussing.

“Would the amount of drinking on drinking days be about the same? 

More? If so, how much more? Less? If so, how much less?”

Some clients can give a percentage estimate (e.g., about half as many, 

about twice as much) that can be used to approximate the number 

based on the anchor period. Note that this is an estimate only for the 

amount of drinking on drinking days, not the number of days of drinking, which is a separate issue (item 61). The question here is:

“On days/weeks when you did drink, how would your drinking compare 

to drinking days from the most recent period which we just discussed?”

What is needed here is a multiplier (item 64) which best captures the 

client’s comparison of these two periods. It is not likely that most clients could generate this number themselves. Rather, the interviewer 

must make the decision, based on the client’s report. For example, if 

the client’s estimate is “about half as much,” the interviewer could use 

0.50 as the multiplier. Similarly, if the client suggests “twice as much,” 

the multiplier chosen would be 2.00.

Calculate the product of this multiplier and item 63, the average SECs 

per drinking day for the current period obtained from summary statistics. This yields item 65, the best guess as to the average number of 

SECs per drinking day during the missing period.

Alternatively, ask directly for an estimate of the number of standard 

drinks per drinking day during this interval and enter it on item 65.

Finally, item 65 is multiplied by item 61 to estimate the total number of SECs consumed during the missing followup period (item 66). 

These calculations can also be completed electronically with greater 

reliability.

If no estimate of SECs per drinking day is available from the current 

period (e.g., the client was abstinent during the current period, but 

drank during the missing period), ask the client to estimate the amount 

of drinking on a typical drinking day during the interval, and enter that 

number (in SECs) as item 65.
43

Telephone Interviews

90–AT and 90–AQ

The feasibility of a Form 90 interview by telephone depends heavily upon the tolerance of the client and the skill of the interviewer. 

Although it is highly desirable to conduct as many Form 90 interviews 

in person as possible, it may be necessary to complete a certain percentage by telephone. When a client will not return for an in-person 

interview and a home visit is not feasible, Form 90 can be completed 

by telephone.

The Client Telephone Assessment of Drinking and 

Related Behaviors

Form 90–AT directly parallels 90–AF. No questions are deleted, although 

instructions have been modified slightly for telephone interviewing.

If a telephone interview can be anticipated (e.g., for out-of-town cases 

or scheduled telephone interviews), mail to the client a copy of the retrospective calendar for reference during the interview. In many cases, 

however, this calendar will not be available to the client during the 

interview. In this situation, you may ask clients whether they have a 

calendar at hand to help with recall.

Unless there is an apparent concern about completion of the interview 

by telephone (in which case 90–AQ should be done first), proceed normally through 90–AT. For the drinking quantification portion of the 

interview (items 36–47 and the calendar), work with a calendar in front 

of you, with a goal of accounting for each day through (1) abstinence, 

(2) steady pattern, (3) episodic pattern, or (4) idiosyncratic data. Have 

as your first priorities to establish (1) the dates of first and last drink 

(items 36 and 37) and (2) the total number of days abstinent during the 

assessment window.
44

Form 90

 Quick Drinking Assessment Interview

When it appears that the client is unwilling to give the time necessary 

for a full 90–AT, priority should be given to obtaining the essential 

outcome data contained on 90–AQ. This can be introduced to the 

impatient client by saying:

“I’d like to ask you just six questions about your drinking during the 

period from ________ up through yesterday. That’s a period of 

________ days.”

Then launch directly into the six questions, items 5–10. (Items 5a and 

5b can be considered a single question.) Ask the questions as specified 

on Form 90–AQ. When you have completed 90–AQ, try to persuade the 

client to continue with 90–AT.

NOTE: For certain applications, this simple quick form, which is essentially a quantity-frequency questionnaire, may prove sufficient for all 

cases.
45

Collateral Interview on Drinking

Once you have mastered client interviews with Form 90, it is a short 

step to interviewing significant others (SOs). The special challenge 

with these collaterals is that they typically have more limited information and need encouragement to provide whatever data they have. 

The instructions provided here refer to the shortened Form 90–ACS. A 

more detailed form (90–AC) was used in Project MATCH and was modified to facilitate more general applications.

Preparing for

the Interview

When contacting collaterals (table 3) for the first time, a letter should 

be sent in advance of the call, informing them of the purpose of the 

interview and the fact that it is done with the client’s written permission (see appendix for sample letter). It should also be made clear that 

the information provided is confidential and will not be shared with the 

client. To further protect confidentiality, such letters should be sent 

with a return address that does not reveal the purpose of the project.

When telephoning a collateral, ensure that you are talking to the right 

person. Do not reveal the client’s name or the purpose of your call until 

you know you are are talking to the collateral whom you have written 

permission to interview. In talking to others, give only your name and

TABLE 3. When to contact the collateral for a 90–ACS interview

INTAKE As soon as possible after completing Form 90–AI

FOLLOWUP Whichever comes first:

1. Completion of Form 90–AF

2. Inability to locate the client for 90–AF

3. Client refusal of 90–AF

4. 30 days after the due date for 90–AF
46

Form 90

a general indication of the purpose of your call (e.g., “a professional 

matter” or “about a friend” or “a research program”). Be aware that 

“caller ID” technology is now widely available, indicating the registered 

name and number of the telephone from which you are calling (unless 

you have arranged for such information to be blocked).

Inquire as to whether the collateral received the letter that was sent. 

(In many cases, the collateral will not recall it, or may not have read or 

understood it.) Briefly explain the purpose of your call, then proceed 

with the interview. (Additional general information on interviewing collaterals can be found in Miller and Marlatt 1984, 1987.)

Items 1–4 Items 1–4 can usually be completed from information provided in the 

client file. Before starting the interview, be sure to determine accurately the total number of days in the window to be discussed (see item 

1a).

Table 4 provides recommendations for the starting and ending dates 

for 90–ACS interviews.

TABLE 4. Starting and ending dates for 90–ACS assessment windows

Starting date Ending date

Intake Same as 90–Al: 89 days before the 

date the client reports as his/her last 

drink

Outpatients: Day before 90–Al 

interview

Inpatients: Day before admission

First 

followup

Outpatients: Date of first treatment, 

or if no sessions completed, 5 days 

after completion of intake

Yesterday

Inpatients: Date of discharge Yesterday

Subsequent

followups

Date of last Form

90–AC interview

Yesterday

Conducting 

the Interview

Introduce the first collateral interview with a statement such as:

“Hello, my name is ________ and I’m calling from ________. I would 

like to ask you a few questions about ________, who gave us your 

name as a person who might help us with some information about 

him/her. As you may know, he/she is participating in a research study 

designed to learn more about ________. Did you receive the letter that 

we sent?”
47

Collateral Interview on Drinking

If no, review details.

“The information you give me will be completely confidential. It will be 

used only for our research, and we will not share it with [client].”

Later contacts can be introduced with a statement such as:

“Hello, this is ________ from ________. We have called you before to 

ask you about ________ and to get your help with the study in which 

he/she is participating. Can you talk for a few minutes now? Remember 

that the information you give will be completely confidential. We use it 

only for our research, and we will not share it with [client].”

These introductory remarks should be given in a natural conversational tone and should not sound like a written script.

Item 5 For Item 5, determine how long the collateral has known the client, 

and record this information as the number of months (12 per year).

Item 6 Introduce item 6 by explaining the period of time (assessment window) 

about which you are inquiring. Normally this will be the period from a 

starting date (see table 4) to the day before the interview. For certain 

research purposes, however, this window may be adjusted. A common 

problem is that the period of time asked about in 90–ACS does not correspond exactly with the assessment window used in interviewing the 

client for followup. If direct correspondence is crucial, then the period 

asked about should be the same as was covered with the client in Form 

90–AF.

For item 6, use the script questions to determine the number of days 

during this assessment window when the collateral was in contact with 

the client. Record the number of days that they were in contact. Being 

“in contact” can include in-person shared time or talking by telephone.

Item 7 For item 7, check all of the responses that apply, to indicate the way(s)

in which they have been in contact.

Items 8–13 At item 8, ask the question as written. The SO’s response may immediately indicate the appropriate alternative, or it may be necessary 

to ask a further probe to clarify the correct choice (for example, if the 

collateral says that the client was drinking you might ask whether the 
48

Form 90

collateral suspects or actually observed the drinking). If the appropriate alternative is not immediately clear, read the options and ask the 

SO to choose the most accurate response. If abstinence is reported 

(options 1 or 2), record zero (0) for items 9, 11, and 12; and for item 

10 (abstinent days) record the total number of days in the assessment 

window (from item la). Then skip to item 13.

If nonabstinence (options 2 or 3) is reported on item 8, proceed to ask 

items 9–13 as written. Code “998” to indicate a “Don’t know” response. 

For item 11, use the SEC unit when determining the number of standard drink units consumed per day. This is best done by clarifying the 

type(s) and amount(s) of alcohol beverages consumed, then making 

the conversion into SEC units (e.g., by using the BACCuS software). 

Do not rely upon the collateral to specify a number of drinks without 

knowing what the collateral is considering to be a “drink.”

For item 13, read the question and the alternatives and ask the respondent to choose the most appropriate option.
49

References

Del Boca, F.K.; Babor, T.F.; and McRee, B. Reliability enhancement 

and estimation in multisite clinical trials. J Stud Alcohol Suppl 

12:130–136, 1994.

Gorenstein, E.E. Comprehensive Drinker Profile (review). In: Keyser, 

D.J., and Sweetland, R.C., eds. Test Critiques. Vol. 3. Kansas City, 

MO: Test Corporation of America, 1985.

Grant, K.A.; Tonigan, J.S.; and Miller, W.R. Comparison of three alcohol consumption measures: A concurrent validity study. J Stud 

Alcohol 56:168–172, 1995.

Leake, C.D., and Silverman, M. The chemistry of alcoholic beverages. 

In: Kissin, B., and Begleiter, H., eds. The Biology of Alcoholism. 

Vol. 1. New York: Plenum, 1971.

Markham, M.R.; Miller, W.R.; and Arciniega, L. BACCuS 2.01: 

Computer software for quantifying alcohol consumption. Behav 

Res Meth Instru Comput 25:420–421, 1993.

Matthews, D.B., and Miller, W.R. Estimating blood alcohol concentration: Two computer programs and their applications in therapy 

and research. Addict Behav 4:55–60, 1979.

McLellan, A.T.; Parikh, G.; Bragg, A.; Cacciola, J.; Fureman, B.; and 

Incmikoski, R. Addiction Severity Index Administration Manual. 

5th ed. VA Center for Studies of Addiction, Pennsylvania State 

University, 1990.

Miller, W.R. Behavioral treatment of problem drinkers: A comparative 

outcome study of three controlled drinking therapies. J Consult 

Clin Psychol 46:74–86, 1978.

Miller, W.R., and Del Boca, F.K. Measurement of drinking behavior 

using the Form 90 family of instruments. J. Stud Alcohol (Suppl) 

12:112–118, 1994.

Miller, W.R., and Marlatt, G.A. Comprehensive Drinker Profile Manual.

Odessa, FL: Psychological Assessment Resources, 1984.

Miller, W.R., and Marlatt, G.A. Comprehensive Drinker Profile Manual 

Supplement. Odessa, FL: Psychological Assessment Resources, 

1987.

Miller, W.R.; Heather, N.; and Hall, W. Calculating standard drink 

units: International comparisons. Br J Addiction 86:43–47,1991.

Project MATCH Research Group. Project MATCH: Rationale and methods for a multisite clinical trial matching patients to alcoholism 

treatment. Alcoholism Clin Exp Res 17:1130–1145,1993.
50

Form 90

Sobell, L.C., and Sobell, M.B. Timeline follow-back: A technique for 

assessing self-reported alcohol consumption. In: Litten, R.Z., and 

Allen, J., eds. Measuring Alcohol Consumption: Psychosocial and 

Biological Methods. Totowa, NJ: Humana Press, 1992. pp. 41–72.

Sobell, L.C., and Sobell, M.B. Timeline Followback (TLFB) User’s 

Manual. Toronto: Addiction Research Foundation, 1994.

Sobell, M.B.; Maisto, S.A.; Sobell, L.C.; Cooper, A.M.; Cooper, T.; and 

Sanders, B. Developing a prototype for evaluating alcohol treatment effectiveness. In: Sobell, L.C.; Sobell, M.B.; and Ward, E., 

eds. Evaluating Alcohol and Drug Abuse Treatment Effectiveness: 

Recent Advances. New York: Pergamon, 1980. pp. 129–150.

Tonigan, J.S.; Miller, W.R.; and Brown, J.M. The reliability of Form 90: 

An instrument for assessing alcohol treatment outcome. J Stud 

Alcohol 58:358–364, 1997.
51

Appendices

The Form 90 Family of Instruments 

Form 90–A

Form 90-AI ......................................................53

Form 90–AF......................................................65

Form 90–AT ......................................................79

Form 90–AQ .....................................................93

Form 90–ACS ...................................................95

Form 90–D

Form 90–DI ......................................................99

Form 90–DF ................................................... 109

Standard Drink Graphic ...........................................78

Categories for Days of Use....................................... 108

Confidence Scale..................................................... 108

Drug Cards for Sorting............................................ 117

Treatment Experiences Questionnaire..................... 119

Sample Letter to Collaterals .................................... 123

53

Form 90–AI

Drinking Assessment Interview—Intake

“I’d like to begin by reminding you that whatever you say here is 

confidential. I am going to be asking you some specific questions 

about the period from about 3 months before your last drink up until 

(yesterday/the day of your admission).”

[Place calendar in front of client.]

“Here is a calendar to help you remember this period of time. First of 

all, when was your last drink?”

[Count back 89 days from the day of last drink, and cross 

out with Xs the days preceding this period.]

“So the period I’m going to be asking you about is from [beginning 

date, 89 days prior to last drink] up through [end date].”

“I realize that this is a long period of time to remember things that 

happened, so we will use this calendar to help you identify events 

that occurred during this period. Notice that a few events are already 

printed in the calendar.”

[Point out some specific events already printed on the 

calendar.]

“Were there any particularly memorable things that happened during 

this time—any birthdays, illnesses or accidents, anniversaries, parties, hospitalizations, vacations, changes in your work or at home, 

things like that?”

[Record on calendar.]

“Now, the rest of the questions that I will ask you are also about this 

period, from ______ up through ______. I’ll be asking you about 

your drinking in a few minutes, but first I’d like to know about a few 

other things. Feel free to take your time in answering, since it is 

important for you to remember as accurately as you can. Let me 

know if you’re not sure what I am asking, or what I mean by a particular question. OK?”

1. For period from 

____/____/____ 

through 

____/____/____

2. Number of days in this 

assessment period: 

__________

3. This is (0) Intake

4. _____ (1) Female

_____ (2) Male

5. Current body weight 

in pounds: 

__________

6. Weight was obtained 

by:

_____ (1) weighing

_____ (2) self-report

7. This interview was 

conducted:

_____ (1) on site

_____ (2) by telephone

_____ (3) home visit

_____ (4) other location
54

Form 90–AI

Treatment/Incarceration/Living Experiences

“During this period, how many days did you spend in a hospital or 

treatment program where you stayed overnight?”

[Mark days on calendar]

Total number of hospital days for medical problems 8. _______________ Hm

Total number of hospital days for detoxification 9. _______________ Htox

Total number of nonhospital residential detox days 10. _______________ Rtox

Total number of ambulatory detox treatment days 11. _______________

Total number of residential days alcohol treatment 12. _______________ Ra

Total number of residential days for other drug problems 13. _______________ Rd

Total residential days for emotional/psych problems 14. _______________ Rp

Total days in residential treatment during this period 15. _______________ Total

[Sum of 8 + 9 + 10 + 12 + 13 + 14: Do not include 11.]

“During this period, did you spend any time in jail or prison?” 

[Mark days on calendar.]

Total days incarcerated during period 16. _______________ In

Total days in institutions [Add 15 + 16.] 17. _______________ Total

“During this period, where did you live? How many days did you live 

in the following?”

[Do not record on calendar unless useful as memory aids.]

Total number of days in own house, apartment, room 18. _______________

Total number of days living with others (no rent) 19. _______________

Total number of days living in halfway house 20. _______________

Total number of days homeless (shelters, etc.) 21. _______________

[Items 17 + 18 + 19 + 20 + 21 must equal item 2.]
55

Form 90–AI

“During this period, how many days were there (not including hospital or detox days) when you saw a doctor, nurse, nurse practitioner, 

or physician’s assistant for any kind of medical care?”

[Do not record on calendar unless useful as memory aids.]

Total days seen for medical care 22. _______________

“During this period, on how many days did you have a session with 

a counselor or therapist?”

[Do not record on calendar unless useful as memory aids.]

Total number of days for alcohol problems** 23. _______________

Total number of days for other drug problems** 24. _______________

[** Administer the Treatment Experiences Questionnaire if 

client received alcohol or drug treatment.]

Total days for emotional/psychological problems 25. _______________

[If treatment was received, describe briefly here:] ___________

___________________________________________________________

“During this period, on how many days did you attend a meeting of 

Alcoholics Anonymous or another 12-step meeting?”

[Do not record on calendar unless useful as memory aids.]

Total number of days attending 12-step meetings [Enter 0 if 26. _______________

none.]

Other Activities

[Do not enter activity days on the calendar unless they 

appear to be of value for recalling drinking ]

“How many days have you been paid for working during this period?” 27. _______________ Work

“How many days have you been in school or training during this 28. _______________ 

period?” Education

“On how many days during this time did you attend a worship service 29. _______________ 

or other religious celebration?” Religious Attendance
56

Form 90–AI

Medications

“During this period, on how many days did you take any medications 

prescribed by a physician?”

[Do not enter medication days on the calendar unless they 

appear to be of memory value.]

To treat a medical problem 30. _______________

Specify medication: _______________________________________

To prevent you from drinking (antidipsotropic only) 31. _______________

To help you detoxify/come off alcohol or another drug 32. _______________

Specify medication: _______________________________________

To help you stabilize or change your use of drugs other than 

alcohol

Maintaining/stabilizing drugs (e.g., methadone) 33. _______________

Specify medication: ____________________________________

Drug antagonists/blockers 34. _______________

Specify medication: ____________________________________

For psychological or emotional problems 35. _______________

Specify medication: _______________________________________

Periods of Abstinence

“Now I’d like to ask you about your drinking during this same period. 

The things already recorded on the calendar here may help you to 

remember better. First of all, were there any periods of days when 

you had nothing to drink at all?”

[Mark all abstinent days as “A” on calendar.] 

Date of first drink during period 36. ____/____/____

Date of last drink during period 37. ____/____/____
57

Form 90–AI

“During this period of time, when you were drinking, I’d like to see if 

your pattern was at all similar from one week to the next, at least for 

a few of these weeks. I realize that drinking will vary from day to day 

and from week to week, but I want to know if there was any similarity among weeks. Was there any consistency to your drinking from 

week to week?”

[If NO, skip to item 42, episodic pattern charts. If YES, 

continue and complete steady pattern grid(s).]

“Could you describe for me a usual or typical week of drinking. In 

a typical week, let’s start with weekdays—Monday through Friday. 

What did you normally drink in the morning, from the time you got up 

until about lunchtime?”

[Record on steady pattern grid.]

[For each drinking period, obtain time estimates to allow 

BAC calculation. For example:]

“About what time did you normally have your first drink? ... And when 

did you usually finish the last one?”

“Now how about weekday afternoons, including what you drank with 

lunch up through the afternoon until dinner time—what did you normally drink on weekday afternoons, Monday through Friday?”

[Record on grid.]

“And how about weekday evenings? What did you normally drink 

with dinner, up through the rest of the evening, until the time you 

went to sleep?”

[Record on grid.]

[Repeat same instructions for weekend days.]
58

Form 90–AI

P1—Steady Pattern Grid 1

Morning Afternoon Evening Total SECs

M

O

N Time: Time: Time: __________.______

T

U

E Time: Time: Time: __________.______

W

E

D Time: Time: Time: __________.______

T

H

U Time: Time: Time: __________.______

F

R

I Time: Time: Time: __________.______

S

A

T Time: Time: Time: __________.______

S

U

N Time: Time: Time: __________.______

Total number of standard drinks (SECs) per week 38. ____________.______

Estimated BAC peak for steady pattern week (mg%) 39. __________________

[Enter all days of this pattern on calendar as P1.]

[If the above pattern does not describe all drinking weeks, 

ask:]

“Now on the other weeks when you were drinking, was your drinking 

at all the same from week to week?”

[If YES, complete steady pattern grid 2. If NO, proceed to 

item 42, episodic pattern charts.]
59

Form 90–AI

P2—Steady Pattern Grid 2

Morning Afternoon Evening Total SECs

M

O

N Time: Time: Time: __________.______

T

U

E Time: Time: Time: __________.______

W

E

D Time: Time: Time: __________.______

T

H

U Time: Time: Time: __________.______

F

R

I Time: Time: Time: __________.______

S

A

T Time: Time: Time: __________.______

S

U

N Time: Time: Time: __________.______

 

Total number of standard drinks (SECs) per week 40. ____________.______

Estimated BAC peak for steady pattern week (mg%) 41. __________________

[Enter all days of this pattern on calendar as P2.]

 
60

Form 90–AI

Episodic Pattern Charts

Instructions when steady pattern grids were completed:

“Now that we have your regular pattern, I’d like you to tell me about 

times during this period when your drinking was different from this. 

Look at the calendar again, and think back over this period. When 

were times that you had more or less than your regular amount to 

drink?”

Instructions when no regular pattern was detected (steady 

pattern grids have been skipped):

“If you didn’t have a regular pattern from week to week, tell me about 

times when you did drink during the period on this calendar.”

Followthrough for all clients (when a particular episode is 

identified):

“Did that happen more than once during this period?”

[If NO, record data directly on the calendar. If YES, record 

as episode type 1 below and continue.]

“Now, using the calendar, which were the days when your drinking 

was about like that?”

[Record El in the middle of those day blocks.]

[Continue to probe in this manner for up to two other 

episode types: E2 and E3 days.]

[If no repeated episode types can be identified, proceed to fill 

in the calendar day by day.]

E1 Episode Type 1

Beverages and amounts: __________________________________

Total SECs 42. _________._____

Time to consume: _____________________________________

Estimated peak BAC for episode type 1 (mg%) 43. _______________

[Record on calendar as El.]
61

Form 90–AI

E2 Episode Type 2

Beverages and amounts: __________________________________

Total SECs

Time to consume: _____________________________________

44. _________._____

Estimated peak BAC for episode type 2 (mg%) 

[Record on calendar as E2.]

45. _______________

E3 Episode Type 3

Beverages and amounts: __________________________________

Total SECs 46. _________._____

Time to consume: _____________________________________

Estimated peak BAC for episode type 3 (mg%) 47. _______________

[Record on calendar as E3.]

[Proceed to fill in any other drinking days on calendar not 

accounted for by P or E codes. Then identify the THREE 

HEAVIEST DRINKING DAYS in the calendar. If not P or E 

days, obtain the time of first drink and last drink, to permit 

BAC calculation.]

Other Drug Use

“Now I’m going to show you this set of cards. Each card names a 

kind of drug that people sometimes use. I’d like you to sort them 

into two piles for me. In one pile here [indicate position] I’d like you 

to place those cards that name a kind of drug that you have tried at 

least once in your life. In the other pile here [indicate position], place 

the cards that name types of drugs that you have never tried at all.”

[Give cards to client in numerical order with nicotine on top, 

cannabis next, and so on. Use the header cards provided 

(“Drugs I have used at least once” and “Drugs I have not used”) 

to mark where the two piles are to be placed. Emphasize that 

you are asking about drug use ever in the client’s life. When 

the sorting is complete, take the NO (never used) pile, and 

check all these categories as “NO” in the Lifetime Use column 

on items 48–58. Continue with the YES pile.]
62

Form 90–AI

“Now for each of these types of drugs, I’d like you to give me an 

estimate of how long you have used them in your lifetime. What I 

will want to know is: during how many weeks during your lifetime 

have you used each type of drug at least once. Let’s start with [use 

nicotine, or first YES card from numerical sequence]. How many 

weeks, during your lifetime, would you say that you used ________ 

at least once?”

[Record response. It may be recorded in months or years, but 

must always be converted into weeks. Repeat for each YES 

drug card. Then give YES pile back to client.]

“Now I’d like you to sort these again to say which kinds of drugs you 

have used at least once during the period we’ve been talking about 

on this calendar, from ________ up through ________. If you used 

the drug at least once during this time, put it in a pile here [indicate 

“Drugs I have used at least once” pile], and if you never used it at 

all during this period, put it here [indicate “Drugs I have have not 

used” pile].”

[Alternatively, if there are few cards, simply ask: “Which of 

these have you used at least once during this period we’ve 

been talking about . . .” Be clear that you are now asking 

about recent use during a specified calendar period.]

[For each of the YES cards, specify the drug(s) used and 

ask:]

“During this period, how many days would you say you used 

________?”

[Record on items 48–58 and repeat for all YES cards.]
63

Form 90–AI

Other Drug Use Chart

Lifetime Use? Weekly Use 

Year=52, Month=4

Current period

48. Nicotine

Specify: ____(0)No ____(1)Yes Lifetime weeks: ______________

____________Days

Cigarettes per day in 

current period:

49. Cannabis 

Specify: ____(0)No ____(1)Yes Lifetime weeks: ______________ ____________Days

50. Sedatives 

Specify: ____(0)No ____(1)Yes Lifetime weeks: ______________ ____________Days

51. Hypnotics 

Specify: ____(0)No ____(1)Yes Lifetime weeks: ______________ ____________Days

52. Steroids 

Specify: ____(0)No ____(1)Yes Lifetime weeks: ______________ ____________Days

53. Amphetamines 

Specify: ____(0)No ____(1)Yes Lifetime weeks: ______________ ____________Days

54. Cocaine 

Specify: ____(0)No ____(1)Yes Lifetime weeks: ______________ ____________Days

55. Hallucinogens 

Specify: ____(0)No ____(1)Yes Lifetime weeks: ______________ ____________Days

56. Inhaled Toxicants

Specify: ____(0)No ____(1)Yes Lifetime weeks: ______________ ____________Days

57. Opiates

Specify: ____(0)No ____(1)Yes Lifetime weeks: ______________ ____________Days

58. Other Drugs 

Specify: ____(0)No ____(1)Yes Lifetime weeks: ______________ ____________Days

65

Form 90–AF

Followup Interview Assessment of 

Drinking and Related Behaviors

“Now, as in the interview(s) you’ve had before, I’d like to remind you 

that whatever you say here is confidential. I am going to be asking 

you some specific questions about the period of time from ______ 

up through yesterday.”

[Place calendar in front of client.]

“Here is a calendar to help you remember this period of time.I realize 

that this is a long period of time to remember things that happened, 

so we will use this calendar to help you identify events that occurred 

during this period. As before, you can see that there are some 

events already printed on the calendar. Were there any particularly 

memorable things that happened during this time—any birthdays, 

illnesses or accidents, anniversaries, parties, hospitalizations, vacations, changes in your work or at home, things like that?”

[Record on calendar.]

“Now, the rest of the questions that I will ask you are also about this 

time period, from ______ up through yesterday. I’ll be asking about 

your drinking in a few minutes, but first I’d like to know about a few 

other things. Feel free to take your time in answering, because it is 

important for you to remember as accurately as you can. Let me 

know if you’re not sure what I am asking, or what I mean by a particular question. OK?”

1. For period from 

____/____/____ 

through 

____/____/____

2. Number of days in this 

assessment period: 

__________

3. This is ________-month 

followup

4. _____ (1) Female

_____ (2) Male

5. Current body weight 

in pounds: 

__________

6. Weight was obtained 

by:

_____ (1) weighing

_____ (2) self-report

7. This interview was 

conducted:

_____ (1) on site

_____ (2) by telephone

_____ (3) home visit

_____ (4) other location
66

Form 90–AF

Treatment/Incarceration/Living Experiences

“During this period, how many days did you spend in a hospital or 

treatment program where you stayed overnight?”

[Mark days on calendar.]

Total number of hospital days for medical problems 8. _______________ Hm

Total number of hospital days for detoxification 9. _______________ Htox

Total number of nonhospital residential detox days 10. _______________ Rtox

Total number of ambulatory detox treatment days 11. _______________

Total number of residential days alcohol treatment 12. _______________ Ra

Total number of residential days for other drug problems 13. _______________ Rd

Total residential days for emotional/psych problems 14. _______________ Rp

Total days in residential treatment during this period 15. _______________ Total

[Sum of 8 + 9 + 10 + 12 + 13 + 14: Do not include 11.]

“During this period, did you spend any time in jail or prison?” 

[Mark days on calendar.]

Total days incarcerated during period 16. _______________ In

Total days in institutions [Add 15 + 16.] 17. _______________ Total

“During this period, where did you live? How many days did you live 

in the following?”

[Do not record on calendar unless useful as memory aids.]

Total number of days in own house, apartment, room 18. _______________

Total number of days living with others (no rent) 19. _______________

Total number of days living in halfway house 20. _______________

Total number of days homeless (shelters, etc.) 21. _______________

[Items 17 + 18 + 19 + 20 + 21 must equal item 2.]
67

Form 90–AF

“During this period, how many days were there (not including hospital or detox days) when you saw a doctor, nurse, nurse practitioner, 

or physician’s assistant for any kind of medical care?”

[Do not record on calendar unless useful as memory aids.]

Total days seen for medical care 22. _______________

“During this period, on how many days did you have a session with 

a counselor or therapist?”

[Do not record on calendar unless useful as memory aids.]

Total number of days for alcohol problems** 23. _______________

Total number of days for other drug problems** 24. _______________

[** If alcohol or drug treatment was received, administer the 

Treatment Experiences Questionnaire.]

Total days for emotional/psychological problems 25. _______________

[If treatment was received, describe briefly here:] ___________

___________________________________________________________

“During this period, on how many days did you attend a meeting of 

Alcoholics Anonymous or another 12-step meeting?”

[Do not record on calendar unless useful as memory aids.]

Total number of days attending 12-step meetings [Enter 0 if 26. _______________

none.]

Other Activities

[Do not enter activity days on the calendar unless they 

appear to be of value for recalling drinking ]

“How many days have you been paid for working during this period?” 27. _______________ Work

“How many days have you been in school or training during this 28. _______________ 

period?” Education

“On how many days during this time did you attend a worship service 29. _______________ 

or other religious celebration?” Religious Attendance
68

Form 90–AF

Medications

“During this period, on how many days did you take any medications 

prescribed by a physician?”

[Do not enter medication days on the calendar unless they 

appear to be of memory value.]

To treat a medical problem 30. _______________

Specify medication: _______________________________________

To prevent you from drinking (antidipsotropic only) 31. _______________

To help you detoxify/come off alcohol or another drug 32. _______________

Specify medication: _______________________________________

To help you stabilize or change your use of drugs other than 

alcohol

Maintaining/stabilizing drugs (e.g., methadone) 33. _______________

Specify medication: ____________________________________

Drug antagonists/blockers 34. _______________

Specify medication: ____________________________________

For psychological or emotional problems 35. _______________

Specify medication: _______________________________________

Periods of Abstinence

“Now I’d like to ask you about your drinking during this same period. 

The things already recorded on the calendar here may help you to 

remember better. First of all, were there any periods of days when 

you had nothing to drink at all?”

[Mark all abstinent days as “A” on calendar. NOTE: If the 

client was mostly abstinent, it may be easier to ask about 

drinking days first, and record these on the calendar.] 

Date of first drink during period 36. ____/____/____

Date of last drink during period 37. ____/____/____
69

Form 90–AF

“During this period of time, when you were drinking, I’d like to see if 

your pattern was at all similar from one week to the next, at least for 

a few of these weeks. I realize that drinking will vary from day to day 

and from week to week, but I want to know if there was any similarity among weeks. Was there any consistency to your drinking from 

week to week?”

[If NO, skip to item 42, episodic pattern charts. If YES, 

continue and complete steady pattern grid(s).]

“Could you describe for me a usual or typical week of drinking. In 

a typical week, let’s start with weekdays—Monday through Friday. 

What did you normally drink in the morning, from the time you got up 

until about lunchtime?”

[Record on steady pattern grid.]

[For each drinking period, obtain time estimates to allow 

BAC calculation. For example:]

“About what time did you normally have your first drink? ... And when 

did you usually finish the last one?”

“Now how about weekday afternoons, including what you drank with 

lunch up through the afternoon until dinner time—what did you normally drink on weekday afternoons, Monday through Friday?”

[Record on grid.]

“And how about weekday evenings? What did you normally drink 

with dinner, up through the rest of the evening, until the time you 

went to sleep?”

[Record on grid. Repeat same instructions for weekend 

days.]
70

Form 90–AF

P1—Steady Pattern Grid 1

Morning Afternoon Evening Total SECs

M

O

N Time: Time: Time: __________.______

T

U

E Time: Time: Time: __________.______

W

E

D Time: Time: Time: __________.______

T

H

U Time: Time: Time: __________.______

F

R

I Time: Time: Time: __________.______

S

A

T Time: Time: Time: __________.______

S

U

N Time: Time: Time: __________.______

Total number of standard drinks (SECs) per week 38. ____________.______

Estimated BAC peak for steady pattern week (mg%) 39. __________________

[Enter all days of this pattern on calendar as P1.]

[If the above pattern does not describe all drinking weeks, 

ask:]

“Now on the other weeks when you were drinking, was your drinking 

at all the same from week to week?”

[If YES, complete steady pattern grid 2. If NO, proceed to 

item 42, episodic pattern charts.]
71

Form 90–AF

P2—Steady Pattern Grid 2

Morning Afternoon Evening Total SECs

M

O

N Time: Time: Time: __________.______

T

U

E Time: Time: Time: __________.______

W

E

D Time: Time: Time: __________.______

T

H

U Time: Time: Time: __________.______

F

R

I Time: Time: Time: __________.______

S

A

T Time: Time: Time: __________.______

S

U

N Time: Time: Time: __________.______

 

Total number of standard drinks (SECs) per week 40. ____________.______

Estimated BAC peak for steady pattern week (mg%) 41. __________________

[Enter all days of this pattern on calendar as P2.]

 
72

Form 90–AF

Episodic Pattern Chart

Instructions when steady pattern grids were completed:

“Now that we have your regular pattern, I’d like you to tell me about 

times during this period when your drinking was different from this 

pattern. Look at the calendar again, and think back over this period. 

When were times that you had more or less than your regular amount 

to drink?”

Instructions when no regular pattern was detected (steady 

pattern grids have been skipped):

“If you didn’t have a regular pattern from week to week, tell me about 

times when you did drink during the period on this calendar.”

Followthrough for all clients (when a particular episode is 

identified):

“Did that happen more than once during this period?”

[If NO, record data directly on the calendar. If YES, record 

as episode type 1 below and continue.]

“Now, using the calendar, which were the days when your drinking 

was about like that?”

[Record El in the middle of those day blocks.]

[Continue to probe in this manner for up to two other 

episode types: E2 and E3 days.]

[If no repeated episode types can be identified, proceed to fill 

in the calendar day by day.]

E1 Episode Type 1

Beverages and amounts: __________________________________

Total SECs 42. _________._____

Time to consume: _____________________________________

Estimated peak BAC for episode type 1 (mg%) 43. _______________

[Record on calendar as El.]
73

Form 90–AF

E2 Episode Type 2

Beverages and amounts: __________________________________

Total SECs 44. _________._____

Time to consume: _____________________________________

Estimated peak BAC for episode type 2 (mg%) 45. _______________

[Record on calendar as E2.]

E2 Episode Type 3

Beverages and amounts: __________________________________

Total SECs 46. _________._____

Time to consume: _____________________________________

Estimated peak BAC for episode type 3 (mg%) 47. _______________

[Record on calendar as E3.]

[Proceed to fill in any other drinking days on calendar not 

accounted for by P or E codes. Then identify the THREE 

HEAVIEST DRINKING DAYS in the calendar. If not P or E 

days, obtain the time of first drink and last drink, to permit 

BAC calculation.]
74

Form 90–AF

Other Drug Use

“Now I’m going to show you this set of cards, which you have seen 

before. Each card names a kind of drug that people sometimes use. 

I’d like you to sort them into two piles for me. In one pile here [indicate position and use marker card] I’d like you to place those cards 

that name a kind of drug that you have used at least once during 

this period. In the other pile here [indicate position and use marker 

card], place the cards that name types of drugs that you have not 

used at all, not even once, during this period.”

[Give cards to client in numerical order, with nicotine on 

top, cannabis next, and so on. When the sorting has been 

completed, take the NO pile and mark all these categories 

as zero (0) days on items 48–58, respectively. Then for each 

of the YES cards, ask about specific drug(s) and route(s) of 

administration. For example:

“Which drug(s) from this group have you used at least once during 

this period? And how did you take it?”

[Routes of administration include oral ingestion, smoke, 

nasal inhalation, and needle injection.]

[Record on items 48–58.]

[Also determine frequency of use for each drug class:] 

“During this period, on how many days would you say you used 

________?”

[Record on items 48–58 and repeat for all YES cards.]

[If the reported use in a drug category qualifies (see table 2, 

page 36), enter the number of days of use for that category 

on the drug use chart. If the reported use does not qualify 

(e.g., prescribed use for less than 30 days), enter zero (0) 

days even though the client initially placed the card in the 

YES pile.]
75

Form 90–AF

Current Drug Use

Days*

Nicotine

Specify number of cigarettes

per day in current period: ____________

48. _______________

Cannabis

Specify: 49. _______________

Sedatives

Specify: 50. _______________

Hypnotics

Specify: 51. _______________

Steroids

Specify: 52. _______________

Amphetamines

Specify: 53. _______________

Cocaine

Specify: 54. _______________

Hallucinogens

Specify: 55. _______________

Inhaled Toxicants

Specify: 56. _______________

Opiates

Specify: 57. _______________

Other drugs

Specify: 58. _______________

*Days = Total number of days in which any drug from the class was used during this followup 

window. Do not include drugs used during prior followup windows but not this window. Do not 

report drug use that does not qualify (see table 2, page 36).
76

Form 90–AF

Remote Reconstruction

[Complete only when the period being reconstructed is 

from a prior missed followup (not the most recent period). 

ALWAYS attempt items 1–37 and 48–58, but highest priority should be given to items 36–37 and the information 

below.]

[Indicate the present followup period from which 

reconstruction is being conducted (not the period being 

reconstructed).]

PRESENT followup point is 59. ______________ months

[If the calendar can be reconstructed with reasonable confidence, do so, to obtain daily consumption data needed for 

summary statistics. If day-by-day reconstruction is not viable, complete the following procedure instead:]

Total number of abstinent (A) days in reconstructed period 60. _______________

Total number of drinking days in same period 61. _______________

[Note: 60 + 61 must equal item 2.]

Total number of drinking days with 6 drinks (SECs) or more 62. _______________

per day [Use “one drink” graphic if needed.]

Average SECs per drinking day from the most recent 63. _______________

followup period [Obtain from summary statistics for current 

period.]

Multiplier 64. _______________

[What is needed here is a multiplier that best captures the 

client’s comparison of these two periods. It is not likely 

that most clients could generate this number themselves. 

Rather, the interviewer must make the decision, based on 

the client’s report. Some examples:

Client’s description Multiplier

About half as much 0.50

About the same 1.00

Just a little more 1.10

About half again as much 1.50

Twice as much 2.00

Four times as much 4.00

[See also manual instructions.]
77

Form 90–AF

Estimated SECs/drinking day in reconstructed period 65. _______________

[item 64 x item 63]

Estimated SECs in reconstructed period 66. _______________

[item 61 x item 65]
78

Form 90–AF

ONE STANDARD DRINK IS:

BEER

WINE

80 PROOF LIQUOR

100 PROOF LIQUOR

10 oz

4 oz

11⁄4 oz

1.0 oz
79

Form 90–AT

Client Telephone Assessment 

of Drinking and Related Behaviors

[If the client’s cooperation seems tenuous, complete Form 90–AQ 

first to obtain critical variables, then proceed with 90–AT.]

“Now, as in the interview(s) you’ve had before, I’d like to remind you 

that whatever you say here is confidential. I am going to be asking 

you some specific questions about the period of time from ______ 

up through yesterday.”

[If calendar has been mailed and received, have the 

client refer to it now. If not, ask the client to get a regular 

calendar.]

“The calendar should help you remember this period of time. I 

realize that this is a long period of time to remember things that 

happened, so we will use this calendar to help you identify events 

that occurred during this period. (As before, you can see that there 

are some events already printed on the calendar.) Were there any 

particularly memorable things that happened during this time—any 

birthdays, illnesses or accidents, anniversaries, parties, hospitalizations, vacations, changes in your work or at home, things like that?”

[Record on your calendar.]

“Now, the rest of the questions that I will ask you are also about this 

time period, from ______ up through yesterday. I’ll be asking you 

about your drinking in a few minutes, but first I’d like to know about a 

few other things. Feel free to take your time in answering, because 

it is important for you to remember as accurately as you can. Let 

me know if you’re not sure what I am asking, or what I mean by a 

particular question. OK?”

1. For period from 

____/____/____ 

through 

____/____/____

2. Number of days in this 

assessment period: 

__________

3. This is ________-month 

followup

4. _____ (1) Female

_____ (2) Male

5. Current body weight 

in pounds: 

__________

6. Weight was obtained 

by:

_____ (1) weighing or

_____ (2) self-report

7. This interview was 

conducted:

_____ (2) by telephone
80

Form 90–AT

Treatment/Incarceration/Living Experiences

“During this period, how many days did you spend in a hospital or 

treatment program where you stayed overnight?”

[Mark days on calendar.]

Total number of hospital days for medical problems 8. _______________ Hm

Total number of hospital days for detoxification 9. _______________ Htox

Total number of nonhospital residential detox days 10. _______________ Rtox

Total number of ambulatory detox treatment days 11. _______________

Total number of residential days alcohol treatment 12. _______________ Ra

Total number of residential days for other drug problems 13. _______________ Rd

Total residential days for emotional/psych problems 14. _______________ Rp

Total days in residential treatment during this period 15. _______________ Total

[Sum of 8 + 9 + 10 + 12 + 13 + 14: Do not include 11.]

“During this period, did you spend any time in jail or prison?” 

[Mark days on calendar.]

Total days incarcerated during period 16. _______________ In

Total days in institutions [Add 15 + 16.] 17. _______________ Total

“During this period, where did you live? How many days did you live 

in the following?”

[Do not record on calendar unless useful as memory aids.]

Total number of days in own house, apartment, room 18. _______________

Total number of days living with others (no rent) 19. _______________

Total number of days living in halfway house 20. _______________

Total number of days homeless (shelters, etc.) 21. _______________

[Items 17 + 18 + 19 + 20 + 21 must equal item 2.]
81

Form 90–AT

“During this period, how many days were there (not including hospital or detox days) when you saw a doctor, nurse, nurse practitioner, 

or physician’s assistant for any kind of medical care?”

[Do not record on calendar unless useful as memory aids.]

Total days seen for medical care 22. _______________

“During this period, on how many days did you have a session with 

a counselor or therapist?”

[Do not record on calendar unless useful as memory aids.]

Total number of days for alcohol problems** 23. _______________

Total number of days for other drug problems** 24. _______________

[** If alcohol or drug treatment was received, administer the 

Treatment Experiences Questionnaire.]

Total days for emotional/psychological problems 25. _______________

[If treatment was received, describe briefly here:] ___________

___________________________________________________________

“During this period, on how many days did you attend a meeting of 

Alcoholics Anonymous or another 12-step meeting?”

[Do not record on calendar unless useful as memory aids.]

Total number of days attending 12-step meetings [Enter 0 if 26. _______________

none.]

Other Activities

[Do not enter activity days on the calendar unless they 

appear to be of value for recalling drinking ]

“How many days have you been paid for working during this period?” 27. _______________ Work

“How many days have you been in school or training during this 28. _______________ 

period?” Education

“On how many days during this time did you attend a worship service 29. _______________ 

or other religious celebration?” Religious Attendance
82

Form 90–AT

Medications

“During this period, on how many days did you take any medications 

prescribed by a physician?”

[Do not enter medication days on the calendar unless they 

appear to be of memory value.]

To treat a medical problem 30. _______________

Specify medication: _______________________________________

To prevent you from drinking (antidipsotropic only) 31. _______________

To help you detoxify/come off alcohol or another drug 32. _______________

Specify medication: _______________________________________

To help you stabilize or change your use of drugs other than 

alcohol

Maintaining/stabilizing drugs (e.g., methadone) 33. _______________

Specify medication: ____________________________________

Drug antagonists/blockers 34. _______________

Specify medication: ____________________________________

For psychological or emotional problems 35. _______________

Specify medication: _______________________________________

Periods of Abstinence

“Now I’d like to ask you about your drinking during this same period. 

The calendar may help you to remember better. First of all, were 

there periods of days when you had nothing to drink at all?”

[Mark all abstinent days as “A” on calendar. NOTE: If the 

client was mostly abstinent, it may be easier to ask about 

drinking days first, and record these on the calendar.]

Date of first drink during period 36. ____/____/____

Date of last drink during period 37. ____/____/____
83

Form 90–AT

“During this period of time, when you were drinking, I’d like to see if 

your pattern was at all similar from one week to the next, at least for 

a few of these weeks. I realize that drinking will vary from day to day 

and from week to week, but I want to know if there was any similarity among weeks. Was there any consistency to your drinking from 

week to week?”

[If NO, skip to item 42, episodic pattern charts. If YES, 

continue and complete steady pattern grids.]

“Could you describe for me a usual or typical week of drinking, then. 

In a typical week, let’s start with weekdays—Monday through Friday. 

What did you normally drink in the morning, from the time you got up 

until about lunchtime?”

[Record on steady pattern grid.]

[For each drinking period, obtain time estimates to allow 

BAC calculation. For example:]

“About what time did you normally have your first drink? ... And when 

did you usually finish the last one?”

“Now how about weekday afternoons, including what you drank with 

lunch up through the afternoon until dinner time—what did you normally drink on weekday afternoons, Monday through Friday?”

[Record on grid.]

“And how about weekday evenings? What did you normally drink 

with dinner, up through the rest of the evening, until the time you 

went to sleep?”

[Record on grid. Repeat same instructions for weekend 

days.]
84

Form 90–AT

P1—Steady Pattern Grid 1

Morning Afternoon Evening Total SECs

M

O

N Time: Time: Time: __________.______

T

U

E Time: Time: Time: __________.______

W

E

D Time: Time: Time: __________.______

T

H

U Time: Time: Time: __________.______

F

R

I Time: Time: Time: __________.______

S

A

T Time: Time: Time: __________.______

S

U

N Time: Time: Time: __________.______

Total number of standard drinks (SECs) per week 38. ____________.______

Estimated peak BAC for steady pattern week (mg%) 39. __________________

[Enter all days of this pattern on calendar as P1.]

[If the above pattern does not describe all drinking weeks, 

ask:]

“Now on the other weeks when you were drinking, was your drinking 

at all the same from week to week?”

[If YES, complete steady pattern grid 2. If NO, proceed to 

item 42, episodic pattern charts.]
85

Form 90–AT

P2—Steady Pattern Grid 2

Morning Afternoon Evening Total SECs

M

O

N Time: Time: Time: __________.______

T

U

E Time: Time: Time: __________.______

W

E

D Time: Time: Time: __________.______

T

H

U Time: Time: Time: __________.______

F

R

I Time: Time: Time: __________.______

S

A

T Time: Time: Time: __________.______

S

U

N Time: Time: Time: __________.______

 

Total number of standard drinks (SECs) per week 40. ____________.______

Estimated peak BAC for steady pattern week (mg%) 41. __________________

[Enter all days of this pattern on calendar as P2.]
86

Form 90–AT

Episodic Pattern Chart 

Instructions when steady pattern grids were completed:

“Now that we have your regular pattern, I’d like you to tell me about 

times during this period when your drinking was different from this 

pattern. Look at the calendar again, and think back over this period. 

When were times that you had more or less than your regular amount 

to drink?”

Instructions when no regular pattern was detected (steady 

pattern grids have been skipped):

“If you didn’t have a regular pattern from week to week, tell me about 

times when you did drink during the period on this calendar.”

Followthrough for all clients (when a particular episode is 

identified):

“Did that happen more than once during this period?”

[If NO, record data directly on the calendar. If YES, record 

as episode type 1 below and continue.]

“Now, using the calendar, which were the days when your drinking 

was about like that?”

[Record El in the middle of those day blocks.]

[Continue to probe in this manner for up to two other 

episode types: E2 and E3 days.]

[If no repeated episode types can be identified, proceed to fill 

in the calendar day by day.]

E1 Episode Type 1

Beverages and amounts: __________________________________

Total SECs

Time to consume: _____________________________________

42. _________._____

Estimated peak BAC for episode type 1 (mg%) 43. _______________

[Record on calendar as El.]
87

Form 90–AT

E2 Episode Type 2

Beverages and amounts: __________________________________

Total SECs 44. _________._____

Time to consume: _____________________________________

Estimated peak BAC for episode type 2 (mg%) 45. _______________

[Record on calendar as E2.]

E3 Episode Type 3

Beverages and amounts: __________________________________

Total SECs 46. _________._____

Time to consume: _____________________________________

Estimated peak BAC for episode type 3 (mg%) 47. _______________

[Record on calendar as E3.]

[Proceed to fill in any other drinking days on calendar not 

accounted for by P or E codes. Then identify the THREE 

HEAVIEST DRINKING DAYS in the calendar. If not P or E 

days, obtain the time of first drink and last drink, to permit 

BAC calculation.]
88

Form 90–AT

Other Drug Use

“Now I’d like to ask you about different kinds of drugs that people 

sometimes use. For each type that I name, I’d like you to tell me 

whether you have used any of those drugs at least once during this 

period that we have been discussing. Remember that this is the 

period from (date) through (date) .”

[Read the cards in order, including the examples listed on 

each card, asking:]

“During this period, did you use any drugs with nicotine—nicotine 

cigarettes, snuff or dip, chewing tobacco, or a nicotine patch or gum? 

... Did you use any marijuana or hashish?” and so forth.

[Sort the cards in front of you into two piles—those used 

and those not used—according to the telephone information 

given to you by the client. When you have finished this step, 

take the NO pile and mark all these categories as zero (0) 

days on items 48–58, respectively. Then for each drug the 

client used during the assessment window (YES pile), ask 

about specific drug(s) and route(s) of administration. For 

example:]

“Which drug(s) from the ________ group have you used at least 

once during this period? And how did you take it?”

[Record the drugs and routes of administration in the 

“specify” spaces for items 48–58. For each category, also 

ask as you go:]

“During this period, on how many days would you say you used 

________?”

[Record the days of use for each YES category in the days 

column for items 48-58. Be sure that the reported use 

qualifies as drug misuse, according to the criteria specified 

in table 2 (page 36). If the reported use does not qualify 

(e.g., prescribed use for less than 30 days), enter zero (0) 

days even though the client initially reported use.]
89

Form 90–AT

Current Drug Use

Days*

Nicotine

Specify number of cigarettes

per day in current period:____________

48. _______________

Cannabis

Specify: 49. _______________

Sedatives

Specify: 50. _______________

Hypnotics

Specify: 51. _______________

Steroids

Specify: 52. _______________

Amphetamines

Specify: 53. _______________

Cocaine

Specify: 54. _______________

Hallucinogens

Specify: 55. _______________

Inhaled Toxicants

Specify: 56. _______________

Opiates

Specify: 57. _______________

Other drugs

Specify: 58. _______________

*Days = Total number of days in which any drug from the class was used during this followup 

window. Do not include drugs used during prior followup windows but not this window. Do not 

report drug use that does not qualify (see table 2, page 36).
90

Form 90–AT

Remote Reconstruction

[Complete only when the period being reconstructed is 

from a prior missed followup (not the most recent period). 

ALWAYS attempt items 1–37 and 48–58, but highest priority should be given to items 36–37 and the information 

below.]

[Indicate the present followup period from which 

reconstruction is being conducted (not the period being 

reconstructed).]

PRESENT followup point is 59. ______________ months

[If the calendar can be reconstructed with reasonable confidence, do so, to obtain daily consumption data needed for 

summary statistics. If day-by-day reconstruction is not viable, complete the following procedure instead:]

Total number of abstinent (A) days in reconstructed period 60. _______________

Total number of drinking days in same period 

[Note: 60 + 61 must equal item 2.]

61. _______________

Total number of drinking days with 6 drinks (SECs) or more 

per day [Use “one drink” graphic if needed.]

62. _______________

Average SECs per drinking day from the most recent 

followup period [Obtain from summary statistics for current 

period.]

63. _______________

Multiplier

[What is needed here is a multiplier that best captures the 

client’s comparison of these two periods. It is not likely 

that most clients could generate this number themselves. 

Rather, the interviewer must make the decision, based on 

the client’s report. Some examples:

Client’s description Multiplier

About half as much 0.50

About the same 1.00

Just a little more 1.10

About half again as much 1.50

Twice as much 2.00

Four times as much 4.00

[See also manual instructions.]

64. _______________
91

Form 90–AT

Estimated SECs/drinking day in reconstructed period 

[item 64 x item 63]

65. _______________

Estimated SECs in reconstructed period

[item 61 x item 65]

66. _______________

93

Form 90–AQ

Form 90–AQ

Quick Drinking Assessment Interview

“I’d like to ask you just six questions about your drinking during the 

period from ______ up through yesterday. That’s a period of ______ 

days.

“First of all, on how many days during this period did you have at 

least one drink containing alcohol?”

[Record as item 5a.]

[To confirm the answer to item 5a:]

“So that means there were [item 2 minus item 5] days during this 

period when you didn’t drink at all.”

[Confirm and record below.]

[Item 5a + item 5b must = item 2.]

“Now, on those days when you did drink, how much did you have to 

drink on average?”

[Probe and record as nearest whole number of standard 

drink units for item 6.]

“Now, of those [read number from item 5a] days on which you drank, 

on how many did you have six or more drinks?”

[Record as item 7.]

“When was the first day that you had a drink during this period?”

[Record date as item 8.]

“And when was the first day that you had six or more drinks in the 

same day?”

[Record date as item 9.]

“And when did you have your last drink?”

[Record date as item 10.]

[If appropriate, continue with longer interview such as Form 

90–AT.]

1. For period from 

____/____/____ through 

____/____/____

2. Number of days in this 

assessment period: 

__________

3. This is ________-month 

followup

4. This interview was 

conducted:

_____ (1) on site

_____ (2) by telephone

_____ (3) home visit

_____ (4) other location

5a. Total number of drinking 

days during period: 

__________

5b. Total number of 

abstinent days during 

period:

__________

6. Number of standard 

drinks per drinking day:

__________

7. Total number of heavy 

drinking days during 

period:

__________

8. Date of first drink during 

period: ____/____/____

9. Date of first heavy 

drinking day in period: 

____/____/____

10. Date of last drink during 

period: 

 ____/____/____

95

Form 90–ACS 

Collateral Interview on Drinking

1. For period from 

____/____/____ through SO Name: _________________________________________________ ____/____/____

SO#: _______________________________________ 1a. Number of days in this 

assessment period: 

__________

“Hello, my name is ____________________ and I’m calling from 2. This is a _____ (0) intake 

or _____-month followup ____________________. I would like to ask you a few questions 

about ____________________, who gave us your name as a per- 3. Interview conducted:

son who might help us with some information about him/her. As you _____ (1) in person

may know, he/she is participating in a research study designed to _____ (2) by telephone

learn more about ____________________. The information you 

give me will be completely confidential. It will be used only for our 4. Relationship to client:

_____ (1) spouse research, and we will not share it with (client) .”

_____ (2) parent

_____ (3) sibling

_____ (4) child

_____ (5) other family

specify:_________________

_____ (6) friend

“How long have you known ____________________?” _____ (7) girlfriend/

boyfriend

[Record as item 5, coded in months.] _____ (8) employer or 

coworker

_____ (9) probation 

officer

“I want to ask you some questions about the period between _____ (0) other

________ and _______ [refer to dates from item 1]. There are a specify:_________________

total of [see 1a] days in that period. On how many of those 5. Known client for [see 1a] days were you in contact with ____________________?” ________ months

[Record as item 6.] 6. Days in contact with 

client: ________

7. Type of contact:

“How have you been in contact during this time?” _____ (1) live together

_____ (2) work together [Check all that apply in item 7.] _____ (3) social visits

_____ (4) scheduled visits 

(e.g., probation)

_____ (5) telephone

_____ (6) other

specify:_________________
96

Form 90–ACS 

“Now I’m going to ask you some questions about what has been 

happening with (client) during this period from ______ up to 

______. [Use dates from item 1.] Some of these things you may 

know about, and some you may not. Just give me the best information you can, and let me know if you’re not clear what I’m asking. I 

also want to remind you that what you say is completely confidential and won’t be shared with (client) or anyone else outside our 

research project. Do you have any questions before we begin?”

“First of all, did __________ drink any alcohol during that time 

period?”

[Determine which of the following statements is the most 

accurate response. If necessary, read the statements to the 

SO. Then enter the appropriate code for item 8.]

Code

0 I am sure that __________ did not drink during that period.

1 I am reasonably certain that __________ did not drink 

during that time period.

[If abstinent (0 or 1) enter zero (0) codes for questions 9, 

11, and 12, and enter the number of days in the period 

(from item 1) for question 10. Then skip to question 13.]

2 Yes, I suspect that __________ did drink during that time 

period, although I did not observe it firsthand.

[Record reason for suspicion here:]

_______________________________________________________

_______________________________________________________

3 I am sure that __________ did drink during that time 

period because I observed it.

8 I don’t know whether ___________ did or did not drink 

during that time period.

8. ________ (code 0–3 or 8)

“During the period of ________ days that we have been discussing, 

how many days would you say __________ drank at least some 

alcohol?”

Total number of drinking days during period 

[Enter 998 for don’t know.]

9. _______________
97

Form 90–ACS 

“That would mean that __________ had nothing to drink at all on 

[item 1–item 9] days during this period. Does that sound right?”

Total number of abstinent days during period 

[Enter 998 for don’t know.]

[Adjust items 9 and 10 to equal the number of days in item 

1a.]

“On days when __________ drank during this period, how many 

drinks do you think he/she had, on average?”

[Prompts: What kind of alcohol would he/she usually 

drink? And how many (beers, etc.) would he/she have in 

one day?]

10. _______________

Total number of standard drinks per day 

[Enter 998 for don’t know.]

“On how many days during this period of [item 1] days do you 

think __________ had 6 or more drinks?”

11. _______________

Total number of heavy drinking days 

[Code 998 for don’t know.]

“Sometimes during these types of interviews people have to guess 

in order to answer questions about someone else. To what extent 

have you guessed during this interview? Would you say:”

12. _______________

Code

1 not at all

2 a little

3 a lot

4 completely

[Enter appropriate code in item 13.]

13. ___________ (code 1–4)

99

Form 90–DI 

Drug Use Assessment (Intake)

“I’d like to begin by reminding you that whatever you say here is 

confidential. In this first interview, I am going to be asking you some 

specific questions about your drug use in the 90 days before your 

last use. I’ll be asking about drugs that were prescribed for you as 

well as others that you have used during this period. [Place calendar in front of client.] Here is a calendar to help you remember this 

period of time. First of all, when was the last time that you used any 

drug?”

[Drug is as defined in table 2 on page 36; count back 89 

days and cross out with Xs the days preceding this period.]

“So the period I’m going to be asking you about is from [beginning 

date] up through [end date].”

“I realize that this is a long period of time to remember things that 

happened, so we will use this calendar to help you identify events 

that occurred during this period. Notice that a few events are already 

printed on the calendar.”

[Point out some specific events already printed on the 

calendar.]

“Were there any particularly memorable things that happened during 

this time—any birthdays, illnesses or accidents, anniversaries, parties, hospitalizations, vacations, changes in your work or at home, 

things like that?”

[Record on calendar.]

“Now, the rest of the questions that I will ask you are also about 

this time period, from ______ up through ______. I’ll be asking you 

about your drug use in a few minutes, but first I’d like to know about 

a few other things. Feel free to take your time in answering, since it 

is important for you to remember as accurately as you can. Let me 

know if you’re not sure what I am asking, or what I mean by a particular question. OK?”

1. For period from 

____/____/____ 

through 

____/____/____

2. Number of days in this 

assessment period: 

__________

3. This is 

(0) Pretreatment

4. _____ (1) Female

_____ (2) Male

5. Current body weight 

in pounds: 

__________

6. Weight was obtained 

by:

_____ (1) weighing

_____ (2) self-report

7. This interview was 

conducted:

_____ (1) on site

_____ (2) by telephone

_____ (3) home visit

_____ (4) other location

8. Presenting drug 

______________________
100

Form 90–DI 

Treatment/Incarceration/Living Experiences

“During this period, how many days did you spend in a hospital or 

treatment program where you stayed overnight?”

[Mark days on calendar]

Total number of hospital days for medical problems 9. _______________ Hm

Total number of hospital days for detoxification 10. _______________ Htox

Total number of nonhospital residential detox days 11. _______________ Rtox

Total number of ambulatory detox treatment days 12. _______________

Total number of residential days alcohol treatment 13. _______________ Ra

Total number of residential days for other drug problems 14. _______________ Rd

Total residential days for emotional/psych problems 15. _______________ Rp

Total days in residential treatment during this period 

[Sum of 9 + 10 + 11 + 13 + 14 + 15: Do not include 12.]

16. _______________ Total

“During this period, did you spend any time in jail or prison?” 

[Mark days on calendar.]

Total days incarcerated during period 17. _______________ In

Total days in institutions [Add 16 + 17.] 18. _______________ Total

“During this period, where did you live? How many days did you live 

in the following?”

[Do not record on calendar unless useful as memory aids.]

Total number of days in own house, apartment, room 19. _______________

Total number of days living with others (no rent) 20. _______________

Total number of days living in halfway house 21. _______________

Total number of days homeless (shelters, etc.)

[Items 18 + 19 + 20 + 21 + 22 must equal item 2.]

22. _______________
101

Form 90–DI 

“During this period, how many days were there (not including hospital or detox days) when you saw a doctor, nurse, nurse practitioner, 

or physician’s assistant for any kind of medical care?”

[Do not record on calendar unless useful as memory aids.]

Total days seen for medical care 23. _______________

“During this period, on how many days did you have a session with 

a counselor or therapist?”

[Do not record on calendar unless useful as memory aids.]

Total number of days for drug problems (EXCEPT alcohol). 

[Write down the drug or drugs.]

__________________________________________________________

__________________________________________________________

[If treatment was received, describe briefly:]

__________________________________________________________

__________________________________________________________

24. _______________

Total number of days for alcohol problems 

[If treatment was received, describe briefly:]

__________________________________________________________

__________________________________________________________

25. _______________

Total days for emotional/psychological problems

[If treatment was received, describe briefly:]

__________________________________________________________

__________________________________________________________

26. _______________

“During this period, on how many days did you attend a 12-step 

meeting like NA, CA, or AA?”

[Do not record on calendar unless useful as memory aids.]

Total number of days attending 12-step meetings 

[Enter 0 if none.]

27. _______________
102

Form 90–DI 

Other Activities

[Do not enter activity days on the calendar unless they 

appear to be of value for recalling drinking ]

“How many days have you been paid for working during this period?” 28. _______________ Work

“How many days have you been in school or training during this 

period?”

29. _______________ 

Education

“On how many days during this time did you attend a worship service 

or other religious celebration?”

30. _______________ 

Religious Attendance

Medications

“During this period, on how many days did you take any medications 

prescribed by a physician?”

[Do not enter medication days on the calendar unless they 

appear to be of memory value.]

To treat a medical problem

Specify medication: _______________________________________

31. _______________

To prevent you from drinking (antidipsotropic only) 32. _______________

To help you detoxify/come off drugs or alcohol

Specify medication: _______________________________________

33. _______________

To help you stabilize or change your use of drugs

Maintaining/stabilizing drugs (e.g., methadone)

Specify medication: ____________________________________

34. _______________

Drug antagonists/blockers

Specify medication: ____________________________________

35. _______________

For psychological or emotional problems

Specify medication: _______________________________________

36. _______________
103

Form 90–DI 

Drug Assessment

Card Sort

“Now I am going to show you this set of cards. Each card names a 

kind of drug that people sometimes use. I’d like you to sort them into 

two piles for me. In one pile here (indicate position and use marker 

card) I’d like you to place those cards that name a kind of drug that 

you have tried at least once in your life. In the other pile (indicate 

position and use marker card), place the cards that name the types 

of drugs that you have never used at all.”

[Give cards to client IN NUMERICAL ORDER—with alcohol 

on top, nicotine next, cannabis next, and so on. When the 

sorting has been completed, take the NO pile and check all 

these categories as “NO” in the Lifetime Use column below.]

[For each card from the “YES” pile, ask:]

“How old were you the first time you used this kind of drug?” 

[For convenience, record here the client’s current age.] ___________ years

Drug Type

Alcohol (al)

Lifetime Use Ever?

____(0)No ____(1)Yes

Age at First Use Lifetime Weeks of Use

Nicotine (to) ____(0)No ____(1)Yes

Cannabis (ma) ____(0)No ____(1)Yes

Sedatives (tr) ____(0)No ____(1)Yes

Hypnotics (do) ____(0)No ____(1)Yes

Steroids (sd) ____(0)No ____(1)Yes

Amphetamines (up) ____(0)No ____(1)Yes

Cocaine (co) ____(0)No ____(1)Yes

Hallucinogens (ha) ____(0)No ____(1)Yes

Inhaled Toxicants (in) ____(0)No ____(1)Yes

Opiates (op) ____(0)No ____(1)Yes

Other Drugs (xx) ____(0)No ____(1)Yes

Total Yes: xxxxxx
104

Form 90–DI 

[Then continue with the “YES” pile.]

“Now for each of these types of drugs, I’d like you to give me an 

estimate of how long you have used them in your lifetime. What 

I will want to know is about how many weeks during your lifetime 

have you used each type of drug at least once. Let’s start with 

____________.”

[Use first YES card from numerical sequence.]

“How many weeks, during your lifetime, would you say that you used 

____________ at least once?”

[Record responses on the chart on the previous page. 

Convert all responses into weeks. Year = 52 weeks if used 

every week, month = 4 weeks, etc. Repeat the query for each 

YES drug card. Then give YES pile back to client.]

Periods of Abstinence

“Now I’d like to ask you about your drug use during this same period 

we were discussing before. The things already recorded on the calendar here may help you to remember better. I’m not asking here 

about drugs that were prescribed for you for medical problems, like 

antibiotics or stomach or blood pressure medicine. I’m asking about 

drugs not prescribed for you, although I do want to know about any 

medication prescribed for pain or to help you relax or sleep. I will 

also ask you about your use of alcohol. First of all, were there any 

periods of days during this time when you used no drugs (including 

alcohol) at all?”

[Mark all abstinent days with a capital “A” on calendar.] 

Date of first drug use during period 37. ____/____/____

Drug:________________________________

Date of last drug use during period 38. ____/____/____

Drug:________________________________
105

Form 90–DI 

[Give back the YES pile and say:]

“Now I’d like you to sort these cards again to say which kinds of 

drugs you have used at least once during the period we’ve been 

talking about on this calendar, from ______ up through ______. If 

you used the drug at least once during this time, put it in the pile here 

(indicate position and use marker card), and if you never used it at 

all during this period, put it the other pile here (indicate position and 

use marker card).”

[Alternatively, if there are few cards, simply ask: “Which of 

these have you used at least once during this period we’ve 

been talking about?”]

[For each NO card in this sort, print a zero (0) under “total 

days used” on the use pattern grid. For the remainder, 

proceed with the calendar instructions.]

Use Pattern Grid

Drug classes

Total 

days 

used

Use* Oral 

ingestion Smoke Nasal inhale Needle Other

1 2 3

Alcohol al — — —

Nicotine to —

Cannabis ma —

Sedatives tr — —

Hypnotics do — —

Steroids sd — —

Amphetamines up

Cocaine co

Hallucinogens ha

Inhaled Toxicants in

Opiates op — — —

Other Drugs xx

Totals 12

*Use categories:

1 = Single use, 2 = Several uses, 3 = Steady or heavier use
106

Form 90–DI 

Enter days of each type of use. 1+2+3 must equal total days 

of use.]

[Enter days of each route of administration. These must 

total to at least the number of days of use, but total may be 

higher if multiple routes of administration were used on the 

same day.]

[If “other” route of administration, specify drug(s) and route 

here: _______________________________________________]

Calendar

[Show the client the categories for days of use.]

“Now I’d like to ask you about each of the drugs that you have used 

during this period. I’d want to get an idea of what your pattern of use 

was during this period of time for each of these drugs. We’ll use this 

calendar to make it easier. Let’s start with __________. When were 

you using ____________ during this period?”

[Proceed drug by drug, entering drug codes for each day 

of use. For a day on which alcohol, cannabis, and cocaine 

were used, for example, three codes would be entered into 

the box for that day: al, ma, co. Using different colored 

pencils for different drugs can be helpful.]

[Using the calendar, carefully count the total number of 

days of use during the assessment period for each drug 

class, and put this information on the use pattern grid.]

“Now I’m going to go back through these drugs once again and ask 

you two more questions about each. For each one, I will tell you the 

total number of days that you said you used the drug during this 

period, and I will want to know how many of those days you think fell 

into each of these three categories.”

[Show client categories for days of use.]
107

Form 90–DI 

“According to the calendar we did, you used __________ on a total 

of ______ days during this period. Help me divide those days up 

among these three categories. On how many of those ______ days 

would you say that you used ____________ only once? How many 

of those days did your use fall in between? And that would mean 

that on ______ days your use of ____________ fell in this third category—does that seem right? And how did you give yourself (take) 

____________ during this period of time we have been talking 

about? Any other way?”

[If more than one route of administration for a drug class, 

ask:]

“According to the calendar we did, you used on 

a total of ______ days during this period. On how many of those 

______ days would you say that you gave yourself [drug] by 

[route] ?”

[Repeat for each drug class. Be sure you have accounted 

for all days of use. The total across routes of administration 

should be at least the same as the number of days of use, 

although the total may be higher if multiple routes are used 

on the same day.]

[Fill in the information on the use pattern grid. Be sure 

1+2+3 totals to the number of days of use.]

[When you have completed the calendar for all drug classes 

used, show the client the confidence scale and ask:]

“Now I’d like you to tell me, using this line, how confident you feel 

about the information you’ve given me about your drug use. How 

accurate do you think you have been in estimating your drug use on 

this calendar? I’m not asking if you got each drug on the exact days 

you used it. But overall, how accurate is this calendar in showing 

how much you used drugs during this period?”

5 4 3 2 1

Very

Accurate

Fairly

Accurate

Not at all

Accurate
108

Form 90–DI 

CATEGORIES FOR DAYS OF USE

(1) Single use. On this day you used the drug only once.

Examples: One alcoholic drink

One cigarette

One dose

(2) Medium use. On this day you used the drug more than once, but not steadily or heavily. 

Examples: 2–4 drinks

2–9 cigarettes

Two doses of other drugs

(3) Heavier use. On this day you used the drug more heavily than the “medium” category. 

Examples: 5 or more drinks

10 or more cigarettes (half a pack or more)

Three or more doses of other drugs

WAYS OF TAKING DRUGS

Orally Eating, drinking, swallowing, placing the drug under the tongue, 

chewing, dipping

Smoking Lighting and smoking the drug

Inhaling Snorting, breathing in the drug (but not smoking)

Injecting Taking a drug by needle; injecting under the skin or into a vein 

CONFIDENCE SCALE

5 4 3 2 1

Very

Accurate

Fairly

Accurate

Not at all

Accurate

 
109

Form 90–DF 

Drug Use Assessment (Followup)

“Now, as in the interview(s) you’ve had before, I’d like to remind you 

that whatever you say here is confidential. I am going to be asking 

you some specific questions about your drug use in the time period 

from __________ up through yesterday. I’ll be asking about drugs 

that were prescribed for you as well as others that you have used 

during this period.”

[Place calendar in front of client.]

“Here is a calendar to help you remember this period of time.”

“I realize that this is a long period of time to remember things that 

happened, so we will use this calendar to help you identify events 

that occurred during this period. As before, there are some events 

already printed on the calendar. Were there any particularly memorable things that happened during this time—any birthdays, illnesses 

or accidents, anniversaries, parties, hospitalizations, vacations, 

changes in your work or at home, things like that?”

[Record on calendar.]

“Now, the rest of the questions that I will ask you are also about this 

time period, from __________ up through yesterday. I’ll be asking 

you about your drug use in a few minutes, but first I’d like to know 

about a few other things. Feel free to take your time in answering, 

since it is important for you to remember as accurately as you can. 

Let me know if you’re not sure what I am asking, or what I mean by 

a particular question. OK?”

1. For period from 

____/____/____ 

through 

____/____/____

2. Number of days in this 

assessment period: 

__________

3. This is ________-month 

followup

4. _____ (1) Female

_____ (2) Male

5. Current body weight 

in pounds: 

__________

6. Weight was obtained 

by:

_____ (1) weighing

_____ (2) self-report

7. This interview was 

conducted:

_____ (1) on site

_____ (2) by telephone

_____ (3) home visit

_____ (4) other location
110

Form 90–DF

Treatment/Incarceration/Living Experiences

“During this period, how many days did you spend in a hospital or 

treatment program where you stayed overnight?”

[Mark days on calendar]

Total number of hospital days for medical problems 8. _______________ Hm

Total number of hospital days for detoxification 9. _______________ Htox

Total number of nonhospital residential detox days 10. _______________ Rtox

Total number of ambulatory detox treatment days 11. _______________

Total number of residential days alcohol treatment 12. _______________ Ra

Total number of residential days for other drug problems 13. _______________ Rd

Total residential days for emotional/psych problems 14. _______________ Rp

Total days in residential treatment during this period 

[Sum of 8 + 9 + 10 + 12 + 13 + 14: Do not include 11.]

15. _______________ Total

“During this period, did you spend any time in jail or prison?” 

[Mark days on calendar.]

Total days incarcerated during period 16. _______________ In

Total days in institutions [Add 15 + 16.] 17. _______________ Total

“During this period, where did you live? How many days did you live 

in the following?”

[Do not record on calendar unless useful as memory aids.]

Total number of days in own house, apartment, room 18. _______________

Total number of days living with others (no rent) 19. _______________

Total number of days living in halfway house 20. _______________

Total number of days homeless (shelters, etc.)

[Items 17 + 18 + 19 + 20 + 21 must equal item 2.]

21. _______________
111

Form 90–DF

“During this period, how many days were there (not including hospital or detox days) when you saw a doctor, nurse, nurse practitioner, 

or physician’s assistant for any kind of medical care?”

[Do not record on calendar unless useful as memory aids.]

Total days seen for medical care 22. _______________

“During this period, on how many days did you have a session with 

a counselor or therapist?”

[Do not record on calendar unless useful as memory aids.]

Total number of days for drug problems (EXCEPT alcohol) 

[Write down the drug or drugs.]

__________________________________________________________

__________________________________________________________

[If treatment was received, describe briefly:]

__________________________________________________________

__________________________________________________________

23. _______________

Total number of days for alcohol problems 

[If treatment was received, describe briefly:]

__________________________________________________________

__________________________________________________________

24. _______________

Total days for emotional/psychological problems

[If treatment was received, describe briefly:]

__________________________________________________________

__________________________________________________________

25. _______________

“During this period, on how many days did you attend a 12-step 

meeting like NA, CA, or AA?”

[Do not record on calendar unless useful as memory aids.]

Total number of days attending 12-step meetings 

[Enter 0 if none.]

26. _______________
112

Form 90–DF

Other Activities

[Do not enter activity days on the calendar unless they 

appear to be of value for recalling drinking ]

“How many days have you been paid for working during this period?” 27. _______________ Work

“How many days have you been in school or training during this 

period?”

28. _______________ 

Education

“On how many days during this time did you attend a worship service 

or other religious celebration?”

29. _______________ 

Religious Attendance

Medications

“During this period, on how many days did you take any medications 

prescribed by a physician?”

[Do not enter medication days on the calendar unless they 

appear to be of memory value.]

To treat a medical problem

Specify medication: _______________________________________

30. _______________

To prevent you from drinking (antidipsotropic only) 31. _______________

To help you detoxify/come off drugs or alcohol

Specify medication: _______________________________________

32. _______________

To help you stabilize or change your use of drugs

Maintaining/stabilizing drugs (e.g., methadone)

Specify medication: ____________________________________

33. _______________

Drug antagonists/blockers

Specify medication: ____________________________________

34. _______________

For psychological or emotional problems

Specify medication: _______________________________________

35. _______________
113

Form 90–DF

Drug Assessment

Periods of Abstinence

“Now I’d like to ask you about your drug use during this period. 

The things already recorded on the calendar here may help you to 

remember better. I’m not asking here about drugs that were prescribed for you for medical problems, like antibiotics or stomach or 

blood pressure medicine. I’m asking about drugs not prescribed for 

you, although I do want to know about any medication prescribed for 

pain or to help you relax or sleep. I will also ask you about your use 

of alcohol. First of all, were there any periods of days during this time 

when you used no drugs (including alcohol) at all?”

[Mark all abstinent days with a capital “A” on calendar.] 

Date of first drug use during period

Drug:________________________________

36. ____/____/____

Date of last drug use during period 

Drug:________________________________

37. ____/____/____

Card Sort

“Now I’d like you to sort these cards, to say which kinds of drugs you 

have used at least once during this period. If you used the drug at 

least once during this time, put it in a pile here (indicate position and 

use marker card), and if you never used it at all during this period, 

put it on the other pile here (indicate position and use marker card).”

[For each NO card in this sort, print a zero (0) under “Used 

in this period” on the use pattern grid on the next page. For 

the remainder, proceed with the calendar instructions.]
114

Form 90–DF

Use Pattern Grid

Drug classes

Total 

days 

used

Use* Oral 

ingestion Smoke Nasal inhale Needle Other

1 2 3

Alcohol al — — —

Nicotine to —

Cannabis ma —

Sedatives tr — —

Hypnotics do — —

Steroids sd — —

Amphetamines up

Cocaine co

Hallucinogens ha

Inhaled Toxicants in

Opiates op — — —

Other Drugs xx

Totals 12

*Use categories:

1 = Single use, 2 = Several uses, 3 = Steady or heavier use

[After the calendar has been completed, continue to enter 

the following data in the use pattern grid.]

[Enter days of each type of use. 1+2+3 must equal total 

days used.]

[Enter days of each route of administration. These must 

total to at least the number of days of use, but total may be 

higher if multiple routes of administration were used on the 

same day.]

[If “other” route of administration, specify drug(s) and route 

here:_____________________________________________________]
115

Form 90–DF

“Now I’d like to ask you about each of the drugs that you have used 

during this period. I’d want to get an idea of what your pattern of use 

was during this period of time for each of these drugs. We’ll use this 

calendar to make it easier. Let’s start with __________. When were 

you using ____________ during this period?”

[Proceed drug by drug, entering drug codes for each day 

of use. For a day on which alcohol, cannabis, and cocaine 

were used, for example, three codes would be entered into 

the box for that day: al, ma, co. Using different colored 

pencils for different drugs can be helpful.]

[Using the calendar, carefully count the total number of 

days of use during the assessment period for each drug 

class, and put this information on the use pattern grid.]

“Now I’m going to go back through these drugs once again and ask 

you two more questions about each. For each one, I will tell you the 

total number of days that you said you used the drug during this 

period, and I will want to know how many of those days you think fell 

into each of these three categories.”

[Show client categories for days of use.]

“According to the calendar we did, you used __________ on a total 

of ______ days during this period. Help me divide those days up 

among these three categories. On how many of those ______ days 

would you say that you used ____________ only once? How many 

of those days did your use fall in between? And that would mean 

that on ______ days your use of ____________ fell in this third category—does that seem right? And how did you give yourself (take) 

____________ during this period of time we have been talking 

about? Any other way?”

[If more than one route of administration for a drug class, 

ask:]

“According to the calendar we did, you used on 

a total of ______ days during this period. On how many of those 

______ days would you say that you gave yourself [drug] by 

[route] ?”

[Repeat for each drug class. Be sure you have accounted 

for all days of use. The total across routes of administration 

should be at least the same as the number of days of use, 

although the total may be higher if multiple routes are used 

on the same day.]
116

Form 90–DF

[Fill in the information on the use pattern grid. Be sure 

1+2+3 totals to the number of days of use.]

[When you have completed the calendar for all drug classes 

used, show the client the confidence scale and ask:]

“Now I’d like you to tell me, using this line, how confident you feel 

about the information you’ve given me about your drug use. How 

accurate do you think you have been in estimating your drug use on 

this calendar? I’m not asking if you got each drug on the exact days 

you used it. But overall, how accurate is this calendar in showing 

how much you used drugs during this period?”

5 4 3 2 1

Very

Accurate

Fairly

Accurate

Not at all

Accurate
117

Form 90 Drug Card Sort

Copy this sheet onto card stock and cut out cards

Form 90 

Drug Card Sort

OTHER DRUGS

Designer Drugs

Amyl/Butyl Nitrates (poppers) 

Nitrous Oxide (laughing gas)

Over-the-counter remedies like 

Dextromethorphan (DM) etc.

11

Yes

Drugs I have used 

at least once

No

Drugs I have not used

NICOTINE

Tobacco cigarettes 

Snuff (dip) 

Chewing tobacco 

Nicotine patch or gum

1

CANNABIS

Marijuana (pot) 

Hashish

2

SEDATIVES

Librium, Valium

Ativan, Serax 

Xanax, etc.

3

HYPNOTICS (Downers)

Quaalude (ludes) 

Barbiturates 

Seconal (reds) 

Amytal (blues) 

Nembutal (yellow jackets), etc.

4
118

Form 90 Drug Card Sort

STEROIDS

5

AMPHETAMINES 

(Uppers)

Amphetamine (Speed)

Methamphetamine

Dexedrine, Benzedrine

Ritalin, Ice, etc.

6

COCAINE

Freebase

Crack

Powder

Paste, etc.

7

HALLUCINOGENS

LSD (Acid)

Mescaline (Peyote)

PCP (Angel Dust)

Morning Glory Seeds

MDMA (Ecstasy)

Mushrooms, etc.

8

INHALED TOXICANTS

Aerosol Sprays

Glue

Paint

Gasoline, etc.

9

OPIATES

Heroin, Morphine

Opium, Methadone

Percodan, Demerol

Codeine, etc.

10 

Use the following card for Form 90–D only.

ALCOHOL

Beer, Wine 

Liquor, etc.

0
119

Treatment Experiences Questionnaire

The Treatment Experiences Questionnaire is to be filled out 

by individuals who have had additional outpatient, partial 

hospitalization, or residential treatment for alcohol/drug 

problems. This Project MATCH version contains four scales:

Twelve-step facilitation treatment elements 1, 5, 8, 13, 20

Cognitive-behavioral treatment elements 2, 4, 9, 11, 14

Motivational enhancement treatment elements 7, 10, 12, 15, 19

General treatment characteristics 3, 6, 16, 17, 18, 21

There are five items corresponding to each of the three unique 

treatments evaluated in Project MATCH (1993). Scores on 

these items can be summed to yield scales corresponding 

to the three treatments. The remaining six items describe 

general characteristics of additional treatment received and 

do not sum to a meaningful score.
120

Treatment Experiences Questionnaire

Treatment Experiences Questionnaire

Please describe the treatment you received during this calendar period for alcohol/drug problems. 

Circle YES or NO for every item.

Did any counselor, doctor, or other therapist who treated you during this time:

1. Encourage you to attend 12-step (AA, NA, ACoA) meetings? Yes No

2. Help you think about “high risk” situations in which you are in danger 

of relapsing?

Yes No

3. See you and your husband/wife/partner together? Yes No

4. Help you practice how to refuse drinks or drugs? Yes No

5. Encourage you to make changes in your life (like healthy diet, exercise, 

hobbies, getting enough rest) to help you stay sober?

Yes No

6. See you for more than five sessions? Yes No

7. Leave it up to you whether or not you drink or use drugs? Yes No

8. Encourage you to use the Twelve Steps? Yes No

9. Have you keep a diary of your urges? Yes No

10. Give you personal feedback based on test results? Yes No

11. Help you learn new skills to deal with depression, anger, or other 

negative moods?

Yes No

12. Encourage you to make your own decisions about what to do about 

your drinking or drug use?

Yes No

13. Give you 12-step literature to read? Yes No

14. Help you plan how to handle a relapse, in case it happens? Yes No

15. Emphasize that it is your responsibility to decide whether and how to 

change your alcohol/drug use?

Yes No

16. See you for personal, individual sessions with no one else in the room? Yes No

17. Tell you that you are an alcoholic or addict, who can never drink or use 

drugs again?

Yes No

18. Have you participate in group therapy? Yes No
121

Treatment Experiences Questionnaire

19. Help you think about the positives and the negatives about your drinking or drug use?Yes No

20. Encourage you to use AA tools (such as getting a sponsor, remembering AA slogans, and associating with AA/NA friends) to deal with urges 

and problems?

Yes No

21. Did you participate in any treatment program designed especially for 

a particular group of people — for example, women only, men only, 

Hispanics only?

Yes No

If you answered YES, what group was the program designed for? ________________________

123

Sample Letter to Collaterals

(in advance of Form 90–ACS interview)

Dear ________________________________________:

We are conducting a research program designed to develop new methods for treating people who 

have problems with alcohol. Our most important goal is to determine the effectiveness of the treatment approaches we are using. We are asking for your help in improving the work we do.

_____________________________ is participating in our study, which includes a very thorough evaluation both before and after the program. As one part of this evaluation, we ask all participants for 

the name of someone whom they trust, who knows them well, and who is in fairly close contact with 

them on a regular basis. We then call this person to ask some questions about our participant’s 

drinking and other behaviors. _____________________________ has given us your name as a trusted 

person who could answer these questions for us.

Within the next week or so you will be receiving a telephone call from a member of our staff. The 

purpose of this call is for us to get a clearer understanding of _____________________________’s situation and drinking pattern. Your help is very important and will be greatly appreciated.

We want you to understand several things before you receive this call:

1. We will be calling you with _____________________________’s full knowledge and written permission. There is nothing secret about the fact that we are calling you. You can feel free to 

discuss it with_____________________________ if you wish.

2. All information that you provide to us will be kept in strict confidence, and will not be 

shared with _____________________________.

3. Because of our policy of strict confidentiality, we will not be able to tell you anything 

about _____________________________’s progress in treatment or participation in our study.

4. It is important that the information you give us be as accurate as possible. We would rather 

have no information than have inaccurate or misleading information. We depend upon 

honesty to draw the most accurate conclusions from our study, which will be used to help 

many other people. Your accurate information can help our research and in this way benefit the lives of many others who will be treated in the future.

We greatly appreciate your assistance with our work. 

[signature]