CDE Detailed Report
Disease: Huntington's Disease
Subdomain Name: Epidemiology/Environmental History
CRF: Non-prescribed Drug Use Questionnaire
Displaying 1 - 16 of 16
Subdomain Name: Epidemiology/Environmental History
CRF: Non-prescribed Drug Use Questionnaire
Displaying 1 - 16 of 16
| CDE ID | CDE Name | Variable Name | Definition | Short Description | Question Text | Permissible Values | Description | Data Type | Disease Specific Instructions | Disease Specific Reference | Population | Classification (e.g., Core) | Version Number | Version Date | CRF Name (CRF Module / Guidance) | Subdomain Name | Domain Name | Size | Input Restrictions | Min Value | Max Value | Measurement Type | External Id Loinc | External Id Snomed | External Id caDSR | External Id CDISC |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| C00712 | Subscribed drug or substance illicitly used category | SbscrbdDrgSubIllctUseCat | Category of illegal drugs, prescription, or over-the-counter drugs subscribed by the participant/subject, and used for purposes other than those for which they are meant to be used, or in large amounts | Category of illegal drugs, prescription, or over-the-counter drugs subscribed by the participant/subject, and used for purposes other than those for which they are meant to be used, or in large amounts | If YES, specify illicit drug type(s) used | Sedatives (e.g., sleeping pills, barbiturates, Seconal, Quaaludes, or Chloral Hydrate);Marijuana, hash, THC, or grass;Hallucinogens (e.g., Ecstasy, LSD, mescaline, psilocybin, PCP, angel dust, or peyote);Inhalants or Solvents (e.g., amyl nitrate, nitrous oxide, glue, toluene, or gasoline;Other, specify (e.g., Methadone, Elavil, steroids, Thorazine, or Haldol);Stimulants: cocaine/crack;Stimulants: amphetamine, Benzedrine, Methedrine, Dexadrine, Preludin, Ritalin, uppers, speed;Narcotics: heroin, opium, morphine, methadone, codeine, Darvon, Percodan, Oxycontin, Dilaudid, Demerol/meperidine;Tranquilizers or anti-anxiety drugs (e.g., Valium, Librium, muscle relaxants, or Xanax) | Sedatives (e.g., sleeping pills, barbiturates, Seconal, Quaaludes, or Chloral Hydrate);Marijuana, hash, THC, or grass;Hallucinogens (e.g., Ecstasy, LSD, mescaline, psilocybin, PCP, angel dust, or peyote);Inhalants or Solvents (e.g., amyl nitrate, nitrous oxide, glue, toluene, or gasoline;Other, specify (e.g., Methadone, Elavil, steroids, Thorazine, or Haldol);Stimulants: cocaine/crack;Stimulants: amphetamine, Benzedrine, Methedrine, Dexadrine, Preludin, Ritalin, uppers, speed;Narcotics: heroin, opium, morphine, methadone, codeine, Darvon, Percodan, Oxycontin, Dilaudid, Demerol/meperidine;Tranquilizers or anti-anxiety drugs (e.g., Valium, Librium, muscle relaxants, or Xanax) | Alphanumeric |
For each drug class, list specific drug(s) used. Include drugs used at any time in life, but do not include drugs prescribed by doctor. |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-22 09:34:41.527 | Non-prescribed Drug Use Questionnaire | Epidemiology/Environmental History | Participant History and Family History |
Multiple Pre-Defined Values Selected |
3171797 | |||||||
| C17688 | Non-prescribed controlled psychoactive drug substance opioid text | NprscrCntrPschacDrgSbOpioidTxt | The text specifying the drugs within the 'Opioids/Narcotics: heroin, opium, morphine, methadone, codeine, Darvon, Percodan, Oxycontin, Dilaudid, Demerol/meperidine,' category as unprescribed, controlled psychoactive drugs or substances used by the participant/subject | The text specifying the drugs within the Opioids/Narcotic: heroin, opium, morphine, methadone, codeine, Darvon, Percodan, Oxycontin, Dilaudid, Demerol/meperidine category as unprescribed, controlled psychoactive drugs or substances used by the participant | List | Alphanumeric |
For each class of drug, list specific drug(s) used |
No references available | Adult | Supplemental | 4.00 | 2022-06-24 12:09:24.0 | Non-prescribed Drug Use Questionnaire | Epidemiology/Environmental History | Participant History and Family History | 255 |
Free-Form Entry |
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| C00716 | Drug or substance illicit use duration | DrgSubsIllctUseDur | Duration, in years, the participant/subject has used unprescribed, controlled psychoactive drugs or substances | Duration, in years, the participant/subject has used unprescribed, controlled psychoactive drugs or substance | Total Years Used | Numeric Values |
If a class of drug was never used (except if prescribed), then leave years and frequency of use blank and go to the next line in the table Count all years in which some use occurred. |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-22 09:34:41.527 | Non-prescribed Drug Use Questionnaire | Epidemiology/Environmental History | Participant History and Family History |
Free-Form Entry |
0 | 99 | Year | 2004152 | ||||||
| C17689 | Non-prescribed controlled psychoactive drug substance inhalant text | NprscrCntrPschacDrgSbInhlntTxt | The text specifying the drugs within the 'Inhalants: glue, toluene, gasoline, aerosols, paint thinner, nitrous oxide, amyl nitrite,' category as unprescribed, controlled psychoactive drugs or substances used by the participant/subject | The text specifying the drugs within the 'Inhalants: glue, toluene, gasoline, aerosols, paint thinner, nitrous oxide, amyl nitrite,' category as unprescribed, controlled psychoactive drugs or substances used by the participant/subject | List | Alphanumeric |
For each class of drug, list specific drug(s) used |
No references available | Adult | Supplemental | 3.10 | 2022-06-24 12:15:36.0 | Non-prescribed Drug Use Questionnaire | Epidemiology/Environmental History | Participant History and Family History | 255 |
Free-Form Entry |
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| C08232 | Drug or substance illicit use ever indicator | DrgSubIllicitEverUseInd | Indicator of participant's/subject's use of illegal drugs, prescription or over-the-counter drugs at any point in his/her lifetime for purposes other than those for which they are meant to be used, or in large amounts | Indicator of participant's/subject's use of an unprescribed, controlled psychoactive drugs or substances used by the participant/subject. at any point in his/her lifetime | Ever used | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric |
Do not include substances prescribed by doctor or available over-the-counter |
No references available | Adult | Supplemental | 3.00 | 2013-07-22 09:34:41.527 | Non-prescribed Drug Use Questionnaire | Epidemiology/Environmental History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C17690 | Non-prescribed controlled psychoactive drug substance hallucinogen text | NprscrCntrPschacDrgSbHalcnTxt | The text specifying the drugs within the 'Hallucinogens: ecstasy/MDMA, LSD, mescaline/peyote, psilocybin/mushrooms, PCP/phencylidine/angel dust, MDA/STP/DOM,' category as unprescribed, controlled psychoactive drugs or substances used by the participant/subject | Text specifying the drugs within the 'Hallucinogens: ecstasy/MDMA, LSD, mescaline/peyote, psilocybin/mushrooms, PCP/phencylidine/angel dust, MDA/STP/DOM,' category as unprescribed, controlled psychoactive drugs or substances used by the participant | List | Alphanumeric |
For each class of drug, list specific drug(s) used |
No references available | Adult | Supplemental | 3.10 | 2022-06-24 12:17:25.0 | Non-prescribed Drug Use Questionnaire | Epidemiology/Environmental History | Participant History and Family History | 255 |
Free-Form Entry |
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| C08233 | Drug or substance first illicit use date and time | DrgSubFirstIllicitUseDateTime | Date (and time if applicable and known) the participant/subject first used the category of illegal drugs, prescription or over-the-counter drugs | Date (and time if applicable and known) the participant/subject first used the category of illegal drugs, prescription or over-the-counter drug | First Used | Date or Date & Time |
Record the date/time according to the ISO 8601, the International Standard for the representation of dates and times (http://www.iso.org/iso/home.html). The date/time should be recorded to the level of granularity known (e.g., year, year and month, complete date plus hours and minutes, etc.). |
No references available | Adult | Supplemental | 3.00 | 2013-07-22 09:34:41.527 | Non-prescribed Drug Use Questionnaire | Epidemiology/Environmental History | Participant History and Family History |
Free-Form Entry |
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| C17691 | Non-prescribed controlled psychoactive drug substance other text | NprscrCntrPschacDrgSubOthTxt | The text specifying the drugs within the 'Others: (non-perscribed, non-over-the-counter)' categoryas an unprescribed, controlled psychoactive drugs or substances used by the participant/subject | The text specifying the drugs within the 'Others: (non-perscribed, non-over-the-counter)' categoryas an unprescribed, controlled psychoactive drugs or substances used by the participant/subjec | List | Alphanumeric |
For each class of drug, list specific drug(s) used. Non-perscribed and non-over-the-counter. |
No references available | Adult | Supplemental | 3.00 | 2013-08-30 17:06:52.8 | Non-prescribed Drug Use Questionnaire | Epidemiology/Environmental History | Participant History and Family History | 255 |
Free-Form Entry |
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| C08234 | Drug or substance last illicit use date and time | DrgSubLastIllicitUseDateTime | Date (and time if applicable and known) of the participant's/subject's last use of an unprescribed, controlled psychoactive drugs or substances used by the participant/subject | Date (and time if applicable and known) of the participant's/subject's last use of an unprescribed, controlled psychoactive drugs or substances used by the participant/subjec | Last Used | Date or Date & Time |
Record the date/time according to the ISO 8601, the International Standard for the representation of dates and times (http://www.iso.org/iso/home.html). The date/time should be recorded to the level of granularity known (e.g., year, year and month, complete date plus hours and minutes, etc.). |
No references available | Adult | Supplemental | 3.00 | 2013-07-22 09:34:41.527 | Non-prescribed Drug Use Questionnaire | Epidemiology/Environmental History | Participant History and Family History |
Free-Form Entry |
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| C18670 | Subscribed drug or substance illicitly used category other text | SbscrbdDrgSubIllctUseCatOTH | The free-text field related to 'Subscribed drug or substance illicitly used category' specifying other text. Category of illegal drugs, prescription, or over-the-counter drugs the participant/subject used for purposes other than those for which they are meant to be used, or in large amounts | Subscribed drug substance illicitly used category specifying other text. Category of illegal drugs, prescription, or over-the-counter drugs the participant/subject used for purposes other than those for which they are meant to be used, or in large amounts | Other, specify | Alphanumeric |
For each drug class, list specific drug(s) used. Include drugs used at any time in life, but do not include drugs prescribed by doctor. |
No references available | Adult;Pediatric | Supplemental | 1.10 | 2022-06-24 11:33:13.0 | Non-prescribed Drug Use Questionnaire | Epidemiology/Environmental History | Participant History and Family History | 4000 |
Free-Form Entry |
3171797 | ||||||||
| C08235 | Drug or substance illicit use frequency | DrgSubIllicitUseFreq | The subject's/participant's average or typical use frequency during the year of greatest use of an unprescribed, controlled psychoactive drugs or substances used by the participant/subject | The subject's/participant's average or typical use frequency during the year of greatest use of an unprescribed, controlled psychoactive drugs or substances used by the participant/subjec | Frequency of Use | Alphanumeric |
If a class of drug was never used (except if prescribed), then leave years and frequency of use blank and go to the next line in the table Average or typical frequency during the year of greatest use. List number of uses per day (_/d), week (_/w), month (_/m), or year (_/y), as applicable. |
No references available | Adult | Supplemental | 3.00 | 2013-07-22 09:34:41.527 | Non-prescribed Drug Use Questionnaire | Epidemiology/Environmental History | Participant History and Family History | 255 |
Free-Form Entry |
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| C17683 | Non-prescribed controlled psychoactive drug substance marijuana text | NprscrbContrPschacDrgSbMrjTxt | The text specifying the drugs within the Marijuana: hash, THC category as unprescribed, controlled psychoactive drugs or substances used by the participant/subject | The text specifying the drugs within the Marijuana: hash, THC category as unprescribed, controlled psychoactive drugs or substances used by the participant/subjec | List | Alphanumeric |
For each class of drug, list specific drug(s) used |
No references available | Adult | Supplemental | 3.10 | 2022-06-24 11:44:17.0 | Non-prescribed Drug Use Questionnaire | Epidemiology/Environmental History | Participant History and Family History | 255 |
Free-Form Entry |
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| C17684 | Non-prescribed controlled psychoactive drug substance stimulant cocaine text | NprscrCntrPschacDrgSbStmCocTxt | The text specifying the drugs within the Stimulants: cocaine/crack category as unprescribed, controlled psychoactive drugs or substances used by the participant/subject | The text specifying the drugs within the Stimulants: cocaine/crack category as unprescribed, controlled psychoactive drugs or substances used by the participant/subjec | List | Alphanumeric |
For each class of drug, list specific drug(s) used |
No references available | Adult | Supplemental | 3.10 | 2022-06-24 11:48:57.0 | Non-prescribed Drug Use Questionnaire | Epidemiology/Environmental History | Participant History and Family History | 255 |
Free-Form Entry |
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| C17685 | Non-prescribed controlled psychoactive drug substance stimulant amphetamine text | NprscrCntrPschacDrgSbStmAmpTxt | The text specifying the drugs within the 'Stimulants: amphetamine, Benzedrine, Methedrine, Dexedrine, Preludin, Ritalin, uppers, speed,' category as unprescribed, controlled psychoactive drugs or substances used by the participant/subject | The text specifying the drugs within the 'Stimulants: amphetamine, Benzedrine, Methedrine, Dexedrine, Preludin, Ritalin, uppers, speed,' category as unprescribed, controlled psychoactive drugs or substances used by the participant/subjec | List | Alphanumeric |
For each class of drug, list specific drug(s) used |
No references available | Adult | Supplemental | 3.10 | 2022-06-24 11:53:43.0 | Non-prescribed Drug Use Questionnaire | Epidemiology/Environmental History | Participant History and Family History | 255 |
Free-Form Entry |
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| C17686 | Non-prescribed controlled psychoactive drug substance sedative tranquilizer text | NprscrCntrPschacDrgSbSedTrnTxt | The text specifying the drugs within the 'Sedatives/minor tranquilizers/muscle relaxants-benzodiazepines and others: Valium/diazepam, Librium, Halcion, Xanax, Dalmane, Flexeril,' category as unprescribed, controlled psychoactive drugs or substances used by the participant/subject | The text specifying the drugs within the 'Sedatives/minor tranquilizers/muscle relaxants-benzodiazepines and others: Valium/diazepam, Librium, Halcion, Xanax, Dalmane, Flexeril,' category as unprescribed, controlled psychoactive drugs or substances us | List | Alphanumeric |
For each class of drug, list specific drug(s) used |
No references available | Adult | Supplemental | 3.10 | 2022-06-24 12:01:23.0 | Non-prescribed Drug Use Questionnaire | Epidemiology/Environmental History | Participant History and Family History | 255 |
Free-Form Entry |
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| C17687 | Non-prescribed controlled psychoactive drug substance sedative barbiturate text | NprscrCntrPschacDrgSbSedBrbTxt | The text specifying the drugs within the 'Sedatives-barbiturates and others: phenobarbital, Seconol, Nembutal, Dorieden, Quaalude, Amytal, Fiorinal, downers,' category as unprescribed, controlled psychoactive drugs or substances used by the participant/subject | Text specifying the drugs within the 'Sedatives-barbiturates and others: phenobarbital, Seconol, Nembutal, Dorieden, Quaalude, Amytal, Fiorinal, downers,' category as unprescribed, controlled psychoactive drugs or substances used by the participant | List | Alphanumeric |
For each class of drug, list specific drug(s) used |
No references available | Adult | Supplemental | 3.10 | 2022-06-24 12:07:04.0 | Non-prescribed Drug Use Questionnaire | Epidemiology/Environmental History | Participant History and Family History | 255 |
Free-Form Entry |
