# BHA Substance Use Disorder Questionnaire - Colorado BHA FHIR Implementation Guide v0.1.0-current

* [**Table of Contents**](toc.md)
* [**Artifacts Summary**](artifacts.md)
* **BHA Substance Use Disorder Questionnaire**

## Questionnaire: BHA Substance Use Disorder Questionnaire 

| | | |
| :--- | :--- | :--- |
| *Official URL*:http://bha.colorado.gov/fhir/bha-ig/Questionnaire/BHASubstanceUseDisorderQuestionnaire | *Version*:0.1.0-current | |
| * Standards status: *[Trial-use](http://hl7.org/fhir/R4/versions.html#std-process) | [Maturity Level](maturity.md): 0 | *Computable Name*:BHASubstanceUseDisorderQuestionnaire |

 
Behavioral Health Administration substance use disorder questionnaire for collecting substance use information from a person receiving behavioral health services 

### Example Questionnaire Responses

* [BHA Substance Use Disorder Questionnaire Response](QuestionnaireResponse-BHASubstanceUseDisorderQuestionnaireResponseExample.md)



## Resource Content

```json
{
  "resourceType" : "Questionnaire",
  "id" : "BHASubstanceUseDisorderQuestionnaire",
  "meta" : {
    "profile" : ["http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire|3.0.0"]
  },
  "extension" : [{
    "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
    "valueInteger" : 0,
    "_valueInteger" : {
      "extension" : [{
        "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom",
        "valueCanonical" : "http://bha.colorado.gov/fhir/bha-ig/ImplementationGuide/bha-ig"
      }]
    }
  },
  {
    "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
    "valueCode" : "trial-use",
    "_valueCode" : {
      "extension" : [{
        "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom",
        "valueCanonical" : "http://bha.colorado.gov/fhir/bha-ig/ImplementationGuide/bha-ig"
      }]
    }
  }],
  "url" : "http://bha.colorado.gov/fhir/bha-ig/Questionnaire/BHASubstanceUseDisorderQuestionnaire",
  "version" : "0.1.0-current",
  "name" : "BHASubstanceUseDisorderQuestionnaire",
  "title" : "BHA Substance Use Disorder Questionnaire",
  "status" : "active",
  "subjectType" : ["Patient"],
  "date" : "2025-12-17",
  "publisher" : "Colorado Behavioral Health Administration",
  "contact" : [{
    "name" : "Colorado Behavioral Health Administration",
    "telecom" : [{
      "system" : "url",
      "value" : "https://bha.colorado.gov"
    },
    {
      "system" : "email",
      "value" : "FHIRFeedback@state.co.us"
    }]
  }],
  "description" : "Behavioral Health Administration substance use disorder questionnaire for collecting substance use information from a person receiving behavioral health services",
  "jurisdiction" : [{
    "coding" : [{
      "system" : "http://unstats.un.org/unsd/methods/m49/m49.htm",
      "code" : "840"
    }]
  }],
  "item" : [{
    "linkId" : "ASAM_LEVEL_OF_CARE",
    "text" : "ASAM Level of Care",
    "type" : "choice",
    "required" : false,
    "answerValueSet" : "http://bha.colorado.gov/fhir/bha-ig/ValueSet/bha-asam-level-of-care-vs"
  },
  {
    "linkId" : "PRIMARY_SUBSTANCE_USE",
    "text" : "Primary Substance Use",
    "type" : "choice",
    "required" : true,
    "answerValueSet" : "http://bha.colorado.gov/fhir/bha-ig/ValueSet/bha-substance-use-primary-vs"
  },
  {
    "extension" : [{
      "url" : "http://hl7.org/fhir/StructureDefinition/minValue",
      "valueInteger" : 0
    },
    {
      "url" : "http://hl7.org/fhir/StructureDefinition/maxValue",
      "valueInteger" : 30
    }],
    "linkId" : "PRIMARY_LAST_USED_30_DAYS",
    "text" : "Times Used Primary Substance in Last 30 Days",
    "type" : "integer",
    "enableWhen" : [{
      "question" : "PRIMARY_SUBSTANCE_USE",
      "operator" : "!=",
      "answerCoding" : {
        "system" : "http://bha.colorado.gov/fhir/bha-ig/CodeSystem/bha-substance-use-cs",
        "code" : "0"
      }
    }],
    "required" : true
  },
  {
    "linkId" : "PRIMARY_ROUTE_OF_USE",
    "text" : "Route of Use of Primary Substances",
    "type" : "choice",
    "enableWhen" : [{
      "question" : "PRIMARY_SUBSTANCE_USE",
      "operator" : "!=",
      "answerCoding" : {
        "system" : "http://bha.colorado.gov/fhir/bha-ig/CodeSystem/bha-substance-use-cs",
        "code" : "0"
      }
    }],
    "required" : true,
    "answerValueSet" : "http://bha.colorado.gov/fhir/bha-ig/ValueSet/bha-substance-use-route-of-administration-vs"
  },
  {
    "linkId" : "PRIMARY_START_AGE",
    "text" : "Age of First Use of Primary Substances",
    "type" : "integer",
    "enableWhen" : [{
      "question" : "PRIMARY_SUBSTANCE_USE",
      "operator" : "!=",
      "answerCoding" : {
        "system" : "http://bha.colorado.gov/fhir/bha-ig/CodeSystem/bha-substance-use-cs",
        "code" : "0"
      }
    }],
    "required" : true
  },
  {
    "linkId" : "SECONDARY_SUBSTANCE_USE",
    "text" : "Secondary Substance Use",
    "type" : "choice",
    "required" : true,
    "answerValueSet" : "http://bha.colorado.gov/fhir/bha-ig/ValueSet/bha-substance-use-secondary-tertiary-vs"
  },
  {
    "extension" : [{
      "url" : "http://hl7.org/fhir/StructureDefinition/minValue",
      "valueInteger" : 0
    },
    {
      "url" : "http://hl7.org/fhir/StructureDefinition/maxValue",
      "valueInteger" : 30
    }],
    "linkId" : "SECONDARY_LAST_USED_30_DAYS",
    "text" : "Times Used Secondary Substance in Last 30 Days",
    "type" : "integer",
    "enableWhen" : [{
      "question" : "SECONDARY_SUBSTANCE_USE",
      "operator" : "!=",
      "answerCoding" : {
        "system" : "http://bha.colorado.gov/fhir/bha-ig/CodeSystem/bha-substance-use-cs",
        "code" : "0"
      }
    }],
    "required" : true
  },
  {
    "linkId" : "SECONDARY_ROUTE_OF_USE",
    "text" : "Route of Use of Secondary Substances",
    "type" : "choice",
    "enableWhen" : [{
      "question" : "SECONDARY_SUBSTANCE_USE",
      "operator" : "!=",
      "answerCoding" : {
        "system" : "http://bha.colorado.gov/fhir/bha-ig/CodeSystem/bha-substance-use-cs",
        "code" : "0"
      }
    }],
    "required" : true,
    "answerValueSet" : "http://bha.colorado.gov/fhir/bha-ig/ValueSet/bha-substance-use-route-of-administration-vs"
  },
  {
    "linkId" : "SECONDARY_START_AGE",
    "text" : "Age of First Use of Secondary Substances",
    "type" : "integer",
    "enableWhen" : [{
      "question" : "SECONDARY_SUBSTANCE_USE",
      "operator" : "!=",
      "answerCoding" : {
        "system" : "http://bha.colorado.gov/fhir/bha-ig/CodeSystem/bha-substance-use-cs",
        "code" : "0"
      }
    }],
    "required" : true
  },
  {
    "linkId" : "TERTIARY_SUBSTANCE_USE",
    "text" : "Tertiary Substance Use",
    "type" : "choice",
    "required" : true,
    "answerValueSet" : "http://bha.colorado.gov/fhir/bha-ig/ValueSet/bha-substance-use-secondary-tertiary-vs"
  },
  {
    "extension" : [{
      "url" : "http://hl7.org/fhir/StructureDefinition/minValue",
      "valueInteger" : 0
    },
    {
      "url" : "http://hl7.org/fhir/StructureDefinition/maxValue",
      "valueInteger" : 30
    }],
    "linkId" : "TERTIARY_LAST_USED_30_DAYS",
    "text" : "Times Used Tertiary Substance in Last 30 Days",
    "type" : "integer",
    "enableWhen" : [{
      "question" : "TERTIARY_SUBSTANCE_USE",
      "operator" : "!=",
      "answerCoding" : {
        "system" : "http://bha.colorado.gov/fhir/bha-ig/CodeSystem/bha-substance-use-cs",
        "code" : "0"
      }
    }],
    "required" : true
  },
  {
    "linkId" : "TERTIARY_ROUTE_OF_USE",
    "text" : "Route of Use of Tertiary Substance",
    "type" : "choice",
    "enableWhen" : [{
      "question" : "TERTIARY_SUBSTANCE_USE",
      "operator" : "!=",
      "answerCoding" : {
        "system" : "http://bha.colorado.gov/fhir/bha-ig/CodeSystem/bha-substance-use-cs",
        "code" : "0"
      }
    }],
    "required" : true,
    "answerValueSet" : "http://bha.colorado.gov/fhir/bha-ig/ValueSet/bha-substance-use-route-of-administration-vs"
  },
  {
    "linkId" : "TERTIARY_START_AGE",
    "text" : "Age of First Use of Tertiary Substance",
    "type" : "integer",
    "enableWhen" : [{
      "question" : "TERTIARY_SUBSTANCE_USE",
      "operator" : "!=",
      "answerCoding" : {
        "system" : "http://bha.colorado.gov/fhir/bha-ig/CodeSystem/bha-substance-use-cs",
        "code" : "0"
      }
    }],
    "required" : true
  }]
}

```
