> ## Documentation Index
> Fetch the complete documentation index at: https://coloradobehavioralhealthadministration.mintlify.site/llms.txt
> Use this file to discover all available pages before exploring further.

# SIA & SID - Substance Use Disorder

> Substance use information at admission and discharge

> [!NOTE]
>
> **Record Types:** `SIA` (Admission), `SID` (Discharge) | **Version:** CoBHRM 2026-Q3 | **Parent:** ADMISSION

## Overview

The SUBSTANCE USE DISORDER schema captures detailed information about substances used by clients. There are two record types:

* **SIA** - Substance Use at Admission: Substance use patterns at intake
* **SID** - Substance Use at Discharge: Substance use status at end of treatment

Unlike a repeating-record model, this schema uses **named slots** for primary, secondary, and tertiary substances. Each slot captures the substance code, times used in last 30 days, route of use (required at admission, optional at discharge), and age of first use (required at admission, optional at discharge).

> [!NOTE]
>
> **Transaction Types:** All record types support Add (`A`), Update (`U`), and Replace (`R`) transactions. See [Transaction Types](https://coloradobehavioralhealthadministration.mintlify.site/getting-started/transaction-types.md) for details.

***

## 1. Schema Reference

### Identifier Fields

| BHA Column Name | Field Name | Format | Required | Valid Values | Notes |
| - | - | - | - | - | - |
| `RECORD_TYPE` | Record Type | `x(3)` | Y | `SIA` or `SID` | `SIA` = Admission, `SID` = Discharge |
| `TRANSACTION_TYPE` | Transaction Type | `x(1)` | Y | `A`, `U`, `R` | See [Transaction Types](https://coloradobehavioralhealthadministration.mintlify.site/getting-started/transaction-types.md) |
| `BHASO_ADMISSION_IDENTIFIER` | Admission Identifier | `x(-)` | Y | Alphanumeric | Must exist in ADMISSION |
| `EFFECTIVE_DATE` | Effective Date | `date` | Y | `YYYY-MM-DD` | |

### ASAM Level of Care

| BHA Column Name | Field Name | Format | Required | Valid Values | Notes |
| - | - | - | - | - | - |
| `ASAM_LEVEL_OF_CARE` | ASAM Level of Care | `x(12)` | Conditional | See [ASAM Level of Care](https://coloradobehavioralhealthadministration.mintlify.site/reference/appendix-a/substance-types/asam-level-of-care.md) | Required for all non-DUI SUD services. Required on SIA. Must match LADDERS Provider/Clinic registration |

> [!WARNING]
>
> The ASAM Level of Care must be in the valid range for the Admission's Service Identifier and must match the LADDERS Provider/Clinic's registered ASAM Level of Care.

### Primary Substance Fields

| BHA Column Name | Field Name | Format | Required | Valid Values | Notes |
| - | - | - | - | - | - |
| `PRIMARY_SUBSTANCE_USE` | Primary Substance Use | `9(2)` | Y | See [Substance Use Codes](https://coloradobehavioralhealthadministration.mintlify.site/reference/appendix-a/substance-types/substance-use-codes.md) | Use None code if no substance use is applicable. Nicotine cannot be primary |
| `PRIMARY_LAST_USED_30_DAYS` | Times Used Primary (Last 30 Days) | `9(2)` | Conditional | `0`-`30` | Required if Primary Substance is not None |
| `PRIMARY_ROUTE_OF_USE` | Route of Use of Primary Substance | `9(2)` | Conditional | See [Route of Administration](https://coloradobehavioralhealthadministration.mintlify.site/reference/appendix-a/substance-types/route-of-administration.md) | Required at admission (`SIA`), optional at discharge (`SID`). Applies if Primary is not None |
| `PRIMARY_START_AGE` | Age of First Use of Primary Substance | `9(2)` | Conditional | `5`-`99` | Required at admission (`SIA`), optional at discharge (`SID`). Applies if Primary is not None |

### Secondary Substance Fields

| BHA Column Name | Field Name | Format | Required | Valid Values | Notes |
| - | - | - | - | - | - |
| `SECONDARY_SUBSTANCE_USE` | Secondary Substance Use | `9(2)` | Y | See [Substance Use Codes](https://coloradobehavioralhealthadministration.mintlify.site/reference/appendix-a/substance-types/substance-use-codes.md) | Use None code if not applicable |
| `SECONDARY_LAST_USED_30_DAYS` | Times Used Secondary (Last 30 Days) | `9(2)` | Conditional | `0`-`30` | Required if Secondary Substance is not None |
| `SECONDARY_ROUTE_OF_USE` | Route of Use of Secondary Substance | `9(2)` | Conditional | See [Route of Administration](https://coloradobehavioralhealthadministration.mintlify.site/reference/appendix-a/substance-types/route-of-administration.md) | Required at admission (`SIA`), optional at discharge (`SID`). Applies if Secondary is not None |
| `SECONDARY_START_AGE` | Age of First Use of Secondary Substance | `9(2)` | Conditional | `5`-`99` | Required at admission (`SIA`), optional at discharge (`SID`). Applies if Secondary is not None |

### Tertiary Substance Fields

| BHA Column Name | Field Name | Format | Required | Valid Values | Notes |
| - | - | - | - | - | - |
| `TERTIARY_SUBSTANCE_USE` | Tertiary Substance Use | `9(2)` | Y | See [Substance Use Codes](https://coloradobehavioralhealthadministration.mintlify.site/reference/appendix-a/substance-types/substance-use-codes.md) | Use None code if not applicable |
| `TERTIARY_LAST_USED_30_DAYS` | Times Used Tertiary (Last 30 Days) | `9(2)` | Conditional | `0`-`30` | Required if Tertiary Substance is not None |
| `TERTIARY_ROUTE_OF_USE` | Route of Use of Tertiary Substance | `9(2)` | Conditional | See [Route of Administration](https://coloradobehavioralhealthadministration.mintlify.site/reference/appendix-a/substance-types/route-of-administration.md) | Required at admission (`SIA`), optional at discharge (`SID`). Applies if Tertiary is not None |
| `TERTIARY_START_AGE` | Age of First Use of Tertiary Substance | `9(2)` | Conditional | `5`-`99` | Required at admission (`SIA`), optional at discharge (`SID`). Applies if Tertiary is not None |

> [!WARNING]
>
> **Discharge substances must match admission substances.** Primary, Secondary, and Tertiary substance types at discharge (`SID`) must match the corresponding types at admission (`SIA`). If they differ, the admission record must be updated before proceeding with the discharge submission.

> [!NOTE]
>
> **Admission vs. Discharge fields:** Route of Use and Age of First Use are **required at admission** (`SIA`) and **optional at discharge** (`SID`). At discharge, substance type and usage frequency in the last 30 days are always required.

### System Metadata Fields

These fields are required in every submission and track record creation and modification:

| BHA Column Name | Field Name | Format | Required | Notes |
| - | - | - | - | - |
| `CREATED_DATE` | Created Date | `yyyy-mm-dd HH24:MI:SS.FF` | Y | Date/time record was created |
| `CREATED_BY` | Created By | `x(100)` | Y | User/system that created the record |
| `LAST_UPDATED_DATE` | Last Updated Date | `yyyy-mm-dd HH24:MI:SS.FF` | Y | If `TRANSACTION_TYPE = A`, must equal `CREATED_DATE` |

***

## 2. Examples

### Minimal Valid Example (SIA - Admission)

Client using alcohol as primary substance, no secondary or tertiary. ASAM Level 1.0 (Outpatient).

```csv theme={null}
RECORD_TYPE|TRANSACTION_TYPE|BHASO_ADMISSION_IDENTIFIER|EFFECTIVE_DATE|ASAM_LEVEL_OF_CARE|PRIMARY_SUBSTANCE_USE|PRIMARY_LAST_USED_30_DAYS|PRIMARY_ROUTE_OF_USE|PRIMARY_START_AGE|SECONDARY_SUBSTANCE_USE|SECONDARY_LAST_USED_30_DAYS|SECONDARY_ROUTE_OF_USE|SECONDARY_START_AGE|TERTIARY_SUBSTANCE_USE|TERTIARY_LAST_USED_30_DAYS|TERTIARY_ROUTE_OF_USE|TERTIARY_START_AGE|CREATED_DATE|CREATED_BY|LAST_UPDATED_DATE
SIA|A|ADM-000001|2024-01-15|1.0|01|20|01|16|00||||00||||2024-01-15 10:00:00|system|2024-01-15 10:00:00
```

### Minimal Valid Example (SID - Discharge)

Corresponding discharge record. Substances must match admission. Route of Use and Age of First Use are optional at discharge.

```csv theme={null}
RECORD_TYPE|TRANSACTION_TYPE|BHASO_ADMISSION_IDENTIFIER|EFFECTIVE_DATE|ASAM_LEVEL_OF_CARE|PRIMARY_SUBSTANCE_USE|PRIMARY_LAST_USED_30_DAYS|PRIMARY_ROUTE_OF_USE|PRIMARY_START_AGE|SECONDARY_SUBSTANCE_USE|SECONDARY_LAST_USED_30_DAYS|SECONDARY_ROUTE_OF_USE|SECONDARY_START_AGE|TERTIARY_SUBSTANCE_USE|TERTIARY_LAST_USED_30_DAYS|TERTIARY_ROUTE_OF_USE|TERTIARY_START_AGE|CREATED_DATE|CREATED_BY|LAST_UPDATED_DATE
SID|A|ADM-000001|2024-06-15||01|5|||00||||00||||2024-06-15 10:00:00|system|2024-06-15 10:00:00
```

### Complete Example: Multiple Substances (SIA)

Client with heroin (primary), methamphetamine (secondary), and nicotine (tertiary). All per-slot fields populated.

```csv theme={null}
RECORD_TYPE|TRANSACTION_TYPE|BHASO_ADMISSION_IDENTIFIER|EFFECTIVE_DATE|ASAM_LEVEL_OF_CARE|PRIMARY_SUBSTANCE_USE|PRIMARY_LAST_USED_30_DAYS|PRIMARY_ROUTE_OF_USE|PRIMARY_START_AGE|SECONDARY_SUBSTANCE_USE|SECONDARY_LAST_USED_30_DAYS|SECONDARY_ROUTE_OF_USE|SECONDARY_START_AGE|TERTIARY_SUBSTANCE_USE|TERTIARY_LAST_USED_30_DAYS|TERTIARY_ROUTE_OF_USE|TERTIARY_START_AGE|CREATED_DATE|CREATED_BY|LAST_UPDATED_DATE
SIA|A|ADM-000002|2024-02-10|3.5|11|28|04|19|08|15|03|22|28|30|02|18|2024-02-10 09:30:00|jdoe|2024-02-10 09:30:00
```

> [!NOTE]
>
> Nicotine (`28`) is valid as secondary or tertiary but **cannot** be used as the primary substance. Route of Use and Age of First Use are required at admission for each substance that is not `00` (None).

### Edge Case: Differential Assessment (No Substances)

For a differential assessment admission (`SERVICE_IDENTIFIER = 00`), substance codes can all be `00` (None).

```csv theme={null}
RECORD_TYPE|TRANSACTION_TYPE|BHASO_ADMISSION_IDENTIFIER|EFFECTIVE_DATE|ASAM_LEVEL_OF_CARE|PRIMARY_SUBSTANCE_USE|PRIMARY_LAST_USED_30_DAYS|PRIMARY_ROUTE_OF_USE|PRIMARY_START_AGE|SECONDARY_SUBSTANCE_USE|SECONDARY_LAST_USED_30_DAYS|SECONDARY_ROUTE_OF_USE|SECONDARY_START_AGE|TERTIARY_SUBSTANCE_USE|TERTIARY_LAST_USED_30_DAYS|TERTIARY_ROUTE_OF_USE|TERTIARY_START_AGE|CREATED_DATE|CREATED_BY|LAST_UPDATED_DATE
SIA|A|ADM-000004|2024-04-01||00||||00||||00||||2024-04-01 10:00:00|system|2024-04-01 10:00:00
```

***

## 3. Template

> **[View SUBSTANCE USE Template](https://coloradobehavioralhealthadministration.mintlify.site/reference/templates/downloads.md#substance-use-template-sia-sid)**
>
> SUBSTANCE USE schema template with headers and sample row

***

## 4. Parsing Rules

### CSV Parsing Rules

| Property | Value |
| - | - |
| Encoding | UTF-8 |
| Delimiter | Pipe (`\|`) |
| Quote Character | Double quote (`"`) |
| Escape | Backslash (`\`) |
| Date Format | `YYYY-MM-DD` |
| Timestamp Format | `YYYY-MM-DD HH24:MI:SS.FF` (Mountain Time) |
| Null Representation | Empty field (`\|\|`) |

See [File Format Requirements](https://coloradobehavioralhealthadministration.mintlify.site/getting-started/file-format-requirements.md) for full details on encoding, quoting, data types, and null handling.

***

## 5. Update Semantics

### Primary Key

`RECORD_TYPE` + `BHASO_ADMISSION_IDENTIFIER`

### Transaction Types

| Type | Code | Behavior |
| - | - | - |
| Add | `A` | Creates new substance use record |
| Update | `U` | Updates existing record (new effective date) |
| Replace | `R` | Overwrites most recent record |

***

## Related Schemas

| Schema | Relationship | Key Field |
| - | - | - |
| [ADMISSION](https://coloradobehavioralhealthadministration.mintlify.site/schemas/admission.md) | Parent | `BHASO_ADMISSION_IDENTIFIER` |
| [CLIENT](https://coloradobehavioralhealthadministration.mintlify.site/schemas/client.md) | Grandparent | `BHASO_CLIENT_IDENTIFIER` |


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