A Microsoft extension to the ANSI SQL language that includes procedural programming, local variables, and various support functions.
The first thing I would do with this query so it is reformat it to be more readable. Although, that is true, what is one programmer's well-written code is another programmer's unreadable junk. Nevertheless, the way the query is written now, I find it difficult to follow.
Anyway, when browsing through the query I see several constructs that are potentially problematic. OR often leads the optimizer astray. And then these LIKE conditions...
Before starting to performance-tuning a query there is a one precondition that some people miss, to wit: does the query produce the correct result? It has happened to me more than once that I've found that when a query was slow, it was because I made some silly mistake.
But one recommendation is to break up the complex query in several, using intermediate temp tables. This does not always work out to the better, but it can make things run faster it you index the temp table appropriately. If nothing else, it makes debugging easier.