* 1. You are:

* 2. How old are you?

* 3. Have you ever taken prescription drugs for a non-medical reason?

* 4. If you answered yes, why did you take them? (Check all that apply)

* 5. Have you ever self-diagnosed your own health problem and treated it with a pill given to by a friend?

* 6. What type of prescription meds do you abuse most?

* 7. How many times have you used an rx for a non-medical purpose?

* 8. How common is it among you and your friends to swap prescription meds recreationally?

* 9. Where did you get the meds you’ve taken? (Check all that apply)

* 10. Do you ever take prescription drugs with alcohol?

* 11. Do the prescription drugs you take ever cause other health issues?

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