Youth Opioid Response Pre-Survey Please answer the following questions to the best of your ability Question Title * 1. What is your age? Question Title * 2. Gender Identity Male Female Transgender Rather not say Question Title * 3. Check 5 options from below that you believe are the greatest concern to the well-being of youth (age 12-24) in Lake County. Academic Stress Poverty Crime College/Future Plans Gangs Depression Healthcare Discrimination/Racism Alcohol Use Loneliness/Feeling Lonely Drug Use Bullying Peer Pressure Violence Self-esteem Sexual Orientation Suicide Family Neglect/Violence Question Title * 4. What do you do for fun outside of school? Check all that apply. Sporting Events Movies Read Social Media Browse Online Music/Dancing Parties Study Take Classes Gaming Spending time on the lake Outdoor Activities (hiking, fishing, etc.) Other (i.e. out of town) Question Title * 5. How do you keep up with current events in your area? Check all that apply. Twitter Snapchat Kik Tumblr YouTube Community Organizations Social Service Worker Friends Newspaper School Parents TV E-mail Facebook Instagram Counselor Mentor Question Title * 6. How many of your friends use opioids? (heroin, fentanyl, prescription painkillers [Oxycontin, Vicodin, codeine, morphine], etc.) 0-4 5-9 10-14 15+ Question Title * 7. How many of your friends use alcohol? 0-2 3-5 6-8 9+ Question Title * 8. Is anyone in your immediate household prescribed opioid medications? Yes No Not Sure Question Title * 9. Do you drink alcohol? Yes No Sometimes Rather not say Question Title * 10. Do you think doing marijuana will lead you to do other drugs? Yes No Not Sure Question Title * 11. Do you use drugs? (heroin, meth, opioids, vape, etc.) Yes No Question Title * 12. How many times a week do you use drugs? (i.e. heroin, meth, opioids, vape, etc.) 0-3 times 4-6 times 7-9 times 10+ Question Title * 13. What would you do to help a friend if they were addicted to drugs? Tell a counselor/teacher/parent Give them information on addiction and treatment Tease them about it Give them a Narcan kit Let them know you love and support them Other Question Title * 14. What does the term "Game Changer" mean to you? Done