Drug Free Community Annual Survey (Dec 2009)
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1. Middle School (grades 6-8) Survey

 

1. Which school do you attend?

2. What grade are you in?

3. What is your gender?

4. What race are you?

5. What county do you live in?

6. On how many occasions (if any) have you had beer, wine, or hard liquor during the past 30 days?

7. How frequently have you smoked cigarettes during the past 30 days?

8. On how many occasions (if any) have you used marijuana during the past 30 days?

9. How old were you when you first had more than one or two sips of beer, wine, or hard liquor (for example: vodka, whiskey, or gin)?

10. How old were you when you first smoked a cigarette-even a puff?

11. How old were you when you first smoked marijuana?

12. How much do you think people risk harming themselves (physically or in other ways) if they take one or two drinks of an alcoholic beverage (beer, wine, liquor) nearly every day?

13. How much do you think people risk harming themselves (physically or in other ways) if they smoke one or more packs of cigarettes per day?

14. How much do you think people risk harming themselves (physically or in other ways) if they smoke marijuana regularly?

15. How wrong do your parents/families feel it would be for you to drink beer, wine, or hard liquor (for example: vodka, whiskey, or gin) regularly (at least twice a month)?

16. How wrong do your parents/families feel it would be for you to smoke cigarettes?

17. How wrong do your parents/families feel it would be for you to smoke marijuana?

18. On how many occasions have you used the following prescription drugs (misused or without consent from a doctor) in the past 30 days?

 0 occasions1-2 occasions3-5 occasions6-9 occasions10-19 occasions20-39 occasions40 or more occasions
Vicodin/Hydrocodone/Lortab
OxyContin, Oxy
Adderall/Ritalin
Morphine
Methadone/Suboxone

19. On how many occasions have you used the following street drugs in the past 30 days?

 0 occasions1-2 occasions3-5 occasions6-9 occasions10-19 occasions20-39 occasions40 or more occasions
Cocaine/Crack
Heroin/Smack
Crystal Meth/Ice/Crank
Hallucinogens [Acid, Angel Dust, Shrooms, Ecstasy, Salvia]

20. On how many occasions have you used the following inhalants in the past 30 days?

 0 occasions1-2 occasions3-5 occasions6-9 occasions10-19 occasions20-39 occasions40 or more occasions
Gas
Aerosol Products
Paint
Glue
Other

21. How old were you when you first used the following prescription (misuse or without a doctor's consent) drugs?

 Never have7 or younger89101112131415
Vicodin/Hydrocodone/Lortab
OxyContin, Oxy
Adderall/Ritalin
Morphine
Methadone/Suboxone

22. How old were you when you first used the following street drugs?

 Never have7 or younger89101112131415
Cocaine/Crack
Heroin/Smack
Crystal Meth/Ice/Crank
Hallucinogens (Acid, Angel Dust, Shrooms, Ecstasy, Salvia)

23. How old were you when you first used the following inhalants?

 Never have7 or younger89101112131415
Gas
Aerosol Products
Paint
Glue
Other

24. How many other students do you know that are using the following prescription (misuse or without a doctor's consent) drugs?

 OneTwoThreeFour or more
Vicodin/Hydrocodone/Lortab
OxyContin, Oxy
Adderall/Ritalin
Morphine
Methadone/Suboxone

25. How many other students do you know that are using the following street drugs?

 OneTwoThreeFour or more
Cocaine/Crack
Heroin/Smack
Crystal Meth/Ice/Crank
Hallucinogens (Acid, Angel Dust, Shrooms, Ecstasy, Salvia)

26. How many other students do you know that are using the following inhalants?

 OneTwoThreeFour or more
Gas
Aerosol Products
Paint
Glue
Other

27. How much do you think people risk harming themselves (physically or in other ways) if they used the following prescription (misuse or without a doctor's consent)drugs nearly every day?

 No riskSlight riskModerate riskGreat riskI don't know
Vicodin/Hydrocodone/Lortab
OxyContin, Oxy
Adderall/Ritalin
Morphine
Methodone/Suboxone

28. How much do you think people risk harming themselves (physically or in other ways) if they use the following street drugs?

 No riskSlight riskModerate riskGreat riskI don't know
Cocaine/Crack
Heroin/Smack
Crytal Meth/Ice/Crank
Hallucinogens [Acid, Angel Dust, Shrooms, Ecstasy, Salvia]

29. How much do you think people risk harming themselves (physically or in other ways) if they use the following inhalants?

 No riskSlight riskModerate riskGreat riskI don't know
Gas
Aerosol Products
Paint
Glue
Other

30. How wrong do your parents/families feel it would be for you to use the following prescription drugs (misuse or without a doctor's consent), street drugs, or inhalants at least twice a month?

 Very wrongWrongA little bit wrongNot at all wrongI don't know
Vicodin/Hydrocodone/Lortab
OxyContin, Oxy
Adderall/Ritalin
Morphine
Methadone/Suboxone
Cocaine/Crack
Heroin/Smack
Crystal Meth/Ice/Crank
Hallucinogens [Acid, Angel Dust, Shrooms, Ecstasy, Salvia]
Inhalants [gas, aerosol products, paint, glue, other]

31. In your opinion, how do people who abuse prescription medication (misuse or without consent of a doctor) usually obtain it?

32. If you wanted to, how easy would it be for you to get some beer, wine, or hard liquor (for example: vodka, tequila, whiskey)?

33. The last time you got some beer, wine, or hard liquor (example: vodka, whiskey, or gin), how difficult was it to get?

34. How much do you think people risk harming themselves (physically or in other ways) if they have five or more drinks at a time of beer, wine, or hard liquor (for example: vodka, whiskey, or gin)?

35. How many alcohol (beer, wine, or hard liquor)related automobile crashes do you know of in your community where either someone was killed or someone was injured?