Drug Use Survey
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1
. What age group are you in?
What age group are you in?
17-19
20-29
30-39
40-49
50+
*
2
. Which of the following drugs do you use?
Which of the following drugs do you use?
Alcohol
Tobacco
Cannabis
MDMA / ecstasy
Cocaine
Opiades / Heroin
Amphetamine
Other (please specify)
*
3
. How often do you use drugs?
How often do you use drugs?
Sometimes (1-2 times a month)
Occasionally (1-2 times a week)
Most of the time (nearly everyday)
Everyday
*
4
. We are interested in your overall well-being. Thinking just about the last 12 months:
Not Satisfied
Satisfied
Very Satisfied
N/A
Your standard of living
*
We are interested in your overall well-being. Thinking just about the last 12 months: Your standard of living Not Satisfied
Your standard of living Satisfied
Your standard of living Very Satisfied
Your standard of living N/A
Your health
Your health Not Satisfied
Your health Satisfied
Your health Very Satisfied
Your health N/A
What you are achieving in life
What you are achieving in life Not Satisfied
What you are achieving in life Satisfied
What you are achieving in life Very Satisfied
What you are achieving in life N/A
Your personal relationships
Your personal relationships Not Satisfied
Your personal relationships Satisfied
Your personal relationships Very Satisfied
Your personal relationships N/A
How safe you feel
How safe you feel Not Satisfied
How safe you feel Satisfied
How safe you feel Very Satisfied
How safe you feel N/A
Feeling part of your community
Feeling part of your community Not Satisfied
Feeling part of your community Satisfied
Feeling part of your community Very Satisfied
Feeling part of your community N/A
Your future security
Your future security Not Satisfied
Your future security Satisfied
Your future security Very Satisfied
Your future security N/A
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