GIRLS ONLY: Do you abuse prescription drugs?
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1
. You are:
You are:
Male
Female
2
. How old are you?
How old are you?
17 and under
18-24
25-34
35 and over
3
. Have you ever taken prescription drugs for a non-medical reason?
Have you ever taken prescription drugs for a non-medical reason?
Yes
No
4
. If you answered yes, why did you take them? (Check all that apply)
If you answered yes, why did you take them? (Check all that apply)
To help me stay up and study or finish a work project
To fall or stay asleep
To have more fun at a party
To cope with stress or depression
To drop lbs fast
Other (please specify)
5
. Have you ever self-diagnosed your own health problem and treated it with a pill given to by a friend?
Have you ever self-diagnosed your own health problem and treated it with a pill given to by a friend?
Yes
No
6
. What type of prescription meds do you abuse most?
What type of prescription meds do you abuse most?
Drugs that ease pain: Vicodin, Percocet
Drugs that help you focus: Adderall, Ritalin
Drugs that help you chill: Ativan, Valium, Xanax
Drugs that help you sleep: Ambien, Lunesta
Other (please specify)
7
. How many times have you used an rx for a non-medical purpose?
How many times have you used an rx for a non-medical purpose?
Just once
Two or three times
Several times, but not on a regular basis
Regularly, like every week
Every day or couple of days
8
. How common is it among you and your friends to swap prescription meds recreationally?
How common is it among you and your friends to swap prescription meds recreationally?
Very common—no one questions it
Somewhat common—if we need to do it for some reason, it’s no big deal
Not very common
Not common at all
9
. Where did you get the meds you’ve taken? (Check all that apply)
Where did you get the meds you’ve taken? (Check all that apply)
From my doctor—I have an rx for a legit medical reason and keep refilling it
From a doctor—but I fake a reason to get the prescription
From a friend with a prescription
I swipe it from someone’s medicine cabinet
At parties or clubs from random people or friends
I buy then online
Other (please specify)
10
. Do you ever take prescription drugs with alcohol?
Do you ever take prescription drugs with alcohol?
Yes
No
11
. Do the prescription drugs you take ever cause other health issues?
Do the prescription drugs you take ever cause other health issues?
Yes
No
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