Prescription Painkiller Survey

Please note that this is a confidential survey. Please answer honestly as we are trying to get a real idea of how prescription painkillers are possibly affecting the lives of our readers. We will NOT share ANY information with outside sources.

1. Have you ever tried a painkiller not prescribed to you?

Have you ever tried a painkiller not prescribed to you? Yes

2. If yes, why?

If yes, why? I was under a lot of stress

Peer pressure

I had low self-esteem / a desire to fit in

I was curious what it would be like

Other (please specify)

3. Do you feel prescription painkiller abuse is common among girls your age?

Do you feel prescription painkiller abuse is common among girls your age? Yes

I’m not really sure

4. If you’ve ever taken a painkiller not prescribed to you, how old were you when you first tried it? Never taken a painkiller? Please jump to question 21.

If you’ve ever taken a painkiller not prescribed to you, how old were you when you first tried it? Never taken a painkiller? Please jump to question 21. 9 or younger

19 or older

5. What painkillers have you tried? Check all that may apply.

What painkillers have you tried? Check all that may apply. Vicodin

OxyContin

Percocet

Other (please specify)

6. How often do you take painkillers not prescribed to you?

How often do you take painkillers not prescribed to you? Daily

Almost daily

A couple times a week

Only once in a while

Other (please specify)

7. How do you usually get these painkillers? Check all that may apply.

How do you usually get these painkillers? Check all that may apply. I take them from the medicine cabinet at home

I grab them from another family member’s medicine cabinet

I get them from someone at school

I usually find them at a party

I get them from my friends

Other (please specify)

8. What kind of environment do you usually take painkillers not prescribed to you? Check all that may apply.

What kind of environment do you usually take painkillers not prescribed to you? Check all that may apply. At a party

At a gathering with a group of friends

When I’m with one or two friends

Alone

Other (please specify)

9. Why do you take painkillers in this type of setting? Please explain.

Why do you take painkillers in this type of setting? Please explain.

10. Please describe how prescription painkillers make you feel.

Please describe how prescription painkillers make you feel.

11. Do you have any health concerns about taking painkillers not prescribed to you? Please explain what they are and why.

Do you have any health concerns about taking painkillers not prescribed to you? Please explain what they are and why.

12. Have you ever been caught with painkillers not prescribed to you?

Have you ever been caught with painkillers not prescribed to you? Yes

13. If yes, who caught you? Check all that may apply.

If yes, who caught you? Check all that may apply. Parents

Sibling

Friend who didn’t know you were taking them

Teacher

Coach

Law enforcement officer

Other (please specify)

14. How did you feel when you got caught? Please explain.

How did you feel when you got caught? Please explain.

15. Have you ever been in rehab for prescription painkiller abuse?

Have you ever been in rehab for prescription painkiller abuse? Yes

16. Have you tried any other drugs besides prescription painkillers? Check all that may apply.

Have you tried any other drugs besides prescription painkillers? Check all that may apply. Heroine

Cocaine

Marijuana

LSD

Ecstasy

Other prescription medication

I’ve only tried prescription painkillers

Other (please specify)

17. Have you ever mixed prescription painkillers with other drugs or alcohol?

Have you ever mixed prescription painkillers with other drugs or alcohol? Yes

18. If yes, what kind of drugs or alcohol did you mix it with? Please explain.

If yes, what kind of drugs or alcohol did you mix it with? Please explain.

19. Have you ever stolen anything because of painkillers?

Have you ever stolen anything because of painkillers? Yes

20. If yes, what? Please explain.

If yes, what? Please explain.

21. Do you think it’s easy for someone to become addicted to prescription painkillers?

Do you think it’s easy for someone to become addicted to prescription painkillers? Yes

22. Why / why not?

Why / why not?

23. Do you think taking a painkiller not prescribed to you is dangerous?

Do you think taking a painkiller not prescribed to you is dangerous? Yes

24. Why / why not?

Why / why not?

25. Do you think it’s easier to get painkillers than other sorts of drugs?

Do you think it’s easier to get painkillers than other sorts of drugs? Yes

I'm not really sure

26. If yes, why?

If yes, why?

27. Do you think it’s safer to take painkillers than other types of drugs?

Do you think it’s safer to take painkillers than other types of drugs? Yes

I'm not really sure

28. Why / why not?

Why / why not?

29. Have you ever been prescribed a painkiller by a doctor for a medical reason (ie a broken bone, tooth extraction)?

Have you ever been prescribed a painkiller by a doctor for a medical reason (ie a broken bone, tooth extraction)? Yes

30. If yes, what did you do with any leftover painkillers?

If yes, what did you do with any leftover painkillers? I threw them out

I flushed them down the toilet

I gave them to a friend

My parents took them and locked them away

I still have them

Other (please specify)

31. Has anyone ever approached you about selling your prescription painkillers to them?

Has anyone ever approached you about selling your prescription painkillers to them? Yes

32. Has anyone ever approached you about buying painkillers from them?

Has anyone ever approached you about buying painkillers from them? Yes

33. If yes, where were you?

If yes, where were you?

34. Do you know someone who is abusing prescription painkillers?

Do you know someone who is abusing prescription painkillers? Yes, I know for a fact

No, definitely not

I think so, but I’m not sure

I don’t personally know someone, but have heard of people abusing them

35. If yes, who? Please select all that may apply.

If yes, who? Please select all that may apply. My friend

A sibling

My boyfriend

A classmate

Other (please specify)

36. If you do know someone who might be abusing prescription painkillers, how does that make you feel? Please explain.

If you do know someone who might be abusing prescription painkillers, how does that make you feel? Please explain.

37. Has a friendship or relationship of yours ever been affected by someone who might be abusing prescription painkillers?

Has a friendship or relationship of yours ever been affected by someone who might be abusing prescription painkillers? Yes

38. If yes, please explain how it affected you.

If yes, please explain how it affected you.

39. Have you ever hung out with someone when they were high off painkillers?

Have you ever hung out with someone when they were high off painkillers? Yes

I'm not really sure

40. If yes, what was that experience like? Please explain.

If yes, what was that experience like? Please explain.

41. Please tell us why you choose to NOT take painkillers that aren’t prescribed to you. Check all that may apply.

Please tell us why you choose to NOT take painkillers that aren’t prescribed to you. Check all that may apply. It’s illegal, I don’t want to risk my future

I heard there are really bad side effects. I don’t want to risk my life

It’s not my thing, I don’t need drugs in my life

It scares me, I know people or have heard of people who have gotten really messed up because of them

I just never had the opportunity

Other (please specify)

42. How can girls out there help a friend whom they think might be abusing prescription painkillers?

How can girls out there help a friend whom they think might be abusing prescription painkillers?

43. What’s your first name and last initial? Note: We are changing all names for this story, so your answers will remain anonymous.

What’s your first name and last initial? Note: We are changing all names for this story, so your answers will remain anonymous.