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* 1. What is your age?

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* 2. What is your gender?

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* 3. What is the highest grade completed?

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* 4. County that you live in

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* 5. Do you think Substance Misuse is a serious problem for adults in Washington County?

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* 6. Do you think Substance Misuse is a serious problem for Youth in Washington County?

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* 7. Which substances below are opioids or contain opioids?

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* 8. Please write in the street names of some illegal substances being used in Washington County?

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* 9. What kind of prescription medication have you shared with friends or family?

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* 10. Has anyone offered you money or something of value for your pain medication?

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* 11. Has anyone stolen pain medication, stolen money or valuables from you to buy drugs?

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* 12. Which substances do you worry about the most? (Pick your top two)

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* 13. Do you know anyone who has misused prescription medication?

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* 14. If yes to the above question (number 13), do you think it was on purpose?

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* 15. Do you have family or friends who have suffered from a substance use problem?

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* 16. Do you know where to seek help for yourself, family or friends for a substance use problem in Washington County?

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* 17. Out of the items listed below what are the 3 most difficult challenges people faces when trying to get help with substance misuse? (Pick 3)

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* 18. What do think are the 3 biggest reasons people in Washington County misuse substances? (pick 3)

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* 19. Is it illegal to carry prescriptions with you in anything other than a prescription bottle with your name on it?

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* 20. Do you think Narcan (opioid reversing medication) is useful in fighting this crisis?

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* 21. Do you consider Vaping a problem with adults in Washington County?

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* 22. Do you consider vaping a problem with youth in Washington County?

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* 23. What are your thoughts on the Opioid epidemic/crisis facing Washington County and the Nation?

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