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Substance Abuse Youth Survey

Youth Substance Abuse

The purpose of this questionnaire is to assess substance use in Escambia, Santa Rosa, and Okaloosa counties among residents ages 13-19. Your participation and the information you provide will help determine the need for substance abuse programs for youth. 

In this survey, the word “Substances” refers to ALL illegal drugs, prescription medications (not prescribed to self), and alcohol.
1.What is your current age:
2.What is your gender?
3.What is the name of the last school you attended or the school you are currently attending?
4.Have you EVER used: (choose all that apply)
5.In the past month have you used: (Choose all that apply)
6.In the past 12 months have you used: (Choose all that apply)
7.Have you ever used substances to relax, feel better about yourself, or fit in?
8.Have you ever used substances alone?
9.Have you ever been in trouble at school as a result of substance use?
10.Have you ever been in trouble at home as a result of substance use? 
11.Do you know of anyone from school who is currently using substances? (Choose all that apply)
12.Have you ever been in a car driven by someone (including yourself) who was “high” or under the influence of alcohol?
13.Have you heard of Fentanyl? 
14.Have you or anyone you know ever tried a drug with Fentanyl? (select all that apply)
15.Do you have access to Narcon in your home?
16.Have you ever been offered or asked to take part in drugs other than marijuana? 
17.Have you ever used or considered using substances because others around you are using them? 
18.Would you say a majority of your social group uses drugs? 
19.Do you know of someone currently using substances who should seek or be offered help? 

(select all that apply)
20.Do you know of anyone under the age of 21 who is currently in or who has gone to rehab for substance abuse?
21.If you are currently using substances, do you wish you could stop?
22.If you are currently using substances, have you tried to stop using in the past?
23.Has anyone ever told you that you should stop or slow down on your substance use? 
24.Have you ever asked for help to stop or slow down your substance use? 
25.Do you know where you or a friend could find help locally for substance abuse?
Current Progress,
0 of 25 answered