Welcome!

Dear Community Members: Wagoner Community Hospital received a U.S. Department of Health and Human Services Grant to develop a strategy for combating Substance Use Disorder (SUD)/Opioid Use Disorder (OUD) in Wagoner County. Our goal is to strengthen and expand SUD/OUD prevention, treatment, and recovery services in Wagoner County. We are collecting information from members of the community and your input is important to us! Please take a few minutes to complete this survey. Your responses are confidential and your participation is greatly appreciated! If you provide your email address, it will be entered into a raffle drawing for a Gift Card.

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* 1.  Which category best describes you?

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* 2. What is your sex?

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* 3. In what zip code do you live, work or receive treatment services or recovery support?

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* 4. On a typical day, which of the following forms of transportation do you use?

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* 5. Have you ever consumed alcohol and if so at what age?

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* 6. How often do you drink?

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* 7. If you do drink, how much alcohol do you drink at one time? (1 drink is equal to 1 bottle/can beer, 1 4 ounce glass of wine, and 1 ounce shot of liquor). If you don't drink skip to Question 8.

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* 8. Is Alcohol use something you have struggled with/you are currently struggling with?

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* 9. Do you drink to escape pain, either physical or emotional?

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* 10. Is there a history of alcohol in your family?

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* 11. Have you ever sought help for your drinking?

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* 12. Substance Use Disorder (SUD) is defined as the persistent use of drugs despite substantial harm and adverse consequences. Opioid Use Disorder (OUD) is a substance use disorder relating to the use of an opioid. Stigma is defined as a strong feeling of disapproval that most people in a society have about something. Do you think there is a stigma associated with SUD/OUD? If so, please say why you think this is.

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* 13. In your opinion, do you think Wagoner County has a problem with SUD/OUD?

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* 14. How have you been impacted by SUD? Please check all that apply.

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* 15. How have you been impacted by OUD? Please check all that apply to you.

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* 16. Based upon your experiences, what would you say are the top three conditions affecting residents of Wagoner County? Check only three.

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* 17. What services are you aware of that are available in Wagoner County?

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* 18. Have you ever attended a recovery support meeting?

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* 19. Active addiction recovery is defined as being free from addiction or no longer using alcohol or drugs. Are you in active addiction recovery?

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* 20. What is your age group?

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