Heroin Addiction Questionnaire

We are asking for your help as people with an opiate or heroin addiction disease. We have discovered that opiate addiction is genetic! Its not your fault!

We aim to completely revamp the treatment and place it in the hands of doctors. We want to make substitution treatment with suboxone, methodone and others easier to get with less hassle.

We can prove this to the world with your help. It will make a difference in how the country sees addiction as more of a real disease, not a bad person problem.

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* 1. How long have you struggled with addiction?

Less than a year

1-5 years

5-10 years

Over 10 years

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* 2. Do you have family members who struggle with addiction?

Parents/grandparents

Uncles/aunts

Siblings

Cousins

Children/grandchildren

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* 3. How did your addiction start?

A prescription

Given a drug

Experimented with a drug

Other (please specify)

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* 4. Do you remember how it felt the first time you took opiates of any kind?

Extremely desirable/ Euphoric

Very desirable

Somewhat desirable

Not so desirable

Not at all desirable

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* 5. If I could be accepted into a clinic, placed on medical treatment with buprenorphine or methadone, was treated with respect like a human being, and did not have to be clean to enter rehab, I would be interested.

Very likely

Likely

Neither likely nor unlikely

Unlikely

Very unlikely