RCORP Planning Grant Assets, Needs, and Gaps Survey for Newfound Community

Question Title

* 1. Where do you currently live?

Alexandria

Bridgewater

Bristol

Danbury

Groton

Hebron

New Hampton

Hill

Other (please specify)

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* 2. What is your age?

Younger than 13 years old

13 to 17 years old

18 to 22 years old

23 to 30 years old

31 to 40 years old

41 to 50 years old

51 to 60 years old

Over 60 years old

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* 3. Do you or does anyone you know misuse Opioids (pain killers such as OxyContin and Vicodin, fentanyl, heroin, etc.)?

Yes

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* 4. Do you or does anyone you know misuse Methamphetamines (Meth, Speed, blue, ice, etc.)?

Yes

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* 5. What do you think is the most pressing drug problem facing the Newfound region?

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* 6. How much of a problem do you think Opioid misuse is in the Newfound region?

Major problem

Moderate problem

Minor problem

Not a problem

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* 7. How much of a problem do you think Methamphetamine (Meth) misuse is in the Newfound region?

Major problem

Moderate problem

Minor problem

Not a problem

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* 8. Who are the most at-risk groups in your community for developing substance use issues and mental health disorders? Mark all that apply.

Teenagers ages 13 - 17

Young adults ages 18 - 32

Incarcerated or formerly incarcerated individuals

Pregnant/Single parenting women

Individuals living in a household with someone misusing substances such as opioids or methamphetamines

Other (please specify)

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* 9. How much of a barrier would each of the items below be if you ever needed to get treatment for substance misuse?

	Not at all	Not really	Unsure	Somewhat	Very much
Fear of losing my family (e.g. partner, children, etc.)	Fear of losing my family (e.g. partner, children, etc.) Not at all	Fear of losing my family (e.g. partner, children, etc.) Not really	Fear of losing my family (e.g. partner, children, etc.) Unsure	Fear of losing my family (e.g. partner, children, etc.) Somewhat	Fear of losing my family (e.g. partner, children, etc.) Very much
Fear of losing my job	Fear of losing my job Not at all	Fear of losing my job Not really	Fear of losing my job Unsure	Fear of losing my job Somewhat	Fear of losing my job Very much
Fear of going to jail/prison	Fear of going to jail/prison Not at all	Fear of going to jail/prison Not really	Fear of going to jail/prison Unsure	Fear of going to jail/prison Somewhat	Fear of going to jail/prison Very much
Others' judgment of me/Stigma	Others' judgment of me/Stigma Not at all	Others' judgment of me/Stigma Not really	Others' judgment of me/Stigma Unsure	Others' judgment of me/Stigma Somewhat	Others' judgment of me/Stigma Very much
My own self-judgment/Shame	My own self-judgment/Shame Not at all	My own self-judgment/Shame Not really	My own self-judgment/Shame Unsure	My own self-judgment/Shame Somewhat	My own self-judgment/Shame Very much
Cost/Lack of health insurance	Cost/Lack of health insurance Not at all	Cost/Lack of health insurance Not really	Cost/Lack of health insurance Unsure	Cost/Lack of health insurance Somewhat	Cost/Lack of health insurance Very much
Lack of transportation	Lack of transportation Not at all	Lack of transportation Not really	Lack of transportation Unsure	Lack of transportation Somewhat	Lack of transportation Very much
Lack of treatment options	Lack of treatment options Not at all	Lack of treatment options Not really	Lack of treatment options Unsure	Lack of treatment options Somewhat	Lack of treatment options Very much
Lack of privacy/confidentiality	Lack of privacy/confidentiality Not at all	Lack of privacy/confidentiality Not really	Lack of privacy/confidentiality Unsure	Lack of privacy/confidentiality Somewhat	Lack of privacy/confidentiality Very much
Lack of childcare	Lack of childcare Not at all	Lack of childcare Not really	Lack of childcare Unsure	Lack of childcare Somewhat	Lack of childcare Very much
Not knowing where to go for help	Not knowing where to go for help Not at all	Not knowing where to go for help Not really	Not knowing where to go for help Unsure	Not knowing where to go for help Somewhat	Not knowing where to go for help Very much

Other (please specify)

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* 10. The use of substances like opioids and/or methamphetamines (meth) is being addressed effectively in my community.

Strongly agree

Somewhat agree

Unsure

Somewhat disagree

Strongly disagree

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* 11. Misusing Opioids and Methamphetamines is associated with a lack of will power.

Strongly agree

Agree

Neither agree nor disagree

Disagree

Strongly disagree

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* 12. I would never seek treatment for a substance use disorder in my own community because of the embarrassment it would bring to me and my family.

Strongly agree

Agree

Neither agree nor disagree

Disagree

Strongly disagree

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* 13. Naloxone (Narcan) is used to reverse the effects of an opioid overdose and can save lives. It is administered using a needle or a nasal spray. Community members can be trained to administer naloxone and some providers may offer naloxone at no cost. My town has providers that offer naloxone.

Yes

Unsure

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* 14. Addiction specialists are medical and mental health professionals (like primary care providers/doctors, psychiatrists, psychologists, social workers, and counselors) who are specially trained and licensed to treat people with substance use disorders. They provide addiction services such as prevention, screening, intervention, and treatment for substance misuse. My town would benefit from having/having more addiction specialists available.

Strongly agree

Somewhat Agree

Unsure

Somewhat Disagree

Strongly disagree

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* 15. Please share any additional comments you have regarding Substance Use Disorders (Opioids/Methamphetamines/etc.) and/or the prevention, treatment, and recovery services available in the Newfound region.

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* 16. What strengths/assets/resources are already available in the Newfound community for substance use disorder treatment?

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* 17. What resources are already available in the Newfound community for substance use disorder recovery?

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* 18. What is missing or needed for strong substance use services, such as prevention, treatment, and recovery?

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* 19. What is one priority that you would like to see implemented to address youth (under 18 years of age) substance misuse in our region?

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* 20. What is one priority that you would like to see implemented to address young adult (ages 18 - 32) substance misuse in our region?

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* 21. What do you think our community should do to better address substance misuse issues?

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* 22. Please share any additional comments you have regarding Substance Use Disorders (Opioids/Methamphetamines/etc.) and/or the prevention, treatment, and recovery services available in the Newfound region.

RCORP Planning Grant Assets, Needs, and Gaps Survey for Newfound Community

Newfound Community Survey

Question Title

* 1. Where do you currently live?

Question Title

* 2. What is your age?

Question Title

* 3. Do you or does anyone you know misuse Opioids (pain killers such as OxyContin and Vicodin, fentanyl, heroin, etc.)?

Question Title

* 4. Do you or does anyone you know misuse Methamphetamines (Meth, Speed, blue, ice, etc.)?

Question Title

* 5. What do you think is the most pressing drug problem facing the Newfound region?

Question Title

* 6. How much of a problem do you think Opioid misuse is in the Newfound region?

Question Title

* 7. How much of a problem do you think Methamphetamine (Meth) misuse is in the Newfound region?

Question Title

* 8. Who are the most at-risk groups in your community for developing substance use issues and mental health disorders? Mark all that apply.

Question Title

* 9. How much of a barrier would each of the items below be if you ever needed to get treatment for substance misuse?

Question Title

* 10. The use of substances like opioids and/or methamphetamines (meth) is being addressed effectively in my community.

Question Title

* 11. Misusing Opioids and Methamphetamines is associated with a lack of will power.

Question Title

* 12. I would never seek treatment for a substance use disorder in my own community because of the embarrassment it would bring to me and my family.

Question Title

* 13. Naloxone (Narcan) is used to reverse the effects of an opioid overdose and can save lives. It is administered using a needle or a nasal spray. Community members can be trained to administer naloxone and some providers may offer naloxone at no cost. My town has providers that offer naloxone.

Question Title

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* 15. Please share any additional comments you have regarding Substance Use Disorders (Opioids/Methamphetamines/etc.) and/or the prevention, treatment, and recovery services available in the Newfound region.

Question Title

* 16. What strengths/assets/resources are already available in the Newfound community for substance use disorder treatment?

Question Title

* 17. What resources are already available in the Newfound community for substance use disorder recovery?

Question Title

* 18. What is missing or needed for strong substance use services, such as prevention, treatment, and recovery?

Question Title

* 19. What is one priority that you would like to see implemented to address youth (under 18 years of age) substance misuse in our region?

Question Title

* 20. What is one priority that you would like to see implemented to address young adult (ages 18 - 32) substance misuse in our region?

Question Title

* 21. What do you think our community should do to better address substance misuse issues?

Question Title

* 22. Please share any additional comments you have regarding Substance Use Disorders (Opioids/Methamphetamines/etc.) and/or the prevention, treatment, and recovery services available in the Newfound region.