Resources for Families Impacted by Opioid Use Survey

Resources for Families Impacted by Opioid Use Survey

The Walworth County Drug and Alcohol Coalition remains committed to combatting the negative impact of unhealthy substance use in our community.  To that end, we are requesting feedback from the community to support the development of resources for individuals and families impacted by opioid and other substance use.  We are looking for information regarding the types of services or supports to help:
· promote coping and healing when there has been the loss of a loved one;
·strengthen connections to the community through social and/or recreational engagement; and/or
·build knowledge about and access to healthy alternatives to deal with stress and anxiety.
 
If you or someone you know has been impacted by opioid or other substance use, please feel free to complete the survey.
 
1.How many close family members do you have with a  current substance use disorder?
2.What is the relationship between yourself and your family member with a substance use disorder? (check all that apply)
3.Have you faced any of the following challenges due to your relationship with a family member with a substance use disorder? (check all that apply)
4.Are you currently caring for a child as a result of your family member’s substance use disorder?
5.If yes to question 4, what services would be helpful for you or the child you are caring for?
6.Is funding a barrier for participation in any of the activities listed in question 5?
7.Is transportation a barrier for you?
8.If new services/programs for families impacted by substance use disorders becomes available, would you prefer to attend them in person, online, or both?
9.What is your preferred way to learn about information and services for families impacted by substance use disorders? (If you are willing to provide you name and contact information, please also provide this under the comment box in the "other" section.
10.What area of Walworth County do you reside in?