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Help us learn more about attitudes and awareness around opioids in our community - anonymously.

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* 1. Using opioids, even for medicinal purposes, can lower your ability to safely accomplish tasks such as driving a motor vehicle (select your level of awareness)

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* 2. Improper use of opioids can lead to an overdose or death (select your level of awareness)

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* 3. I would recognize the signs of an opioid overdose

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* 4. Mixing opioids with alcohol can magnify harmful effects, including the possibility of overdose or death (select your level of awareness)

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* 5. Mixing opioids with other medications can magnify harmful and effects, including the possibility of overdose or death (select your level of awareness)

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* 6. Drugs obtained illegally – including from friends, family or on the street – often contain fentanyl (select your level of awareness)

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* 7. Drugs obtained illegally – including from friends, family or on the street – are often counterfeit and unsafe (select your level of awareness)

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* 8. Have you ever taken someone else’s medication - that is, prescription medication from friends, family or purchased on the street - that was not prescribed to you by your doctor?

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* 9. Have you ever purchased prescription medication – whether one pill or multiple pills – that was not prescribed to you by your doctor?

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* 10. How many deaths in the U.S. – just in 2021 – were directly caused by people taking counterfeit medicines containing Fentanyl or another synthetic opioid?

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* 11. Does knowing how dangerous it is to take medicine that isn’t yours change your attitude towards sharing your medication with other people?

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* 12. Does knowing how dangerous it is to take medicine that isn’t yours change your attitude towards taking or buying medication that has not been prescribed for you?

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* 13. In the past five years, have you deliberately used any products containing opioids, (such as codeine, oxycodone, OxyContin, hydromorphone, morphine, fentanyl, methadone, Tylenol 3, naloxone, Percocet, Percodan, Tylox and heroin) for either medical or recreational purposes?

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* 14. In the past five years, have you accidentally used any products containing opioids, (such as codeine, oxycodone, OxyContin, hydromorphone, morphine, fentanyl, methadone, Tylenol 3, naloxone, Percocet, Percodan, Tylox and heroin) for either medical or recreational purposes?

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* 15. If I had opioids, I would share my opioids to relieve the pain, stress or other problems of a family member or friend

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* 16. If I had opioids, I would share my opioids with others for non-medicinal or recreational use

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* 17. If I was prescribed opioids, I would not want my family members or friends to know

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* 18. If I used opioids without a prescription, I would not want my family members or friends to know

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* 19. In what year were you born?

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* 20. In what state do you live?

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* 21. Which of the following options most closely aligns with your gender?

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* 22. Which race/ethnicity best describes you? (Please choose only one.)

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