This survey...
  • Will ask 24 questions about your use of prescription drugs, and some other drugs.
  • Results will be used to help inform and improve prevention programs.
  • Is completely voluntary. You may skip any question that you are not comfortable with.
  • Is completely anonymous. We are not asking for your name or other identifying information.
  • It should take approximately 5 minutes to complete.

 

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* 1. How easy do you think it is for persons your age in your community to obtain prescription  pain relievers (such as Oxycontin, Percocet, Vicodin, Hydrocodone, or Tylox) that were not prescribed to them?

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* 2. How easy do you think it is for persons your age in your community to obtain stimulant pills (such as Ritalin, Adderall, or Concerta) that were not prescribed to them?

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* 3. How easy do you think it is for persons your age in your community to obtain prescription tranquilzers or "benzos," (such as Xanax, Valium, or Ativan) that were not prescribed to them?

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* 4. How easy do you think it is for persons your age in your community to obtain heroin?

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* 5. How easy do you think it is for persons your age in your community to obtain fentanyl?

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* 6. How easy do you think it is for a person your age in your community to obtain carfentanil?

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* 7. How much do people risk harming themselves physically and/or in other ways when they use prescription pain relievers that are not prescribed to them?

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* 8. How much do people risk harming themselves physically and/or in other ways when they use heroin?

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* 9. How much do people risk harming themselves physically and/or in other ways when they use fentanyl?

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* 10. How do you feel about someone your age using prescription pain relievers that are not prescribed to them?

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* 11. How do you feel about a person your age using heroin?

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* 12. During the past 30 days, how many days did you use prescription pain relievers (such as Oxycontin, Percocet, Vicodin, or Tylox) that were not prescribed to you?

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* 13. In the past 30 days, how many days did you use heroin?

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* 14. In the past 30 days, how many days did you use fentanyl?

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* 15. If you used prescription drugs such as pain relievers, stimulants or tranquilizers that were not prescribed to you, how did you get them? Check all that apply.

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* 16. During the past 12 months, have you experienced any of the following due to your use of prescription pain relievers, illicit opioids    (heroin or fentanyl) or other prescription drugs? (check all that apply)

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* 17. Do you know where to get help in Steuben County if you're having concerns with a person's use of illicit drugs?

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* 18. How do you access the internet? Check all that apply.

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* 19. Where do you get your local news?

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* 20. In what ZIP code is your home located? (enter 5-digit ZIP code; for example, 00544 or 94305)

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* 21. What is your age?

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* 22. What is your employment status?

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* 23. Are you currently a student?

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* 24. What is your highest level of education?

0 of 24 answered
 

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