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1. School District: (Required.)

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2. Choose the date below that you are taking this survey: (Required.)

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3. How old are you? (Required.)

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4. Are you male or female? (Required.)

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5. What is your ethnic background? (Required.)

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6. How many times have you tried each of the drugs below in your lifetime? (Required.)

  0 times 1-10 times 11-20 times 20-50 times more than 50 times
Tobacco
Alcohol
Marijuana (Weed)
Cocaine (Crack)
Hallucinogens (LSD, Acid, Mushrooms)
Stimulants (Speed, Meth)
Inhalants (Rush, Nitrous)
Non-prescribed prescription/other medicines
Other (Depressants, PCP, Steroids, Heroin, etc)

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7. How many times have you used each of the drugs below in the last month (30 days)? (Required.)

  0 times 1-10 times 11-20 times 20-50 times more than 50 times
Tobacco
Alcohol
Marijuana (Weed)
Cocaine (Crack)
Hallucinogens (LSD, Acid, Mushrooms)
Stimulants (Speed, Meth)
Inhalants (Rush, Nitrous)
Non-prescribed prescription/other medicines
Other (Depressants, PCP, Steroids, Heroin, etc)

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8. Which of the following is not an effective communication skill? (Required.)

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9. An open mind means you are... (Required.)

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10. What percent of students use LSD weekly? (Required.)

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11. What is a self-fulfilling prophecy? (Required.)

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12. Which of the following is NOT a myth of drug use? (Required.)

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13. "Reinterpretation" of drug use consequences means... (Required.)

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14. Difficulty concentrating, urges, sometimes sweating, irritability and restlessness are signs of what? (Required.)

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15. Why might a person in a family affected by drug use feel that he or she must overachieve? (Required.)

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16. What is the best thing to do to support someone who has a drug problem? (Required.)

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17. Which of the following areas of your life may suffer due to marijuana abuse? (Required.)

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18. In terms of damage to the lining of your lungs, two joints are equivalent to how many cigarettes? (Required.)

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19. Which of the following is a good way to deal with tobacco use withdrawal symptoms? (Required.)

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20. What is the third leading cause of preventable death? (Required.)

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21. How many known or suspected cancer-causing substances have been found in tobacco smoke? (Required.)

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22. What does "COPE" stand for? (Required.)

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23. Does drug use cause stress? (Required.)

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24. Laughing at a funeral is an example of... (Required.)

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25. What are the consequences of having negative thoughts? (Required.)

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26. Does drug use lead to negative thinking? (Required.)

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27. What does it mean to have a radical view? (Required.)

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28. A traditional view of gun control would be... (Required.)

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29. What is brainstorming? (Required.)

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30. How likely is it that you will use the following drugs in the next year (12 months)? (Required.)

  definitely not probably not a little likely somewhat likely very likely
Tobacco
Alcohol
Marijuana (Weed)
Cocaine (Crack)
Hallucinogens (LSD, Acid, Mushrooms)
Stimulants (Speed, Meth)
Inhalants (Rush, Nitrous)
Non-prescribed prescription/other medicines
Other (Depressants, PCP, Steroids, Heroin, etc)

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