Bow Valley Opioid Task Force

The Bow Valley Opioid Task Force (Members of the Bow Valley Inter-Agency) would like to ask you 10 short questions to help us with a project we've been working on.  To thank you for your participation, at the end of the survey you can enter your email address for a chance to win one of two $50 grocery cards. Email addresses will be kept separate from survey responses. Please be assured that your opinions and responses are kept completely confidential, and are reported anonymously.  Your answers will always be grouped with others who participate. 
The survey will be available until 4:30pm on Monday, January 21,  2019.

Privacy Statement
Information you provide to the Bow Valley Opioid Task Force is collected under the authority of Section 33(c) of the Freedom of Information and Protection of Privacy (FOIP) Act and is managed in accordance with Part 2 of the (FOIP) Act. Your opinions and comments will be used by the Bow Valley Opioid Task Force for the purpose of identifying and assessing issues of concern in the Bow Valley.

By participating in this survey you are giving the Bow Valley Opioid Task Force permission to use your opinions and comments for input into this project. The results of the survey will be analyzed by the Opioid Task Force and documented in a summary report upon completion of the project. Your personal information will not be used without your written consent or unless required to do so by law. Should you wish to have your personal information removed, corrected or if you have any other concerns, please contact: 

Town of Banff Community Services
Tel: 403-762-1251

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* 1. Are you currently living in the Bow Valley area? (Bow Valley includes Banff, Canmore, Exshaw, Kananskis, Lake Louise and MD Bighorn)

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* 2. Which specific area are you currently living in?

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* 3. Are you

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* 4. Are you

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* 5. In your opinion, how serious of a concern are the following in your community

  1
Not Serious at all
2 3
Somewhat serious
4 5
Very serious
I'm not sure
Alcohol use
Impaired Driving 
Cannabis/marijuana use
Tobacco use
Opioid use (fentanyl, heroin)
Obesity
Other recreational drug use (e.g. cocaine, MDMA/Ecstasy)

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* 6. How much do you agree or disagree with each of the following statements?

  1
Completely Disagree
2
Somewhat Disagree
3
Neutral - Neither agree nor disagree
4
Somewhat agree
5
Completely agree
I'm not sure
Fentanyl is present in recreational drugs in the Bow Valley
People just like me use fentanyl or other opioids
Most people who use recreational drugs aren't aware they could be laced with fentanyl
Someone I know could be at risk of a fentanyl or opioid overdose
People just like me use recreational drugs like cocaine or MDMA/ecstasy
I would recognize the signs of a fentanyl or opioid overdose
If I knew that someone was overdosing on opioids, I would know how to help them

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* 7. To the best of your knowledge, which of the following are signs and symptoms of a fentanyl or opioid overdose?

  Yes No I'm not sure
Bluish skin around lips or fingernails
Making gurgling sounds
Increased heart rate/blood pressure
Inability to wake up
Seizures
Stopped breathing
Nausea or vomiting
Talking excessively

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* 8. To the best of your knowledge, which of the following are effective at preventing someone from dying of a fentanyl or opioid overdose?

  Yes No I'm not sure
Calling 911
Chest compressions
Epinephrine
Induce vomiting
Naloxone
Narcan
Rescue breathing

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* 9. Have you noticed the Bow Valley Fentanyl Awareness Campaign around town or on social media?

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* 10. Would you say that the fentanyl awareness campaign has been an effective way to make people aware that fentanyl is in the region and to be aware of the risks?

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* 11. Thank you for taking the time to complete this survey.  If you would like to be entered to win one of two $50 grocery cards, please enter your email address below.  If not, skip this and select "Done".  
The winners will be selected by random draw from all entries received up to January 18th.  The winner will be notified via email and will have one month to claim their prize.  

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