Fayette County Community Stigma Survey July 2018

Community Behavior Assessment in Relation to Opioid Use Disorder and Opioid Related Overdoses

Baseline Survey of the Community

Please indicate your age:

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* 1. Please indicate your age:

Please indicate your gender:

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* 2. Please indicate your gender:

Please indicate your race:

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* 3. Please indicate your race:

Please indicate your highest completed level of education:

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* 4. Please indicate your highest completed level of education:

Please indicate if you currently have or previously had a substance use disorder:

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* 5. Please indicate if you currently have or previously had a substance use disorder:

Please indicate if someone you know currently has or previously had a substance use disorder:

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* 6. Please indicate if someone you know currently has or previously had a substance use disorder:

Please indicate your occupation: 

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* 7. Please indicate your occupation: 

Please indicate your zip code and county of residence: 

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* 8. Please indicate your zip code and county of residence: 

Please indicate the degree to which you agree with the following statements:

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* 9. Please indicate the degree to which you agree with the following statements:

  Strongly Disagree Disagree Uncertain Agree Strongly Agree
If a person is addicted to a prescription opioid they can stop using it if they really want to.
An individual with a substance use disorder is irresponsible.
Increasing access and utilization of naloxone is a good solution to the current opioid epidemic.
Increasing access and utilization of naloxone provides individuals with a substance use disorder an excuse to continue use.
Substance use disorder treatment is very effective.
Anyone can become addicted to pain medications.
An individual with a substance use disorder is selfish.
Please indicate the degree to which you agree with the following statements:

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* 10. Please indicate the degree to which you agree with the following statements:

  Strongly Disagree Disagree Uncertain Agree Strongly Agree
I would willingly live in the same neighborhood as an individual with a substance use disorder.
I would willingly administer naloxone to a stranger in any overdose situation.
Naloxone should be administered to every individual who is experiencing an overdose, everytime.
Substance use disorders only affects individuals with low incomes.
An overdose related to prescription opioids is the same as an overdose related to heroin.
I can easily spot an individual in my community with a substance use disorder.
Substance use disorders only affect certain races.
Please indicate the degree to which you agree with the following statements:

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* 11. Please indicate the degree to which you agree with the following statements:

  Strongly Disagree Disagree Uncertain Agree Strongly Agree
A substance use disorder is a real illness.
I would be embarrassed to tell people that someone close to me has a substance use disorder.
Medication-assisted treatment (i.e. Methadone, Suboxone, Vivitrol) is a viable form of treatment for substance use disorder.
If I thought my friend had a substance use disorder I would stay away from them.
Individuals with a substance use disorder are likely to be dangerous.
An individual with a substance use disorder should have the same right to a job as anyone else.
It is important for individuals with a substance use disorder to be part of a supportive community.
Substance use disorders only affect adults.
Please indicate the degree to which you agree with the following statements:

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* 12. Please indicate the degree to which you agree with the following statements:

  Strongly Disagree Disagree Uncertain Agree Strongly Agree
It is more important to spend money on treating conditions like diabetes and heart disease instead of substance use disorders.
Abstinence based therapy is the only successful form of treatment for substance use disorders.
Using words like ‘addict’, ‘junkie’, and ‘abuser’ are harmless. No one gets hurt.
There should be a limit to how many times an individual can receive naloxone for an overdose.
If a person is addicted to heroin, they can stop using whenever they want.
Individuals who receive rehabilitation or treatment will use or overdose again.

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