Prescription Drug Disposal Pre-Survey

This survey will be used by The Alcohol and Drug Abuse Prevention Team: The Essex Prevention Coalition, better know as ADAPT, to understand the current knowledge of our community members regarding the disposal of prescription drugs. Please be honest when answering the questions. This survey is completely anonymous. Thank you for in advance for your help in assisting ADAPT serve your community better. Check us out online at www.essexadapt.org and on our various Social Media accounts.

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* 1. Do you keep your prescription drugs in a locked cabinet?

Yes

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* 2. Have you every disposed of any old or unused prescription drugs?

Yes

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* 3. How have you disposed of your old or unused prescription drugs? (Check all that apply)

Flush them down the toilet

Throw them in the garbage

Mix them with coffee grounds and put them in the garbage

Mix them with cat litter and put them in the garbage

Brought them to a location during Drug Take Back Day or a Drug Take Back activity

Brought them to a permanent prescription drug disposal box

Other (please specify)

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* 4. Have you ever attended a Drug Take Back Day event or activity?

Yes

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* 5. Do you keep track of your prescription drugs (i.e., have a count of the number of pills left, a daily log of the amount used)?

Yes

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* 6. If you answered "Yes" to Question #5, please specify how you monitor your prescription drugs

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* 7. Which category below includes your age?

12-17

18-25

26-40

40-65

65 or older

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* 8. I am a (check all that apply)

Community Member

Student in Middle School

Student in High School

Student in College

Parent/Guardian of a child in Elementary School

Parent/Guardian of a child in Middle School

Parent/Guardian of a child in High School

Parent/Guardian of a child in College

Grandparent of a child in Elementary School

Grandparent of a child in Middle School

Grandparent of a child in High School

Grandparent of a child in College

Member of a religious organization, community organization, etc. (please state the name and location)

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* 1. Do you keep your prescription drugs in a locked cabinet?

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* 2. Have you every disposed of any old or unused prescription drugs?

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* 3. How have you disposed of your old or unused prescription drugs? (Check all that apply)

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* 4. Have you ever attended a Drug Take Back Day event or activity?

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* 5. Do you keep track of your prescription drugs (i.e., have a count of the number of pills left, a daily log of the amount used)?

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* 6. If you answered "Yes" to Question #5, please specify how you monitor your prescription drugs

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* 7. Which category below includes your age?

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* 8. I am a (check all that apply)

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* 9. In what city do you live?