Sociology Project: Survey

Fri, 04 Jan 2008 01:41:04 GMT

important:
- the link for the survey is located in the cut below; just copy&paste it into a comment and leave it on this entry.
- some answers will be longer than the comment limit; just post separate parts in separate comments if this applies to you.
- all comments will be screened, meaning that no one can see your answers except for me.
- anonymous posting is definitely allowed.
- honesty is very much appreciated.
- elaborating is very much appreciated - give all the information that you want, regardless of whether or not you think it's necessary or relevant.
- the main question being asked here for my project is what factors of life/socialization affect one's drug use. this survey is not only for those who are addicted to drugs, but also for those who just have a lot of experience, and are willing to share.

thank you (in advance) for your time and honesty.

SURVEY
PT. I - BASIC INFORMATION
[all locations won't be disclosed in final report]
current age:
gender:
ethnicity:
location:
medical conditions (psychological disorders, injuries, genetic disorders, anything that you think counts):

PT. II - DRUG HISTORY
[X the box next to any drugs you have tried. for 'ages used', include your age the first time you tried this, and include the other ages you used this (for example, 12-15). for 'usage', indicate how often you used the drug (tried once, tried a few times, every weekend, whatever).]
FIRST OFF:
what was your first drug?
what is/was your drug of choice?

[ ] 2ce/2ci
ages used:
usage:
[ ] alcohol
ages used:
usage:
[ ] cocaine
ages used:
usage:
[ ] crack
ages used:
usage:
[ ] DMT
ages used:
usage:
[ ] DXM (over-the-counter cough meds, triple c's, ect.)
ages used:
usage:
[ ] heroin
ages used:
usage:
[ ] inhalants
ages used:
usage:
[ ] LSD/acid
ages used:
usage:
[ ] marijuana
ages used:
usage:
[ ] MDMA/ecstasy
ages used:
usage:
[ ] methamphetamine
ages used:
usage:
[ ] mushrooms
ages used:
usage:
[ ] opium
ages used:
usage:
[ ] prescribed barbiturates (fiorinal, luminal, seconal, ect.)
ages used:
usage:
[ ] prescribed benzodiazipemes (xanax, valium, klonopin, rohypnol, ect.)
ages used:
usage:
[ ] prescribed pain killers (oxycontin, percocet, vicodin, ect.)
ages used:
usage:
[ ] prescribed stimulants (ritalin, concerta, adderall, ect.).
ages used:
usage:
[ ] salvia
ages used:
usage:
[ ] speed
ages used:
usage:
[ ] special k
ages used:
usage:

PT. III - CHECK THOSE THAT APPLY
[any elaborations are welcome and encouraged.]
[ ] self-image issues
[ ] eating disorder
[ ] rape victim
[ ] abuse/harassment victim
____[ ] physical
____[ ] mental
____[ ] sexual
[ ] bullied in school
[ ] high class
[ ] middle class
[ ] lower class
[ ] addiction/drug abuse in immidiate family
[ ] addiction/drug abuse in extended family
[ ] parents are divorced
[ ] raised by a single parent
[ ] adopted
[ ] cigarette smoker
[ ] only child
[ ] boyfriend/girlfriend abused drugs
[ ] closest group of friends abused drugs
[ ] school had an anti-drug education program
[ ] lived in an urban neighborhood
[ ] lived in a suburban neighborhood
[ ] lived in a rural neighborhood
[ ] depression
[ ] anxiety
[ ] unemployed
[ ] under a health care program
[ ] experienced loss or trauma at a young age
[ ] gay
[ ] straight
[ ] bi
[ ] raised in a foster home
[ ] juvenile delinquent home
DO YOU:
[ ] consider yourself an addict/recovered addict
[ ] consider yourself as a person who just likes to experiment

PT. IV - OPEN-ENDED
01. describe your peers/friends - [did any of them in particular encourage or discourage drug use?]

02. describe your parents/guardians - [their discipline styles, your relationship, your living arrangement, ect.]

03. describe your education - [did your school have an anti-drug program (like D.A.R.E.)? what age? what were the consequences for possession/usage on school property? were drugs around a lot at school?]

04. describe your locations/past residences - did the environment have any effect on your drug use?

05. have you ever quit or attempted to quit? was there a specific reason? how long were you clean for?

06. has pop culture/mass media had an affect on your drug use? [anti-drug ads, documentaries, celebrities using drugs, music/movies/books on drugs, ect.]

0012230208

Sociology Project: Survey