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'Dispelling Stigma' Post-Gallery Survey
Please answer these questions after reading the information in the 'Dispelling Stigma' gallery. We appreciate your participation and honest feedback!
My age is:
What is your gender identity?
Male
Female
Transgender
Gender non-conforming
Non-binary/third gender
Declined
Unknown
Other
What is your racial identity? (Check all that apply)
Alaska Native
American Indian
Asian
Black or African American
Native Hawaiian/Pacific Islander
White or Caucasian
Declined
Unknown
Other
What is your ethnicity? (Check all that apply)
Hispanic or Latino
Non-Hispanic or Latino
Declined
Unknown
Other
I have a history of substance use disorder.
Yes
No
Prefer not to say
My drug of choice was/is:
None
Alcohol
Cannabis (marijuana, pot, grass, hash, etc.)
Cocaine (coke, crack, etc.)
Hallucinogens (LSD, acid, mushrooms, PCP, Special K, ecstasy, etc.)
Inhalants (nitrous oxide, glue, gas, paint thinner, etc.)
Methamphetamine (speed, crystal meth, ice, etc.)
Prescription opioids (fentanyl, oxycodone [OxyContin, Percocet], hydrocodone [Vicodin], methadone, buprenorphine, etc.)
Prescription stimulants (Ritalin, Concerta, Dexedrine, Adderall, diet pills, etc.)
Sedatives, depressants or sleeping pills (Valium, clonazepam, alprazolam, phenobarbital, Serepax, Ativan, Librium, Xanax, Rohypnol, GHB, etc.)
Street opioids (heroin, opium, etc.)
Declined
Unknown
I have a family member or someone close to me with a history of substance use disorder.
Yes
No
Prefer not to say
The drug of choice of the family member or person close to me was/is:
None
Alcohol
Cannabis (marijuana, pot, grass, hash, etc.)
Cocaine (coke, crack, etc.)
Hallucinogens (LSD, acid, mushrooms, PCP, Special K, ecstasy, etc.)
Inhalants (nitrous oxide, glue, gas, paint thinner, etc.)
Methamphetamine (speed, crystal meth, ice, etc.)
Prescription opioids (fentanyl, oxycodone [OxyContin, Percocet], hydrocodone [Vicodin], methadone, buprenorphine, etc.)
Prescription stimulants (Ritalin, Concerta, Dexedrine, Adderall, diet pills, etc.)
Sedatives, depressants or sleeping pills (Valium, clonazepam, alprazolam, phenobarbital, Serepax, Ativan, Librium, Xanax, Rohypnol, GHB, etc.)
Street opioids (heroin, opium, etc.)
Declined
Unknown
For a person with substance use disorder, I believe the biggest reason for not asking for treatment when they need it is:
Did the information shared in the display cause you to think back to things you have said or ways you have attempted to help someone with substance use disorder?
Yes
No
If you could go back, would you change things in that situation?
Yes
No
Do you think you will make changes in your future interactions with, or conversations about, people with substance use disorder as a result of the information you learned today?
Yes
No
What is one thing that really stuck out to you in the 'Dispelling Stigma' gallery?
Would you add anything to this display?
Would you remove anything from this display?
Is there any additional information you wish to share with us?
Stigma and Harm Reduction
Do you think people who use drugs are treated unfairly or stereotyped because of their drug use?
Yes
No
Not sure/don't know
Declined to answer
Do you think substance use disorder is a
Brain disease
Personal choice
Not sure/don't know
Declined to answer
Other
Are you comfortable talking about your substance use with family/friends?
Yes, comfortable
No, not comfortable
Not sure/don't know
Declined to answer
Do you think that Narcan kits, fentanyl test strips and syringe exchange are helpful for people with substance use disorder?
Helpful
Not helpful
Not sure/don't know
Declined to answer
Other
Submit
Should be Empty: