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Exit Survey
 
 
Which gender do you indentify with?
 
Male
 
Female
 
Other
 
 
 
In which age bracket do you fall?
 
18-22 years
 
23-27 years
 
28-34 years
 
35+ years
 
 
 
What is your current occupation? (Select all that apply)
 
Full-time student
 
Part-time student
 
Apprentice/trainee
 
Employed casually/part-time
 
Employed full-time
 
Not currently employed

 
 

In the past 6 months, how many times (if at all) have you used the following recreational drugs?


0 times 1-2 times 3-4 times 5-9 times 10+ times
Alcohol
Marijuana
Ecstacy/MDMA
Cocaine
GHB
Amphetamines
Ketamine
 
 

On a scale of 0-3 (0 = never, 3 = severe), to what extent have you experienced the following potential immediate harms (i.e. in the hours following ingestion) of ecstacy/MDMA?


0 (never) 1 (mild) 2 (moderate) 3 (severe) Not sure
Vomiting, nausea
Blacking out
Becoming violent or aggressive
Seizure or other acute adverse reaction
Requiring urgent medical assistance
Other
 
 

On a scale of 0-3 (0 = never; 3 = severe), to what extent have you experienced the following potential longer term harms (i.e. in the weeks or months following) of ecstasy/MDMA use?


0 (never) 1 (mild) 2 (moderate) 3 (severe) Not sure
Psychological effects (depression, anxiety, mood swings)
Reduced cognitive ability/efficiency
Insomnia/difficulty sleeping
Physical wellbeing
Addiction or feeling dependent on drugs to 'have fun'
Financial difficulties
Relationship problems (including friends, family and significant other)
Negative impact on student/employment performance
Negative impact on overall quality of life
 
 

On a scale of 0-3 (0 = not at all; 3 = extremely) how concerned are you about the following potential longer term harms (i.e. in the weeks or months following) of ecstasy/MDMA use?


0 (not at all) 1 (mildy concerned) 2 (moderately concerned) 3 (extremely concerned) Not sure
â—‹ Psychological effects (depression, anxiety, general unhappiness)
â—‹ Reduced cognitive ability/efficiency
â—‹ Insomnia/difficulty sleeping
â—‹ Physical wellbeing
â—‹ Addiction or feeling dependent on drugs to 'have fun'
â—‹ Criminal sanctions for being caught by police
â—‹ Other sanctions (eg. Banning) for being caught by venue/event personnel
â—‹ Financial difficulties
â—‹ Relationship problems (including friends, family and significant other)
â—‹ Negative impact on student/employment performance
Negative impact on overall quality of life
 
 
Indicate how often (if ever) you use the following harm minimisation techniques before, during or after ecstasy/MDMA use
Never Rarely Sometimes Often Always
Eating well before/after
Sleeping well before/after
Using vitamins/minerals (Eg. 5HTP) before/after
Staying hydrated during
Monitoring body temperature during
Moderate frequency of use (how often)
Moderate intensity of use (how much ecstasy/MDMA per use)
 
 
 
Rank in order from most useful (1) to least useful (8) how useful the following sources of information are regarding the potential harms of ecstasy/MDMA use:
(If a category does not apply to you please leave it blank)
Peers or siblings
Personal experience
Workmates
Government campaigns
Non-Government campaigns
High school education
University education
Self-guided research
 
 
How would you rate your knowledge/awareness of the following potential harms of ecstacy/MDMA use?:

Do you consider yourself aware of the following potential harms...

Indicate the extent to which you consider yourself to be aware or knowledgeable of the following potential harms



Indicate whether you employ the following harm minimisation strategies before, during and after ecstacy/MDMA use
Very Dissatisfied Not Satisfied Neutral Satisfied Very Satisfied
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