This free survey is powered by
0%
Exit Survey
 
 
how old were you when you first became addicted to heroin?
 
10-15
 
15-18
 
18-21
 
Other
 
 
 
 
how did your addiction to heroin change you'r life?
 
Weekly
 
Monthly
 
Quarterly
 
Annually
 
 
 
did the use of heroin make you feel as if you were estranged from human contact?
 
yes
 
no
 
and if so,did you take it out on you'r self?
 
Other
 
 
 
 
did you have to do certain sexual favors to obtain you'r drugs?
yes
no
and if so how did that make you feel as a person?
 
Weekly
 
Monthly
 
Quarterly
 
Annually
 
 
 
How often do you conduct surveys?
 
Weekly
 
Monthly
 
Quarterly
 
Annually
 
Other
 
 
 
 
if you can get help in changing you'r life style, would you take the help? or would you feel like it is to late for you?
 
yes
 
no
 
Other
 
 
 
 
how do you feel about using protection and the rise in std and h.i.v.?
 
answer with a comment.
 
 
 
over all how do you think you'r drug use has affected your family? and what suggestions do you have for them,in how to help you and understanding you'r addiction to heroin?
 
answer with a commrnt.