How has heroin and/or prescription drug addiction affected you?
Heroin and opiate abuse has skyrocketed in New Jersey over the last decade. As part of our project on heroin and opiate addiction in New Jersey, published Dec. 15, the Star-Ledger and NJ.com want to know how the drug crisis has affected you -- the drug user or the friend or family member of a user.

The goal is to illustrate the struggle heroin and opiate users have with addiction, and how their problem has impacted those around them. During December, we will periodically update our living wall of stories, which will serve as a reminder that no one living through addiction is suffering alone.

If substance abuse has affected you, please fill out the survey below.

Sign in to Google to save your progress. Learn more
What is your first name? *
How old are you? *
What is your gender? *
What town in New Jersey do you live in or are you from? *
What county are you from? *
What your relationship with addiction or a person who is/was addicted to heroin/opiates? *
How have heroin and/or opiates affected you or someone you know? *
Tell us your story. Be as detailed or as brief as you like.
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.