EMHC & Fruit Loop Edmonton LGBTQ2S+ Substance Use Consultation
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Based on the description above, do you consent to participating in this survey?
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Eligibility Step One
Are you someone who currently uses or has used substances, other than alcohol or marijuana, who also identifies as a sexual or gender minority... or as someone who has had sex with another person of the same gender in the last twelve months?
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Thank you for your interest
Eligibility Step Two
In the LAST TWELVE MONTHS, have you used substances (i.e. drugs) other than alcohol and marijuana? [Note: For the purposes of this survey, substance use DOES NOT include prescription drugs if you are using them AS PRESCRIBED by your healthcare provider. It does include prescription drug use if you are NOT taking them as prescribed by your healthcare provider].
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Basic Information About You
What is your age, in years?
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What are the first three digits of your postal code?
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Which of the following options best describe your gender identity? Select all that apply. If none of these options are suitable, please feel free to write your own answer next to the option which reads "other."
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Which of the following options best describe your sexual orientation? Select all that apply. If none of these options are suitable, please feel free to write your own answer next to the option which reads "other."
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Do you identify as any of the following? (Select all that apply)
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What is your employment status? (Check all that apply)
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What is the highest level of education you completed?
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Please indicate whether the following are very true, a little true, or not true about your current financial situation.
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The following questions relate to your housing stability.
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Please answer the following:
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Personal Substance Use Experience
The purpose of this survey is to learn more about your use of opioids and/or other substances. Therefore, "substance use" does NOT include alcohol or marijuana unless specifically mentioned in the question. In addition, it does NOT include prescription drugs UNLESS used without a prescription or with a prescription but more often or in greater amounts than prescribed. Please confirm that you understand this before completing the rest of this section.
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If you had to, how would you rate your overall mental health and wellbeing over the past twelve months?
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Do you feel that your overall mental health and wellbeing affected your substance use over the past twelve months?
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If you had to, how would you rate your overall satisfaction with your social support network over the past twelve months (i.e. friends, family, colleagues, and/or others you can socialize with and who can support you if needed)?
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Do you feel that your satisfaction or dissatisfaction with your social support network affected your substance use over the past twelve months?
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How often have you used the following substances in the past year (12 months)?
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During the past 12 months, did you use any of the following substances within 2 hours before sex or during sex? (CHECK ALL THAT APPLY)
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Which of the following is your primary motivator for having sex while high? (select one)
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In the past 12 months, what portion of your sexual encounters have occurred while you were drunk or high on...
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In the past year, when you used substances, how often did you use them with...
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In the last twelve months, how often have you consumed substances through the following methods? (Remember, this does NOT include alcohol or marijuana)
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In the last twelve months, have you shared any of the following substance use equipment with others? (Check all that apply)
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In the last twelve months, where have you consumed substances, not including alcohol and marijuana? (Check all that apply)
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In the last twelve months who have you used substances with (not including alcohol or marijuana)? (Check all that apply)
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In the last twelve months, from whom have you gotten your substances, not including alcohol and marijuana? (Check all that apply)
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Which of the following statements is true of your personal experience?
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Feelings about Substance Use & Access to Supports
In the last twelve months, how often have these statements described your feelings about your substance use?
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In the last twelve months, I have accessed the following supports, tools, or services as it relates to my substance use. (Check all that apply)
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In the last twelve months, I have delayed accessing support, tools, or services related to my substance use for the following reasons (Check all that apply)
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Which of the following would make you more likely to access substance use supports, tools, and/or services? (Check all that apply)
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The following are true statements. How familiar were you with the information contained in each of them before completing this survey?
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Do you have a naloxone kit?
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Would you know where to get a naloxone kit if you wanted one?
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Do you have a drug testing kit or strips?
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Would you know where to get either if you wanted one?
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Do you feel that you have the adequate knowledge, skills, and/or tools necessary to support someone experiencing an overdose?
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Have you ever helped someone whom you thought was experiencing an overdose?
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If you wanted help or support in addressing your substance use (not including alcohol and marijuana), would you know where to go?
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In the last twelve months, which of the following have acted as motivators for your substance use? (check all that apply)
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What is the main reason you use substances?
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Please feel free to share anything else you would like with us as it relates to your experience of substance use and related services.
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