Hidden Impacts of Drug Use: Health and Wellness Survey

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Hidden Impacts of Drug Use: Health and Wellness Survey

This survey aims to explore the hidden health impacts of synthetic and illicit drug use, focusing on digestive health, nutrition, and overall well-being. Your responses will help uncover patterns and inform solutions to improve health outcomes for individuals facing similar challenges. The survey is anonymous, and your honesty will contribute to a greater understanding of these issues. Thank you for participating and sharing your experiences.

Sex *

Male

Female

Non-binary

What is your date of birth? *

YYYY

Which substances do you use more than 1x per week *

Cannabis

Alcohol

Benzodiazapines (pharmesutical + with medical supervision)

Benzodiazapines (illicit or without medical supervision)

Illicit Opiates

Pharmesutical Opiates

Methamphetamine

GHB

LSD

DMT

PSILOCYBIN

Kratom

Tobacco - Smoked

Tobacco - chewed

Tobacco free smoking alternative like clove cigarettes

Vape/Ecigs

Cocaine

Ketamine

Required

How long have you been using illicit opiates and or methamphetamine? *

Less than a week

1-4 weeks

1-6 months

1-2 years

2+ years

Required

How many days per week do you brush your teeth?

When urinating where does the color/odor of your urine fall on this scale

Clear and Odorless

Dark yellow to orange/brown w/strong odor

Clear selection

What is your best estimate of how much water you drink everyday? *

Do you know where your next meal will come from?

Yes

Clear selection

How many days per week do you eat a complete meal/feel "full"/not hungry *

How many days per week do you poop? *

How many days per week do you eat fruit? *

How many days per week do you eat vegetables? *

How many days per week do you eat dairy? *

How many days per week do you eat grains? *

How many days per week do you eat meat or other protein like eggs or beans? *

How many days per week do you drink alcohol? *

I prefer to use multiple substances together like Opiates and methamphetamine *

True

False

How many times are you using Opiates per day?

I go to sleep every night *

True

False

Are you employed

Part time

Full time

Unemployed

Clear selection

Do you receive food stamps? *

Yes

If you receive food stamps how much do you get monthly?

Have you started experiencing any of the following digestive problems since using illicit synthetic opiates you didn't experience when using non synthetic opiates like heroin? (While under the influence NOT IN RELATION TO DIGESTION ISSUES DURING WITHDRAWAL)

Constipation

Nausea

Gas/Bloating

Diarrhea

Bright red blood in poop

Abdominal cramps

Lactose intolerance

Gluten sensitivity

Lack of appetite

Have you experienced uncontrollable weight gain or loss

Weight gain

Weight loss

Frequent ups and downs with +/- more than 8 pounds per week

Steady weight

Clear selection

What is your housing situation?

I sleep inside more often

I sleep outside more often

Clear selection

I use opiates or methamphetamine intravenously *

True

False

How confident are you in your ability to stop using opiates cold turkey without relapsing *

Have you tried to quit using synthetic Opiates/benzodiazapines before?

Yes

Clear selection

How long has it been and your last attempt to stop using opiates? *

Why do you use opiates continually? *

To avoid withdrawals

For the Euphoria

For pain

Are you addicted to Opiates now add a result of being improperly prescribed pharmesutical opiates?

Yes

Clear selection

Why do you use methamphetamine continually? *

I am physically dependent

For the Euphoria

If you consent to be contacted and wish to be involved further with this study or want to be notified of the results please leave your email or you name and phone number or mailing address and we will reach out.

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