JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Harm Reduction Resource Development Survey
Sign in to Google
to save your progress.
Learn more
How long have you been using substances?
1 year or less
2+ years
10+ years
20+ years
Clear selection
What is your main substance of choice?
Your answer
What other substances have you used?
2C's (2C-B, 2C-X etc)
Alcohol
Amphetamine (Adds, Dexis, Fast, Goey, Pep, Speed, Uppers)
Amyl Nitrate (Poppers)
Benzos (Benzodiazepine, Valium, Xanax)
Cannabis (Yarndi, Weed, Pot)
Cocaine
DMT (Ayahuasca)
DXM (Dextromethorphan)
Gender Affirming Hormones (Estrogen, Progesterone, Testosterone etc)
GHB (Fantasy, Frank)
Ketamine
LSD (Acid)
MDMA (Molly, Pills, Pingas, Ecstasy)
Methamphetamine (Ice, Meth, Rock)
Nitrous Oxide (Nangs, Whippets)
Opioids (Heroin, Codeine, Bupe, Oxy, Subbie, Fentanyl, Methadone)
Psilocybin (mushrooms)
Steroids (AAS, HGH, PIEDS)
Tobacco
Other:
How often do you use substances?
Every day
About once a week
A few times a week
About once a month
A few times a month
Less than once a month
I don't use
Clear selection
What is your favourite thing about the substances you use?
Your answer
What is your least favourite thing about the substances you use?
Your answer
Do you regularly combine substances?
Yes
Rarely
No
Clear selection
If so, what combinations of substances do you use?
Your answer
How would you describe the effects of the substance combinations you use?
Your answer
Have you ever experienced any of the following health impacts in connection to using substances?
Contracted a blood borne virus (eg. Hep C or HIV) from injecting drug use
Mental health concerns
Contracted a sexually transmitted infection (STI)
Other:
What harm reduction methods or advice have you used before?
Testing your drugs with reagent kits
Using sterile equipment
Never sharing equipment
Not combining substances that don't go well together
Dosing yourself instead of being dosed by another person
Not driving when using substances
Using a safe injecting room
Carrying naloxone in case of opioid overdose
Not using substances alone - having people around who can help if something goes wrong
Practicing safe sex
Other:
Have you ever been discriminated against or stigmatised for substance use in any of the following situations or organisations?
Accessing healthcare
School
Workplace
Among friends or family
In the wider community
Centrelink
Child Safety
Queensland Police
Landlord/Real Estate
Department of Housing
Other:
What is your gender?
Your answer
Do any of these align with your lived experience?
Young person
Older person
Aboriginal
Torres Strait Islander
Born outside of Australia
Multilingual
Parenthood or Pregnancy
Living with a disability
Living with a mental health concern
Living rurally
Work in a marginalised industry (eg. sex work)
Lesbian
Gay
Bisexual
Trans
Non-binary
Intersex
Queer
Asexual
Pansexual
Other lived experiences (please expand in next question)
Other lived experiences?
Your answer
Have any of your lived experiences had an impact on your substance use? If so, how would you describe the impact? (eg. if you are a parent, did anything about your substance use change before or after becoming a parent?)
Your answer
What harm reduction information has been the most useful to you when using substances?
Your answer
What information about substance use has been the most difficult to find?
Your answer
What Harm Reduction information or resources for substance use would you like to see?
Your answer
Do you prefer to get information digitally or in print?
Digital (eg. via website, email etc)
Print (newsletter, flyer, poster, magazine, other publication)
Other:
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. -
Terms of Service
-
Privacy Policy
Does this form look suspicious?
Report
Forms
Help and feedback
Contact form owner
Help Forms improve
Report
