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Sample Drug Survey


1.Have you ever used(name of drug goes here)? yes/no. 2. Do you know someone who uses (drug listed above)? 3. Do you know someone who has gotten in trouble with drugs? 4. Are drugs rampant in your community? 5. Are there "crack houses" and/or drug dealers in your community? 6. Do you see who are dealing drugs and if so, what are the gender, race and approximate age of the dealer?
7. Do you think that drug use leads to increased crime in your community? 8. Have you or someone you know ever been a crime victim that you thought was a result of drugs? 9. How do you feel about drugs? 10. Give me two strong reasons why people should NOT use drugs. 



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 EZELL PARKER SEPTEMBER 15, 2000