**Teen Substance Abuse Survey**?

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1. How old are you and what grade are you in?

2. Boy/Girl?

3. Do you get along with your mom? Dad?

4. Do you drink? If yes answer:
-When did you start?
-Why did you start?
-Do your know?
-How often?
-Do you wish you hadn’t?

5. Do you smoke? If yes answer:
-When did you start?
-Why did you start?
-Do you parents know?
-How often?
-Do you wish you hadn’t?

6. Have you ever abused any other substances? If yes answer:
-What substance(s)?
-When did you start?
-Why did you start?
-Do your parents know?
-How often?
-Do you wish you hadn’t?

7. Have you ever lured someone else into ?

8. Do you behave and/or do well in school? How has substance abuse positively or negatively affected this?

9. If you could change one thing about your life, what would it be?

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2 Comments

  1. Jayme
    Apr 16, 2010

    1.I’m 18 and I’m a senior.
    2.I’m a girl.
    3.I get along with my dad just fine.My mom…..not so much.
    4.Yes.
    When I was 14 when I started.
    It was/is fun.
    No.
    I partied/party every weekend.
    No.
    5.No.Smoking is disgusting.
    6.Yes.
    Meth.
    16.
    I wanted to try it.
    No.
    Once.It was horrible.I never tried it again.
    Yes.
    7.No.
    8.Yes I behave well in school.I am a straight A student,class president,and graduating valedictorian and top of my class.I think that my drinking has made a positive affect on my schooling,because it gives me the escape that I need sometimes when my mother gets to bad.
    9.If I could change one thing in my life………..I don’t think that I would change anything.Everything that has happened in my life has got me were I am to day.A full scholarship to the college of my dreams.The love of my life that i’m engaged to.And all of my high school achievements.

  2. BellaMay♥
    Apr 16, 2010

    1. 15 years old , in grade 9.
    2. Girl
    3. Yes , most of the time.
    4. No
    5. No
    6. No
    7. No.
    8. I behave well in school most of the time.
    9. hmm, idk.


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