Sex? (M/F)
What State are you from?
Age
Do you know someone with a Substance Abuse Problem? (Y/N)
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1. How many billions of dollars do you think substance abuse costs our country? A. Less than 100 billion B. 100 to 200 billion C. 200 to 300 billion D. 300 to 400 billion E. 400 to 500 billion
2. How many billions of dollars do you think our country spends on drug and alcohol treatment each year? A. Less than 20 billion B. 20 to 40 billion C. 40 to 60 billion D. 60 to 80 billion E. 80 to 100 billion
3. For each dollar spent on Substance Abuse Prevention, how many dollars could we save? A. Less 20 dollars B. 20 to 40 dollars C. 40 to 60 dollars D. 60 to 80 dollars E. 80 to 100 dollars
4. What percentage of people do you think knows someone with a drug and/or alcohol problem? A. Less than 20 percent B. 20 to 40 percent C. 40 to 60 percent D. 60 to 80 percent E. 80 to 100 percent
5. What percentage of drug users do you think are employed? A. Less than 20 percent B. 20 to 40 percent C. 40 to 60 percent D. 60 to 80 percent E. 80 to 100 percent
6. What percentage of people needing drug and/or alcohol treatment are NOT receiving it? A. Less than 20 percent B. 20 to 40 percent C. 40 to 60 percent D. 60 to 80 percent E. 80 to 100 percent
7. When people are arrested, what percentage are charged with a drug related offense? A. Less than 20 percent B. 20 to 40 percent C. 40 to 60 percent D. 60 to 80 percent E. 80 to 100 percent
8. Of the juveniles arrested on drug charges what percentage do you think are DEPENDENT on a substance? A. Less than 20 percent B. 20 to 40 percent C. 40 to 60 percent D. 60 to 80 percent E. 80 to 100 percent
9. What do you think is the percentage of domestic violence offenders who used drugs and/or alcohol on the day of the offense? A. Less than 20 percent B. 20 to 40 percent C. 40 to 60 percent D. 60 to 80 percent E. 80 to 100 percent
10. How many lost workdays do you thing are due to alcohol and/or drugs? A. 0 to 100 million days B. 100 to 200 million days C. 200 to 300 million days D. 300 to 400 million days E. 400 to 500 million days
11. What do you think is the percentage of child abusers who used alcohol and/or drugs when abusing? A. Less than 20 percent B. 20 to 40 percent C. 40 to 60 percent D. 60 to 80 percent E. 80 to 100 percent
12. What percentage of traffic fatalities do you think are alcohol related? A. Less than 20 percent B. 20 to 40 percent C. 40 to 60 percent D. 60 to 80 percent E. 80 to 100 percent

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Last revised 042704