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How Has Your or a Loved One's Use of Drugs & Alcohol Affected Your Life?

Despite today's epidemic of drug & alcohol use, there has been surprisingly little research on the effectiveness of different treatment programs and addiction's impact on the family. We will use the results of this quick survey to educate others and advocate for better treatment options. Thank you for taking the time to help!

Joanna Conti, CEO

Conquer Addiction, Inc.

joanna@conquer-addiction.org

Whose drug or alcohol use has you concerned (please select only one; you can take the survey again to report on a second person's use): *

Myself

My son or daughter

My spouse

My mother or father

Other family member

A good friend

Other Other

What is their sex? *

Male

Female

What is your sex? *

Male

Female

What is their age now? *

What is your age? *

Do you think your loved one is clean and sober today? *

Yes, I don't think they are using any drugs or alcohol now

I don't know

No, I think they are using drugs or alcohol

Are you clean and sober today? *

Yes, I have not used either drugs or alcohol in the last 30 days

While I haven't used today, I have used drugs or alcohol in the last 30 days

How long do you think your loved one has been clean and sober?

Less than 1 month

1-3 months

4-6 months

7-12 months

13-18 months

19-24 months

2-4 years

5-8 years

9-12 years

More than 12 years

I don't know

How long have you been abstinent from all drugs and alcohol?

Less than 1 month

1-3 months

4-6 months

7-12 months

13-18 months

19-24 months

2-4 years

5-8 years

9-12 years

More than 12 years

I don't know