Riverhead Community Awareness Program Prescription Drug Survey
The Riverhead Community Coalition for Safe and Drug-Free Youth asks that you take a few minutes to complete our brief, confidential survey. This will help us in the planning and implementation of our 5-year Drug-Free Communities Grant. Thank you.
 
1.

Where do you usually store your medicines? (Check all that apply.) 

In a locked box or locked room
Bathroom
Kitchen
Bedroom
Closet
On a counter or table
Other  
2.

Do you currently have expired, unused or unwanted medications in your home? 

Yes
No
3.

How long do you usually store medicines you no longer want or need? 

Less than 6 months
6-12 months
More than 12 months
4.

How do you dispose of medicines you no longer want or need? (Check all that apply.) 

Just throw them in the trash
Throw them in the trash inside a zip lock bag with kitty litter or coffee grounds
Flush in toilet or down the drain
Bring them to the police department
Take them to the DEA Semi-Annual Drug Take-Back Event
Take them to the local pharmacy
I don't know how to dispose of them
Other  
5.

Why do you dispose of unwanted medications? (Check all that apply.) 

To keep them out of the environment
To keep them away from children and others who come to my home
To keep me from taking the wrong medication by mistake
To have less clutter in my home
Other  
6.
Is it convenient for you to be able to drop off unused medications twice a year at a Take-Back Event?
Yes
No
7.

Would you use a drug disposal box in the community if one was available anytime? 

Yes
No
8.

How aware are you of prescription drug abuse and misuse? 

Very aware
Somewhat aware
Not aware
9.

Would you be interested in learning more about the dangers of prescription drug abuse and misuse and how it relates to the rise in heroin use on Long Island? 

Yes
No
10.

Please tell us which age group best describes you. 

under 18
18-21
21-30
31-40
41-50
51-60
61-70
71 or over
11.
Please provide your zip code.

Postal Code:

12.

If there is anything else you would like to add, please use the space below. 

 

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Thank you for your assistance. Please visit our website at www.RiverheadCAP.org to learn more about our organization and the services we offer. You can also follow us on Facebook and Twitter.