Check off all that apply: Have you ever smoked a cigarette? Check Have you ever smoked a cigarette? Have you ever smoked a cigar? Check Have you ever smoked a cigar? Have you ever smoked a bidi? Check Have you ever smoked a bidi? Have you ever smoked a hooka? Check Have you ever smoked a hooka? Have you ever done snuff? Check Have you ever done snuff? Have you ever done chewing tobacco? Check Have you ever done chewing tobacco? Have you ever done Snuss? Check Have you ever done Snuss? Have you ever smoked an e-cigarette? Check Have you ever smoked an e-cigarette? Have you ever drunk beer? Check Have you ever drunk beer? Have you ever drunk a six pack in one sitting? Check Have you ever drunk a six pack in one sitting? Have you ever drunk a 40? Check Have you ever drunk a 40? Have you ever played Edward Forty-Hands? Check Have you ever played Edward Forty-Hands? Have you ever done a power hour? Check Have you ever done a power hour? Have you ever drunk wine? Check Have you ever drunk wine? Have you ever drunk an entire bottle of wine in one sitting? Check Have you ever drunk an entire bottle of wine in one sitting? Have you ever drunk champagne? Check Have you ever drunk champagne? Have you ever drunk an entire bottle of champagne in one sitting? Check Have you ever drunk an entire bottle of champagne in one sitting? Have you ever drunk gin? Check Have you ever drunk gin? Have you ever drunk rum? Check Have you ever drunk rum? Have you ever drunk bourbon? Check Have you ever drunk bourbon? Have you ever drunk Scotch? Check Have you ever drunk Scotch? Have you ever drunk rye? Check Have you ever drunk rye? Have you ever drunk absinthe? Check Have you ever drunk absinthe? Have you ever drunk akvavit? Check Have you ever drunk akvavit? Have you ever drunk Mad Dog 20/20? Check Have you ever drunk Mad Dog 20/20? Have you ever drunk tequila? Check Have you ever drunk tequila? Have you ever drunk vodka? Check Have you ever drunk vodka? Have you ever drunk brandy? Check Have you ever drunk brandy? Have you ever drunk cognac? Check Have you ever drunk cognac? Have you ever drunk schnapps? Check Have you ever drunk schnapps? Have you ever drunk Ayahuasca? Check Have you ever drunk Ayahuasca? Did you experiment with drugs before the age of 21? Check Did you experiment with drugs before the age of 21? Did you experiment with drugs before the age of 18? Check Did you experiment with drugs before the age of 18? Did you experiment with drugs before the age of 15? Check Did you experiment with drugs before the age of 15? Did you experiment with drugs before the age of 13? Check Did you experiment with drugs before the age of 13? Have you ever smoked pot? Check Have you ever smoked pot? Have you ever smoked pot in a public place? Check Have you ever smoked pot in a public place? Have you ever snuck pot onto a plane? Check Have you ever snuck pot onto a plane? Have you ever eaten a pot brownie? Check Have you ever eaten a pot brownie? Have you ever eaten a firecracker? Check Have you ever eaten a firecracker? Have you ever taken a hit out of a gravity bong? Check Have you ever taken a hit out of a gravity bong? Have you ever owned a pot pipe? Check Have you ever owned a pot pipe? Have you ever owned a bong? Check Have you ever owned a bong? Have you ever made your own improvised pipe? Check Have you ever made your own improvised pipe? Have you ever tried to grow your own pot? Check Have you ever tried to grow your own pot? Have you ever smoked weed with another drug in it? Check Have you ever smoked weed with another drug in it? Have you ever done hash? Check Have you ever done hash? Have you ever done whippets? Check Have you ever done whippets? Have you ever added cough syrup to a drink? Check Have you ever added cough syrup to a drink? Have you ever Robo-tripped? Check Have you ever Robo-tripped? Have you ever smoked Salvia divinorum? Check Have you ever smoked Salvia divinorum? Have you ever done 2C-E? Check Have you ever done 2C-E? Have you ever done kratom? Check Have you ever done kratom? Have you ever licked a toad to get high? Check Have you ever licked a toad to get high? Have you ever taken Krokodil? Check Have you ever taken Krokodil? Have you ever done bath salts? Check Have you ever done bath salts? Have you ever done poppers? Check Have you ever done poppers? Have you ever huffed paint? Check Have you ever huffed paint? Have you ever huffed glue? Check Have you ever huffed glue? Have you ever sniffed markers? Check Have you ever sniffed markers? Have you ever done DMT? Check Have you ever done DMT? Have you ever inhaled compressed air cans? Check Have you ever inhaled compressed air cans? Have you ever done MDMA/ecstasy? Check Have you ever done MDMA/ecstasy? Have you ever bought bunk ecstasy at a festival? Check Have you ever bought bunk ecstasy at a festival? Have you ever done GHB? Check Have you ever done GHB? Have you ever done PCP? Check Have you ever done PCP? Have you ever done acid? Check Have you ever done acid? Have you ever done mescaline? Check Have you ever done mescaline? Have you ever done quaaludes? Check Have you ever done quaaludes? Have you ever done peyote? Check Have you ever done peyote? Have you ever done hallucinogenic mushrooms? Check Have you ever done hallucinogenic mushrooms? Have you ever tried to grow your own hallucinogenic mushrooms? Check Have you ever tried to grow your own hallucinogenic mushrooms? Have you ever snorted crystal meth? Check Have you ever snorted crystal meth? Have you ever smoked crystal meth? Check Have you ever smoked crystal meth? Have you ever sold crystal meth? Check Have you ever sold crystal meth? Have you ever snorted Special K? Check Have you ever snorted Special K? Have you ever been in a K-hole? Check Have you ever been in a K-hole? Have you ever smoked crack? Check Have you ever smoked crack? Have you ever snorted heroin? Check Have you ever snorted heroin? Have you ever injected heroin? Check Have you ever injected heroin? Have you ever smoked opium? Check Have you ever smoked opium? Have you ever snorted cocaine? Check Have you ever snorted cocaine? Have you ever snorted cocaine before 12 p.m.? Check Have you ever snorted cocaine before 12 p.m.? Have you ever rubbed cocaine on your gums? Check Have you ever rubbed cocaine on your gums? Have you ever taken barbiturates? Check Have you ever taken barbiturates? Have you ever taken codeine recreationally? Check Have you ever taken codeine recreationally? Have you ever taken morphine recreationally? Check Have you ever taken morphine recreationally? Have you ever taken methadone recreationally? Check Have you ever taken methadone recreationally? Have you ever taken fentanyl recreationally? Check Have you ever taken fentanyl recreationally? Have you ever taken OxyContin recreationally? Check Have you ever taken OxyContin recreationally? Have you ever taken dilaudid recreationally? Check Have you ever taken dilaudid recreationally? Have you ever taken Demerol recreationally? Check Have you ever taken Demerol recreationally? Have you ever taken Adderall recreationally? Check Have you ever taken Adderall recreationally? Have you ever snorted Adderall? Check Have you ever snorted Adderall? Have you ever taken Ritalin recreationally? Check Have you ever taken Ritalin recreationally? Have you ever snorted Ritalin? Check Have you ever snorted Ritalin? Have you ever taken dexedrine recreationally? Check Have you ever taken dexedrine recreationally? Have you ever taken amobarbital recreationally? Check Have you ever taken amobarbital recreationally? Have you ever taken Kadian recreationally? Check Have you ever taken Kadian recreationally? Have you ever taken Laudanum recreationally? Check Have you ever taken Laudanum recreationally? Have you ever taken Percocet recreationally? Check Have you ever taken Percocet recreationally? Have you ever taken Vicodin recreationally? Check Have you ever taken Vicodin recreationally? Have you ever taken Flunitrazepam recreationally? Check Have you ever taken Flunitrazepam recreationally? Have you ever taken Benzodiazepines recreationally? Check Have you ever taken Benzodiazepines recreationally? Have you ever taken Xanax recreationally? Check Have you ever taken Xanax recreationally? Have you ever taken Soma recreationally? Check Have you ever taken Soma recreationally? Have you ever taken Darvon recreationally? Check Have you ever taken Darvon recreationally? Have you ever taken Darvocet recreationally? Check Have you ever taken Darvocet recreationally? Have you ever taken Valium recreationally? Check Have you ever taken Valium recreationally? Have you ever taken Ativan recreationally? Check Have you ever taken Ativan recreationally? Have you ever taken Talwin recreationally? Check Have you ever taken Talwin recreationally? Have you ever taken Ambien recreationally? Check Have you ever taken Ambien recreationally? Have you ever taken Alprazolam recreationally? Check Have you ever taken Alprazolam recreationally? Have you ever taken Clonazepam recreationally? Check Have you ever taken Clonazepam recreationally? Have you ever taken Lorazepam recreationally? Check Have you ever taken Lorazepam recreationally? Have you ever taken Tramadol recreationally? Check Have you ever taken Tramadol recreationally? Have you had a doctor friend or family member write a prescription for you? Check Have you had a doctor friend or family member write a prescription for you? Have you ever lied to get a prescription to use recreationally? Check Have you ever lied to get a prescription to use recreationally? Have you ever started taking a prescribed drug recreationally? Check Have you ever started taking a prescribed drug recreationally? Have you ever personally exchanged money for drugs? Check Have you ever personally exchanged money for drugs? Have you ever personally exchanged more than $100 for drugs? Check Have you ever personally exchanged more than $100 for drugs? Have you ever personally exchanged more than $1,000 for drugs? Check Have you ever personally exchanged more than $1,000 for drugs? Have you ever been arrested for using drugs? Check Have you ever been arrested for using drugs? Have you ever taken a drug to ease or enhance the effects of another drug? Check Have you ever taken a drug to ease or enhance the effects of another drug? Have you ever failed a drug test? Check Have you ever failed a drug test? Have you ever ordered drugs over the internet? Check Have you ever ordered drugs over the internet? Have you ever had a delivery service bring you drugs? Check Have you ever had a delivery service bring you drugs? Have you ever been high around your parents? Check Have you ever been high around your parents? Have you ever gotten high with your parents? Check Have you ever gotten high with your parents? Have you ever smoked pot and then gone to work or class? Check Have you ever smoked pot and then gone to work or class? Have you ever gone to a rave high? Check Have you ever gone to a rave high? Have you ever gone to a laser show high? Check Have you ever gone to a laser show high? Have you ever watched "Adventure Time" while high? Check Have you ever watched "Adventure Time" while high? Have you ever played video games high? Check Have you ever played video games high? Have you ever gone to an amusement park high? Check Have you ever gone to an amusement park high? Have you ever gotten so high that you were worried it would last forever? Check Have you ever gotten so high that you were worried it would last forever? Have you ever gotten high at 4:20 p.m.? Check Have you ever gotten high at 4:20 p.m.? Have you ever gotten high at 4:20 a.m.? Check Have you ever gotten high at 4:20 a.m.? Have you ever looked in a mirror while high and instantly regretted it? Check Have you ever looked in a mirror while high and instantly regretted it? Do you have a prefered brand of eye drops? Check Do you have a prefered brand of eye drops? Have you ever had sex while high? Check Have you ever had sex while high? Have you taken a pill without knowing what it was? Check Have you taken a pill without knowing what it was? Have you ever woken up still high? Check Have you ever woken up still high? Have you ever had a dedicated accessory for doing bumps of cocaine? Check Have you ever had a dedicated accessory for doing bumps of cocaine? Have you ever wake and baked? Check Have you ever wake and baked? Have you ever been high for more than one day straight? Check Have you ever been high for more than one day straight? Have you ever gotten someone else high for the first time? Check Have you ever gotten someone else high for the first time? Have you ever been high in a foreign country? Check Have you ever been high in a foreign country? Have you gotten high with a complete stranger? Check Have you gotten high with a complete stranger? Have you ever tried to make your own drugs? Check Have you ever tried to make your own drugs? Are you high right now? Check Are you high right now? How experienced are you?
