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