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 MALE QUESTIONNAIRE - PAGE 7(i) 

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This section deals with recreational (possibly medicinal) drug use. Although your answers will never be released to any third party, leave the answer at "Never / don't know" if you would prefer not to answer.
827.  Have you used cocaine?
Never / don't know
Minor episode(s) in the past only
Significant episode(s) in the past only
Moderate current use
Heavy current use
828.  Have you used ecstacy?
Never / don't know
Minor episode(s) in the past only
Significant episode(s) in the past only
Moderate current use
Heavy current use
829.  Have you used GHB?
Never / don't know
Minor episode(s) in the past only
Significant episode(s) in the past only
Moderate current use
Heavy current use
830.  Have you used heroin or morphine (other than prescription narcotics)?
Never / don't know
Minor episode(s) in the past only
Significant episode(s) in the past only
Moderate current use
Heavy current use
831.  Have you used LSD?
Never / don't know
Minor episode(s) in the past only
Significant episode(s) in the past only
Moderate current use
Heavy current use
832.  Have you used marijuana?
Never / don't know
Minor episode(s) in the past only
Significant episode(s) in the past only
Moderate current use
Heavy current use
833.  Have you used methamphetamines?
Never / don't know
Minor episode(s) in the past only
Significant episode(s) in the past only
Moderate current use
Heavy current use

Add any additional information here for the questions above:

Please mention the question number(s) if possible.

 


 


GLOSSARY

Narcotic (Narcotics)
A substance that depresses central nervous system function, bringing sleep and lessening pain. By definition, narcotics can be toxic in excess.





























 
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