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Do you often spend a lot of time getting opioids, using them, or feeling their after-effects?
Yes
No
Do you usually take more opioids or use them for a longer time than you planned?
Yes
No
Have you tried to cut down or stop using opioids but couldn't?
Yes
No
Does your use of opioids negatively impact your daily life, such as your performance at work, school, or social interactions?
Yes
No
Do you continue using opioids even when they cause or worsen problems with your friends or family?
Yes
No
Have you stopped or reduced doing things you enjoy, like hobbies or hanging out with friends, because of your opioid use?
Yes
No
Do you need to use more opioids to get the same effect or feel less effect from the same amount?
Yes
No
Have you ever used opioids while doing something dangerous, like driving or using machines?
Yes
No
Do you continue to use opioids even when you know they're causing or making health or mental health issues worse?
Yes
No
When you stop using opioids after a prolonged period of time, do you experience withdrawal? This can include anxiousness, depression, restlessness, muscle aches, runny nose, excessive tearing/yawning, sweating, nausea, vomiting, fever, or trouble sleeping
Yes
No
Are you a Texas resident?
Yes
No
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