Family Insights Survey: Understanding the Impact of Addiction

We genuinely appreciate your willingness to share your experiences and insights through this anonymous survey. Your stories hold immense value—not only for your own journey but also for addressing the mental health and addiction crisis impacting millions of families.

By providing your valuable input, you're contributing to a broader understanding and helping us create meaningful support for families like yours.

Rest assured every question is OPTIONAL. Share only to the extent you feel comfortable.

Your responses will remain confidential and will be used solely to enhance our programs and resources. Your voice makes a difference, and we are immensely grateful for your participation.

Be sure to claim your special gift at the end of the survey as our token of our appreciation for your time, honesty, and willingness to help others!

RELATIONSHIP

Other relationship:

IMPACT

EMOTIONAL IMPACT

In what ways has dealing with your loved one's condition influenced your emotional wellbeing, mental state, or thought patterns? Have you noticed any changes in your stress levels, ability to focus, or overall mental clarity? Are there moments when you've felt overwhelmed or at a breaking point? Please feel free to share any feelings or emotions you’ve experienced. *

PHYSICAL IMPACT

What physical effects, if any, have you experienced as a result of your loved one's condition? This might include changes in sleep patterns, appetite, energy levels, or physical ailments like insomnia, headaches, or digestive issues due to chronic stress. *

SHAME & STIGMA

Studies show that fewer than 10% of those struggling with substance use disorder will seek professional help. This is often due to the stigma and shame associated with their condition (placing an ENORMOUS burden on families).

Have you and/or your family been impacted by stigma or feelings of shame because of your loved one's condition? Please feel free to include any details you feel comfortable sharing. *

Yes

No

Other

LONELINESS & SOCIAL ISOLATION

Do you feel like you need to keep secrets about your loved one's challenges? Please share any feelings of isolation or loneliness you might have experienced. *

Yes

No

FEAR OF OVERDOSE

OVERALL IMPACT

How would you rate the overall emotional, physical, psychological, and social impact of dealing with your loved one's challenges on your family? *

Minimal impact - I'm handling it

Significant impact - I'm seeking solutions to get support

Overwhelming impact - I don't know who to reach out to and/or the solutions I've tried haven't worked

FINANCIAL IMPACT

What are the estimated annual financial costs associated with your loved one's addiction? (including treatment, medical expenses, legal fees, lost income, etc.) *

FINANCIAL IMPACT

To what extent would you say these costs are impacting your family's financial stability? *

Minimal impact

Significant impact

Overwhelming impact

SUPPORT SYSTEMS

Other support resources you've tried:

SUPPORT SYSTEMS

Were the things you've tried so far helpful to you? Please share what is working well for you and what's not. *

Yes

No

SUPPORT SYSTEMS

Other healing modalities you'd be interested to try:

If you found a reliable solution that could help you navigate the challenges of a loved one's addiction and/or mental health challenge, what would you be willing to invest monthly? *

ONLINE COMMUNITY SUPPORT

If there was an online community specifically for people impacted by a loved one's addiction and/or mental health challenge, that was dedicated to ending the stigma and shame around mental health and addiction, and that offered things like:

-support groups
-educational workshops
-yoga
-meditation
-mindful self-care practices
-holistic healing modalities
-book discussions
-opportunities to connect with others experiencing similar struggles

Would you consider joining? *

Yes

No

DESIRED OUTCOMES

What would you hope to achieve by being a part of a family support community? What would make you feel successful in the journey of supporting a loved one struggling with addiction and/or mental health challenges? *

Is there is anything else you'd care to share? *

If you would like to be contacted for a follow-up discussion, have questions, or need support, please provide your email below.

Thank you again for your contribution to this important work. Together, we can make a difference.

Thank you for helping us understand the impact of addiction on families, and for guiding our efforts to provide the best possible support.

THANK YOU for taking the time to share your thoughts and insights. Your input is invaluable!

We will be analyzing your feedback and using it to better understand your experiences and preferences so we can provide the most valuable support and resources to families.

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