FARS - Farsi Addiction Recovery Support, a free & confidential serivce for addiction problem, problematic drug users, family members, farsi communities and UK drug services.

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Home - Needs Assessment - How to participate - Problematic User Questionnaire

Problematic User Questionnaire

• The information given in this questionnaire will be entered into the final report as anonymous statistics. There will be no personal identification of whom the comments or the information have come from.

• The information obtained through this research is to assess the needs of the Farsi speaking community members affected by substance misuse.

• Fill it out this questionnaire as best as you can.

• Send FARS the filled out form via:

Fax: (+44) 0207 351 3356

Or

Post to: FARS Services, PO Box 50892

London SW3 6XP

Date:
Venue:
1- Age group:
2- Sex:
3-Ethnicity?
White British White Irish Other White White & Black Caribbean White & Black African White & Asian Other Mixed Indian Pakistani		Bangladeshi Other Asian Caribbean African Other Black Chinese Iranian Afghanistan Tajikistani Other Not stated
4- What is your country of origin?
5- In which English borough / county do you live?
6- Do you think you have a problem with alcohol or drugs? Yes No Not sure Don't know
6A- If yes, how do you perceive your use?
7- What are the drugs you are currently using?
Alcohol Heroin Opium Cocaine / crack Tranquilizers Khat Cannabis Amphetamines / Ecstasy Other, state:
7a – Which is your main drug of choice?
8- How often and what amounts are you using per day / week?
9- What is your preferred method of use? Inject Sniff Smoke Oral Other, state:
10- In your opinion, what are the underlying factors for your current use?
11- What other problems are you currently experiencing? Emotional – Psychologically Economical / Financial –i.e. housing Political – Visa, Home office. Refuges, Asylum seeker Family / Community Other state and expand:
12- Do you perceive drugs to be your main problem?
12A – If no, explain what do you consider it to be?
Psychological Emotional Social Political Economical Financial
Please explain:

13- What has prevented you from admitting to a drug problem?
Fear of stigma by the family / community Lack of support from family /community Denial Fear of loosing political/economical status Fear of being punished It is a sin Please explain:

14- Have you ever tried to stop?
14A - Please explain how:

15- If relapsed, what prompted it?

16- Have you tried accessing substance misuse services?
16A- If yes, any problems encountered? Please sxplain:

17- Would you prefer a purely Farsi drug service centre to a Western one?
17A – If yes, can you state why?

18- What would assist you in getting help with your alcohol / drug problem? Farsi information / leaflets about drugs, their effects, cost and the law Farsi translated information about your legal rights in UK , i.e. confidentiality Farsi culturally competent service providers / counsellors Farsi forums /seminars to engage, educate and inform your community about drugs Farsi helpline and website on drugs and how and where to get help in your area Confidential outreach work at your local GP's or community centres Farsi information about drug services, their functions and services Farsi information on how to access drug services Other, state:
19- How many problematic alcohol users do you know of in the Farsi speaking community? None up to 3 up to 5 up to 10 more than 10 more than 20
20- how many drug users do you know of in the Farsi speaking community? None up to 3 up to 5 up to 10 more than 10 more than 20
21- Please use this space for any further comments, views or suggestions:

If you are interested to be interviewed for this research, please put your contact details below and a member of our team will call you:
Name
Telephone
E-mail
If you have concerns about yourself or a loved one affected by substance misuse and would like to speak to a Farsi speaking drug professional in confidence and for free, please contact us.