Drug

Select the type of drug, or drug domain, such as alcohol.

Primary Route of Administration

Select the method the child uses to take the drug.

Approximate Age at First Use

Enter the age in years when the  child first started taking the drug.

Used Regularly

Indicate whether the child is taking the drug one or more times each week.

Used within the past 48 Hours

Indicate whether the child has taken the drug within the past 48 hours.