Addictions Researchers - Update

Submit your Information to the Database of Addictions Researchers in Canada

To update your current information, please click here , then enter your *first name, *last name, and *telephone number, plus any fields you wish to update, then submit the survey. The database will be updated once a month.

Please note: Do NOT press the Enter key while filling in the form (it will cause the form to be submitted before it is complete). Press the submit button when you have completed the form. If you accidentally press the Enter key, use the browser 'Back' button and continue entering information. Any duplication will be removed before your information is entered into the database.

Name of researcher: *First: *Last:

Please indicate your preferred mailing address, including phone, fax and email:

Organization (if applicable):

Position/title:

Address/Street:

City: Province: Postal code:

*Tel: Fax: Email:

1. Which, if any, organization(s) are you currently affiliated with for research purposes?

Same as above, OR Enter information below

Organization:

Position/title:

Address/Street:

City: Province: Postal code:

Tel: Fax: Email:

URL:

2. Additional affiliation (if applicable):

Organization:

Position/title:

Address/Street:

City: Province: Postal code:

Tel: Fax: Email:

URL:

3. What previous research-related positions have you held during the past five years?

4. Please indicate your academic background (university, faculty, degree, year obtained):

5. Please indicate your working language(s):

English French Other (please specify)

6. In order to get a better sense of activity in the addictions research community, please list those organizations (i.e., CAMH, SSHRC, NHRDP, MRC, WHO, ILO) from which you have received funding in the past five years for the purpose of addictions-related research. (Do NOT indicate dollar amounts or project descriptions):

7. Has addictions research been funded within your own organization?

Yes No

8. Please check your primary areas of expertise as well as other areas of addictions research of interest to you (check all that apply).

Type of Research	Primary Research Area	Also of Interest
8a. Substance/addiction:	------------	------------
Alcohol
Gambling
Illicit drugs
Legal drugs
Tobacco
8b. Areas of research:	------------	------------
Assessment
Best practices
Biological mechanisms
Corrections
Dual disorders: mental health and addiction
Economic aspects of addictions
Epidemiology
Evaluation research
FAS/FAE/NAS
Genetics of addictions
Injection drug use/HIV
Legal aspects of alcohol/drugs
Medical
Policy
Prevention
Socio-behavioural
Substance use and pregnancy
Treatment/Counselling
Workplace
8c. Target groups:	------------	------------
Aboriginal
General population
Men
Offenders (adult)
Offenders (youth)
Seniors
Women
Youth
Other (specify key words)

9. Please give a brief description of your primary area of expertise.

10. Please list below, or submit by email (to Database Coordinator), a bibliographic listing of the 5 most representative publications in the addictions field, in the past five years, in which you are listed as an other or co-author.

1)

2)

3)

4)

5)

We invite you to send us either a paper copy of the five (5) publications you have listed, or where possible, a link to the full-text publication.

11. If you have listed co-authors in the publications list above, please provide their contact information (email addresses and affiliations, where possible).