2021 Annual Notification Consumer report + EEP + Drug Prevention by Jayaa Singh

MEMO TO:

All Current Students

FROM:

Jayaa Singh, Director

DATE:

September 30, 2021

SUBJECT: Annual notification of Detroit Business Institute-Downriver’s Emergency Evacuation Plan and Drug and Alcohol Prevention Program. Federal regulations require post secondary schools and participants in federal student financial aid programs to provide current students, before October 1st of each year, with the following enclosed items pertaining to our institution. 1) Emergency Response Policy 2) Drug and Alcohol Prevention Program This notice is also to inform our students that the following information has been updated and is available for review on Detroit Business Institute-Downriver’s website. It may be reviewed under the consumer information section at www.dbidownriver.edu. • • •

“Student-Right-to-Know” completion and graduation rates Family Educational Rights and Privacy Act (FERPA) Campus Security Report

If you have any questions or need assistance with consumer information, please contact the school Director or the Director of Student Financial Aid. 734-479-0660

DETROIT BUSINESS INSTITUTEDOWNRIVER

2020-2021 CONSUMER INFORMATION SUPPLEMENT

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Detroit Business Institute-Downriver Consumer Information Supplement TABLE OF CONTENTS

Student Achievement Information…………………………………………………..…3 Information on Completion/Graduation Rates

Crime Awareness and Campus Security Information

Campus Security Statistical Report

Emergency Action, Evacuation and Fire Prevention Plan

Cost of Attendance

Office hours

Voter registration

Additional consumer information may be viewed on the school’s website at www.dbidownriver.edu.

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Student Outcomes Practical Nurse Program The following statistics reflect the students outcomes reported in the Annual Report submitted to our accrediting agency ACCSC for the past two years. The statistics for the 2021 reporting year are based on students starting classes between October 2018 and September 2019, 2020 reporting year are based on the students starting classes between October 2017 and September 2018 and for the 2019 reporting year are based on students starting classes between October 2016 and September 2017.

Graduation Rates Reporting Number of students who began Year the program 2021 2020 2019

34 52 45

Number of students graduating within 150% of the program length 32 43 40

Graduation Rate 94% 83% 89%

Employment Rates Reporting Year 2021 2020 2019

Number of graduates completing the program within 150% of the program length 32 43 40

Number of waivers (1) 1

Number of graduates available for placement 32 43 39

Number employed in field

Employment Rate

25 37 30

78% 86% 77%

NCLEX - PN License Examination Pass Rates Reporting Year 2021 2020 2019

Number of graduates taking exam 31 43 40

Number who passed exam 27 36 33

Number who failed exam 4 7 7

Pass Rate 87% 84% 83%

1(1)

Waivers include: continuing education, death, incarceration, active military deployment, medical condition that prevents employment and international students who have returned to their country of origin.

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DETROIT BUSINESS INSTITUTE-DOWNRIVER CAMPUS CRIME AND SECURITY INFORMATION In accordance with the guidelines set forth by the Jeanne Clery Disclosure of Campus Security Policy and Campus Crime Statistics Act (Clery Act), all institutions that participate in Federal Student Financial Aid programs are required to maintain and disclose information about crime on or near their campuses. Detroit Business Institute-Downriver (DBI-Downriver) has designated the School Director as the Campus Security Authority. Reporting crimes is on a voluntary, confidential basis. In order to ensure a safe environment, the institution encourages students and employees to report all police incidents, security or safety concerns to the School Director. The School Director is responsible to document the incident and report any crimes to local law enforcement agencies as required by law. All crimes committed on the campus by students, faculty or staff, may result in immediate dismissal. The following crimes committed on the DBI-campus or within surrounding and adjacent areas will be reported to law enforcement agencies. Criminal Offenses Murder/Non-negligent manslaughter Negligent manslaughter Sex offenses - forcible Rape Fondling Sex offenses – non-forcible Incest Statutory rape Robbery Aggravated assault Burglary Motor vehicle theft Arson

Hate Crimes Murder/Non-negligent manslaughter Rape Fondling Incest Statutory rape Robbery Aggravated assault Burglary Motor vehicle theft Arson Simple assault Larceny-theft Intimidation Destruction/damage/vandalism of prop.

VAWA offenses Domestic violence Dating violence Stalking

Arrests Weapons: carrying, possession, etc. Drug abuse violations Liquor law violations

Referrals for disciplinary actions DBI -D

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Weapons: carrying, possession, etc. Liquor law violations Drug abuse violations Notification of the availability of the School’s Annual Campus Security report is made annually by October 1st to employees and enrolled students, prospective students and employers upon request, new enrolled students as part of the new student orientation. SECURITY & ACCESS TO CAMPUS FACILITIES The institution is a commuter school and does not maintain off-campus facilities or student housing. The campus limits access to the facility to authorized personnel, enrolled students and visitors. Unauthorized visitors are not permitted on the campus. Students do not have access to the facility unless, at a minimum, one staff person is available on-site during the specific hours of operation. The responsibility of campus security then rests with the staff person, who is authorized to conduct the opening and closing procedures for the school. DBI-Downriver maintains a relationship with local police through collection of annual crime statistics and normal communications. The school’s safety procedures are enhanced by regular police patrols at the campus location and by a high level of police rapidity to requests for community assistance. CRIME AWARENESS AND PREVENTION All new employees and students are instructed on crime awareness during orientation, including a description of procedures for reporting criminal activity or an emergency. The information on crime awareness is readily available upon request and is updated and redistributed to all existing students and staff on an annual basis. Students are required to follow security guidelines for their own personal and property safety and are encouraged to report any suspicious activity. Students performing externship or clinical practice off-campus are expected to practice an extension of the school’s safety guidelines at the site as if they were on-campus. Students are also subject to adhere to the site’s safety and security guidelines.

CRIME INCIDENT REPORT The campus maintains a Daily Crime Log that records the date and time any crime occurs DBI -D

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on campus. The School Director is responsible to make an entry into the Daily Crime Log within two business days of receiving the reported crime information. Only a law enforcement agency can make the determination that a reported crime did not occur. In such situations, the disposition is noted as “unfounded” and an addition to the entry will be made. The Daily Crime Log includes the following information: ● ● ● ● ● ●

Date the entry was completed Incident report date Date/time of crime General location of the crime Nature of the crime/complaint Disposition of the complaint, if available

The above information may be withheld if there is evidence that the release of the information would: ● ● ●

Jeopardize an ongoing investigation or safety of an individual Cause a suspect to flee or evade detection Result in destruction of evidence

The Daily Crime Log is open to public inspection during normal business hours for the most recent 60-day period. Any portion of the log prior to 60-days must be made available within two business days of a request for public inspection. REPORTING CRIMES 1. Students and employees should promptly report criminal acts to the School Director and/or local police departments. 2. Reporting crimes is on a voluntary, confidential basis. 3. The School Director is responsible to document any criminal acts, as well as reporting crimes to the local authorities as required by law. 4. The institution is required to make a timely warning to members of the campus regarding the occurrence of crimes that are considered to represent a threat to students and employees. 5. If there is an ongoing investigation of a crime that would jeopardize, cause the suspect to flee, risk the safety of the individual, or result in destruction of evidence, the timely warning may be delayed. 6. The crime statistics are collected by the institution and submitted to the Department of Education on an annual basis.

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DETROIT BUSINESS INSTITUTE-DOWNRIVER SEXUAL OFFENSE POLICY DBI-Downriver has developed a program on sexual assault awareness to prevent the occurrence of sexual crimes. This information is provided to new students during orientation and to all employees at the time of hire. The institution promotes safety as a core of the program and strictly prohibits incidents of dating violence, domestic violence, sexual offenses and stalking. The program also focuses on the topic of “consent” as it relates to sexual activity and includes a variety of options for stepping up to stop sexual assault through bystander intervention. The institution maintains a variety of information for students and employees that identifies the location of facilities that offer off-campus assault prevention programs and treatment centers for victims of sexual assault. First Step, 44567 Pinetree Drive, Plymouth, MI First Step, 4400 Venoy, Wayne, MI 24 Hour Help Line (734) 722-6800 or (888) 453-5900 Haven, P.O. Box 431045 Pontiac, MI Telephone: (248) 334-1274 or Toll Free (877) 922-1274 Turning Point Inc.,158 S. Main Street, Mt. Clemens, MI (586) 463-4430 Telephone: (586) 463-4430 I. Sex Offenders The Campus Sex Crimes Prevention Act requires schools to disclose to its students the location of sex registries. Students at DBI-Downriver may access the State of Michigan Public Sex Offender Registry web site at www.mipsor.state.mi.us or telephone (517) 2411806. The act also requires registered sex offenders to provide a notice to any campus or higher education in which the offender is employed, carries on a vocation or is a student. II. Sex Offenses If a sex offense occurs, the victim should immediately contact the School Director. Students have the option to report rape or sex offenses to law enforcement. The School Director will assist the student in reporting the offense, should the student select to do so. Students who report dating violence, domestic violence, sexual assault or stalking to the institution, will be provided with a written explanation of their rights and options, DBI -D

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regardless of whether the offense occurred on campus. They will also receive a written notification for counseling, health, mental health, victim advocacy, legal assistance, visa immigration assistance, student financial aid, and other services available within the institution or in the community. The institution will revise an academic schedule for a student as a protective measure, provided a reasonable change can be implemented. In the event of an accusation of a sex offense, the complainant will provide a written complaint to the School Director within two days of the alleged offense. The School Director may select to meet with complainant to hear his/her account of the incident. A formal investigation may be initiated at which time the accused will meet with the School Director and submit a written statement (generally provided within five business days) in response to the allegations. A determination will be made whether or not to proceed with an internal disciplinary proceeding, based on sufficient information to believe sexual misconduct may have occurred. Both parties are entitled to have one individual accompany them during the disciplinary proceeding. Both parties are given timely and equal access to information that will be utilized within informal or formal disciplinary meetings and hearings. II. Disciplinary Proceedings The Higher Education Opportunity Act (HEOA) requires schools to disclose, upon request to the victim of a crime of violence or a non-forcible sex offense, the written results of any disciplinary hearing related to the offense conducted by the campus against the student who is the alleged perpetrator of the crime or offense. The results of an institutional disciplinary hearing determine whether a student or employee committing an allegation of dating violence, domestic violence, sexual assault or stalking, will be subject to disciplinary action imposed by the school. The sanctions imposed may include attendance at a mandatory counseling treatment center, discharge from employment or expulsion from school.

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DETROIT BUSINESS INSTITUTE-DOWNRIVER CAMPUS SECURITY STATISTICAL REPORT Murder/Non-negligent manslaughter Negligent manslaughter Rape Fondling Incest Statutory Rape Robbery Aggravated assault Burglary Motor vehicle theft Arson

2018

2019

2020

0 0 0 0 0 0 0 0 0 0 0

HATE CRIMES Murder/Non-negligent manslaughter Rape Fondling Incest Statutory Rape Robbery Aggravated assault Burglary Motor vehicle theft Arson Simple assault Larceny-theft Intimidation Destruction/damage/vandal ism of property

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2018

2019

2020

0 0 0 0 0 0 0 0 0 0 0 0 0

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ARRESTS 2018

2019

2020

0 0 0

Weapons: carrying, possessing, etc. Drug abuse violations Liquor law violations

DISCIPLINARY ACTIONS 2018

2019

2020

0 0 0

Weapons: carrying, possessing, etc. Drug abuse violations Liquor law violations

INCIDENTS REPORTED Domestic violence Dating violence Stalking

2018 0 0 0

2019 0 0 0

2020 0 0 0

UNFOUNDED CRIMES 2018 0

2019 0

2020 0

(2020 is draft data to be submitted in Oct 21) Title IX coordinator for the 2021 Campus Safety and Security Survey: Jayaa Singh, Director, jsingh@dbidownriver.edu (734) 479-0660 ext. 12

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EMERGENCY ACTION, EVACUATION, LOCK DOWN AND FIRE PREVENTION PLAN

Emergency Action, Evacuation, Lockdown and Fire Prevention Statement The Emergency Action, Evacuation, Lockdown and Fire Prevention Plan outlines the institution’s procedures for carrying out the functions of the EAELFP plan. It is the primary goal of Detroit Business Institute-Downriver to provide a safe and secure environment for the students, faculty and staff members. The plan assigns roles and responsibilities to individuals who are directly responsible for emergency response and support services and provides a structure for coordination and activation of essential resources.

II.

Emergency Response Team (ERT) The Director of the institution is assigned to carry out the established responsibilities of the Incident Commander(CI). The Incident Commander will assess the type and scope of the emergency and if necessary activate other members of the ERT and supervise the activities.

The Operations Officer oversees the implementation of the response procedures to an emergency or emergency evacuation and oversees that all emergency response related activities are conducted in an appropriate and safe manner. The Admissions Representative at the institution is appointed the position of on-site Operations Officer.

Emergency Team Leaders are trained, faculty members, who support the Operations Officer during the implementation of emergency procedures or emergency evacuation.

III.

Emergency Evacuation and Lockdown Procedures

Commander (IC): Calls 911, if necessary Determines if students and site personnel should be evacuated to a safe area

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within the premises, outside the building to a relocation center Activates the Emergency Response Team (ERT) Notifies each Emergency Team Leader verbally, in trained wording, of an emergency or emergency evacuation Directs Emergency Team Leader to follow lockdown procedures if deemed necessary Remains in charge until the emergency is relieved

Operations Officer: Monitors implementation of establishes procedures during evacuation Ensures that individuals requiring extra assistance are accommodated Relates any incidents of critical importance to the Incident Commander Ensures all persons remain in a safe area until notified by the IC that the emergency has ended

Emergency Team Leader: Directs students to follow evacuation or lockdown procedures announced by the IC Allows no one to remain in the classrooms Take class roster Take roll when safely outside Immediately notify Operations Officer of any missing student Remain with the students unless relieved by another Emergency Team Leader If evacuated to relocation center, take roll again

IV.

EMERGENCY EVACUATION ROUTE

In case of an emergency students, faculty and staff will evacuate the premises following the specified routes posted in all classrooms. The following is a summary of the routes students should use to evacuate the building.

▪ Students and faculty in Rooms 101,102,106,107,instructor’s lounge, and the front office are to follow the evacuation route through the front door to the blue zone

▪ Students and faculty in Rooms 103,104,105,and the student lounge are to follow the evacuation route to the red zone behind the building

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▪ Students and faculty in Rooms 108 and 109 are to evacuate through the back door to the red zone behind the building Students will be accounted for by their instructors. They are to remain outside the building until further instructions are given by the Operations Officer.

COST OF ATTENDANCE 2021-2022 AWARD YEAR Day School Course Practical Nurse

Length 45 Weeks

Tuition* $29,400

*The tuition cost includes the use of all books. In addition to the course cost, each practical nurse student entering Detroit Business Institute-Downriver will be charged a $125 application fee. The breakdown below is the cost of attendance by academic years. PRACTICAL NURSE – DAY SCHOOL 2021-2022 Dependent Students 1st Academic Year Tuition $19,600.00 Room and Board $3,297.00 Personal Expenses $2,065.00 Transportation $1,232.00 Total Expenses

2021-2022 Independent Students 1st Academic Year Tuition $19,600.00 Room and Board $6,615.00 Personal Expenses $2,065.00 Transportation $1,232.00

$26,194.00 Total Expenses

$29,512.00

2nd Academic Year 2nd Academic Year Tuition $9,800.00 Tuition $9,800.00 Room and Board $1,413.00 Room and Board $2,835.00 Personal Expenses $885.00 Personal Expenses $885.00 Transportation $528.00 Transportation $528.00 Total Expenses DBI -D

$12,626.00 Total Expenses

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$14,048.00 Rev. September 2021

1st Academic Year = 7 month budget 2nd Academic Year = 3 month budget NATIONAL STANDARDIZED BUDGET 2020-2021 Room & Board

Transportation**

Personal*

Total Monthly Costs

$462

$174

$289

$925

Living at home without dependents

962

174

289

1,425

Living at home or away with dependents

926

174

289

1,389

Attending less than halftime

174

Living at home

*includes clothing, laundry, personal care, recreation, gifts, etc. **denotes transportation costs for attending four days per week OFFICE HOURS

The administrative office is normally open Monday through Friday from 8:00 a.m. until 4:30 p.m. VOTER REGISTRATION

The State of Michigan requires voters to be registered at least thirty days prior to the election day. Voter registration forms are available on line at https://webapps.sos.state.mi.us/mvic. https://mvic.sos.state.mi.us/RegisterVoter

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Detroit Business Institute-Downriver DRUG AND ALCOHOL AWARENESS AND PREVENTION PROGRAM FOR STUDENTS Standards of Conduct Detroit Business Institute prohibits the unlawful possession, use, or distribution of illicit drugs and/or alcohol by students on its property or as part of any of its activities. No student will be permitted to attend class if he/she is under the influence, or suspected of being under the influence, of alcohol or drugs. Legal Sanctions Attached is a description of the legal sanctions under the state and federal law for the unlawful possession or distribution of illicit drugs or alcohol. Health Risks A description of the health risks associated with the use of illicit drugs and the abuse of alcohol is included in the attached two booklets, “What Everyone Should Know About Drug Abuse,” and “Alcohol-Facts to Know”. Counseling and Rehabilitation A partial list of drug/alcohol counseling and rehabilitation programs available in the metropolitan Detroit area is attached. A student that was terminated for violation of Detroit Business InstituteDownriver’s standards of conduct listed above may be eligible for re-entry provided he/she has received clearance from a rehabilitation clinic or doctor that states he/she has been rehabilitated. Disciplinary Sanctions Any student who sells, manufactures, distributes, or has in his/her possession an illicit drug will be immediately terminated and all evidence will be turned over to the proper authorities.

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LOCAL COUNSELING, TREATMENT AND REHABILITATION PROGRAMS

SOUTHEAST MICHIGAN COMMUNITY ALLIANCE (SEMCA) 25363 Eureka Road, Taylor, MI 48180 (734) 229-3500 (administrative offices) (800) 686-6543 (substance abuse 24-hour access line) www.semca.org/sas.html SEMCA is the regional coordination agency designated by the Michigan Department of Community Health/Bureau of Substance Abuse Services to administer federal and state substance abuse treatment and prevention programs. SEMCA services clients residing in Wayne County (excluding the city of Detroit). Services include screening assessment referral and follow-up; outpatient individual, family and group treatment; intensive outpatient treatment (adult and adolescent); women’s intensive outpatient treatment and intensive outpatient treatment with domiciliary care. DETROIT WAYNE MENTAL HEALTH AUTHORITY ACCESS CENTER 707 Milwaukee Street, Detroit, MI (313) 344-9099 Substance abuse access lines: (800) 241-4949 & (313) 224-7000 Screening, referral and authorization for substance abuse treatment, adult and youth. HIV testing, post treatment case management and after care referral services. Wayne county residents only, all others appropriately referred. CATHOLIC SOCIAL SERVICES FOR WAYNE COUNTY 19855 West Outer Drive, Suite 207e, Dearborn Heights, MI 48125 (313) 883-2100 www.csswayne.org Individual family and group therapy. Specialized services include substance abuse treatment and prevention. CATHOLIC CHARITIES OF SOUTHEAST MICHIGAN 25 South Monroe Street, Monroe, MI 48161 (734) 240-3850 www.ccmonroe/org Programs include Head Start, substance abuse treatment, individual, family and group mental health counseling, older adult services.

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FEDERAL LEGAL SANCTIONS Federal Penalties and Sanctions for Illegal Possession of a Controlled Substance • • • •

• • • • • •

First conviction: Up to one year imprisonment and fined at least $1,000 but not more than $100,000, or both After one prior drug conviction: At least fifteen days in prison, not to exceed two years, and fined at least $2,500 but not more than $250,000, or both After two or more drug convictions: At least ninety days in prison, not to exceed three years, and fined at least $5,000 but not more than $250,000, or both Special sentencing provisions for possession of crack cocaine: Mandatory of at least five years in prison, not to exceed twenty years, and fined up to $250,000, or both if: 1. First conviction and amount of crack cocaine possessed exceeds five grams. 2. Second crack conviction and the amount of crack possessed exceeds three grams. 3. Third or subsequent crack conviction and the amount of crack possessed exceeds one gram. Forfeiture of personal and real property used to possess or to facilitate possession of a controlled substance if that offense is punishable by more than one year of imprisonment (see special sentencing provisions regarding crack). Forfeiture of vehicles, boats, aircraft, or any other conveyance used to transport or conceal a controlled substance. Civil fine of up to $10,000 (pending adoption of final regulations). Denial of federal benefits such as student loans, grants, contracts, and professional and commercial licenses, up to one year for first offense and up to five years for second and subsequent offenses. Ineligible to receive or purchase a firearm. Revocation of certain federal licenses and benefits, e.g. pilot licenses, public housing tenancy, etc. are vested within the authorities of individual federal agencies.

Federal Trafficking Penalties for Illegal Distribution of a Controlled Substance • • • • • • •

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Methamphetamine (10-99 gm, or 100-199 gm mixture) Heroin (100-999 gm mixture) Cocaine/Cocaine Base (cocaine -500-4,999 gm mixture; cocaine base – 5-49 gm mixture) Phencyclidine (PCP) (10-99 gm or 100-999 gm mixture) LSD (1-10 gm mixture) Fentanyl/Fentanyl Analogues (Fentanyl – 40-399 gm mixture; Fentanyl Analogues 10-99 gm mixture) Marijuana (mixture containing detectable quantity) (100-1,000 kg, or 100-999 plants) 1. First offense: Not less than five years, not more than forty years. If death or serious injury, not less than twenty years, not more than life. Fine of not more than $5 million individual, $25 million other than individual. 2. Second offense: Not less than ten years, not more than life. If death or serious injury, not less than life. Fine of not more than $8 million individual, $50 million other than individual. Drug & Alcohol Awareness & Prevention Program for Students

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REV 9, 2019

• Methamphetamine (100 gm or more, or 1 kg or more mixture) • Heroin (1 kg or more mixture) Cocaine/Cocaine Base (cocaine-5 kg or more mixture; cocaine base-50 gm or more mixture) • Phencyclidine (PCP) (100 gm or more, or 1 kg or more mixture) • LSD (10 gm or more m ixture) • Fentanyl/Fentanyl Analogue (Fentanyl-400 gm or more mixture; Fentanyl Analogue-100 gm or more mixture) • Marijuana (mixture containing detectable quantity) (1,000 kg or more; or 1, 000 or more plants 1. First offense: Not less than ten years, not more than life. If death or serious injury, not less than twenty years, not more than life. Fine of not more than $10 million individual, $50 million other than individual. 2. Second offense: Not less than twenty years, not more than life. If death or serious injury, not less than life. Fine of not more than $20 million individual, $75 million other than individual. • Marijuana (less than 50 kg) • Hashish/Hashish Oil (hashish – less than 10 kg; hashish oil – less than 1 kg) 1. First offense: Not more than five years. Fine of not more than $250,000 individual, $1 million other than individual. 2. Second offense: Not more than ten years. Fine of not more than $500,000 individual, $2 million other than individual. • Marijuana (50-100 kg, or 50-99 plants) • Hashish/Hashish Oil (hashish – 10-100 kg; hashish oil – 100 kg) 1. First offense: Not more than twenty years. If death or serious injury, not less than twenty years, not more than life. Fine of no more than $1 million individual, $5 million other than individual. 2. Second offense: Not more than thirty years. If death or serious injury, not less than life. Fine of no more than $2 million individual, $10 million other than individual. STATE OF MICHIGAN LEGAL SANCTIONS State of Michigan’s Legal Sanctions for Violation of Drug Laws The State of Michigan’s sanctions pertaining to the use and distribution of a controlled substance are varied and determination of the appropriate penalty to be imposed is based on a variety of circumstances relevant to the situation. A violation may result in a misdemeanor or felony conviction accompanied by a fine, imprisonment, seizure of personal and real property, and denial of federal benefits such as grants, contracts and student loans. The details for a crime relating to the use and distribution of a specific controlled substance is outlined within the Michigan Code section 333,7212, 7214, 7216, 7218 and 7220.

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Treatment for Alcohol Problems: Finding and Getting Help

This guide is written for individuals, and their family and friends, who are looking for options to address alcohol problems. It is intended as a resource to understand what treatment choices are available and what to consider when selecting among them.

Table of Contents When Is It Time for Treatment?

Options for Treatment

Treatments Led by Health Professionals

What FDA-Approved Medications Are Available?

Tips for Selecting Treatment

An Ongoing Process

Resources

When Is It Time for Treatment?

Alcohol-related problems — which result from drinking too much, too fast, or too often — are among the most significant public health issues in the United States. Many people struggle with controlling their drinking at some time in their lives. Approximately 17 million adults ages 18 and older have an alcohol use disorder (AUD) and 1 in 10 children live in a home with a parent who has a drinking problem.

Does Treatment Work? The good news is that no matter how severe the problem may seem, most people with an alcohol use disorder can benefit from some form of treatment. Research shows that about one-third of people who are treated for alcohol problems have no further symptoms 1 year later. Many others substantially reduce their drinking and report fewer alcohol-related problems.

Signs of an Alcohol Problem Alcohol use disorder (AUD) is a medical condition that doctors diagnose when a patient’s drinking causes distress or harm. The condition can range from mild to severe and is diagnosed when a patient answers “yes” to two or more of the following questions. In the past year, have you:

❏ Had times when you ended up drinking more, or longer than you intended? ❏ More than once wanted to cut down or stop drinking, or tried to, but couldn’t?

❏ Spent a lot of time drinking? Or being sick or getting over the aftereffects? ❏ Experienced craving — a strong need, or urge, to drink? ❏ Found that drinking — or being sick from drinking — often interfered with taking care of your home or family? Or caused job troubles? Or school problems?

❏ Continued to drink even though it was causing trouble with your family or friends?

❏ Given up or cut back on activities that were important or interesting to you, or gave you pleasure, in order to drink?

❏ More than once gotten into situations while or after drinking that increased your chances of getting hurt (such as driving, swimming, using machinery, walking in a dangerous area, or having unsafe sex)?

❏ Continued to drink even though it was making you feel depressed or anxious or adding to another health problem? Or after having had a memory blackout?

❏ Had to drink much more than you once did to get the effect you want? Or found that your usual number of drinks had much less effect than before?

❏ Found that when the effects of alcohol were wearing off, you had withdrawal symptoms, such as trouble sleeping, shakiness, irritability, anxiety, depression, restlessness, nausea, or sweating? Or sensed things that were not there? If you have any of these symptoms, your drinking may already be a cause for concern. The more symptoms you have, the more urgent the need for change. A health professional can conduct a formal assessment of your symptoms to see if an alcohol use disorder is present. For an online assessment of your drinking pattern, go to RethinkingDrinking.niaaa.nih.gov.

Options for Treatment When asked how alcohol problems are treated, people commonly think of 12-step programs or 28-day inpatient rehab, but may have difficulty naming other options. In fact, there are a variety of treatment methods currently available, thanks to significant advances in the field over the past 60 years. Ultimately, there is no one-size-fits-all solution, and what may work for one person may not be a good fit for someone else. Simply understanding the different options can be an important first step.

Types of Treatment Behavioral Treatments Behavioral treatments are aimed at changing drinking behavior through counseling. They are led by health professionals and supported by studies showing they can be beneficial.

Medications Three medications are currently approved in the United States to help people stop or reduce their drinking and prevent relapse. They are prescribed by a primary care physician or other health professional and may be used alone or in combination with counseling.

Mutual-Support Groups Alcoholics Anonymous (AA) and other 12-step programs provide peer support for people quitting or cutting back on their drinking. Combined with treatment led by health professionals, mutual-support groups can offer a valuable added layer of support. Due to the anonymous nature of mutual-support groups, it is difficult for

researchers to determine their success rates compared with those led by

health professionals.

Starting With a Primary Care Doctor For anyone thinking about treatment, talking to a primary care physician is an important first step — he or she can be a good source for treatment referrals and medications. A primary care physician can also: •

Evaluate whether a patient’s drinking pattern is risky

•

Help craft a treatment plan

•

Evaluate overall health

•

Assess if medications for alcohol may be appropriate

Types of Professionals Involved in Care Many health professionals can play a role in treatment. Below is a list of providers and the type of care they may offer. Provider Type

Degrees & Credentials

Treatment Type

Primary Care Provider

M.D., D.O. (Doctor of Osteopathic Medicine), additionally you may see a Nurse Practitioner or Physician’s Assistant

Medications, Brief Behavioral Treatment, Referral to Specialist

Psychiatrist

M.D., D.O.

Medications, Behavioral Treatment

Psychologist

Ph.D., Psy.D., M.A.

Behavioral Treatment

Social Worker

M.S.W. (Master of Social Work), L.C.S.W. (Licensed Clinical Social Worker)

Behavioral Treatment

Alcohol Counselor

Varies—most States require some form of certification

Behavioral Treatment

Individuals are advised to talk to their doctors about the best form of primary treatment.

Treatments Led by Health Professionals Professionally led treatments include:

Medications Some are surprised to learn that there are medications on the market approved to treat alcohol dependence. The newer types of these medications work by offsetting changes in the brain caused by alcoholism. All approved medications are non addictive and can be used alone or in combination with other forms of treatment. Learn more about these approved treatments on p. 8.

Behavioral Treatments Also known as alcohol counseling, behavioral treatments involve working with a health professional to identify and help change the behaviors that lead to heavy drinking. Behavioral treatments share certain features, which can include: • Developing the skills needed to stop or reduce drinking • Helping to build a strong social support system • Working to set reachable goals • Coping with or avoiding the triggers that might cause relapse

Types of Behavioral Treatments • Cognitive–Behavioral Therapy can take place one-on-one with a therapist or in small groups. This form of therapy is focused on identifying the feelings and situations (called “cues”) that lead to heavy drinking and managing stress that can lead to relapse. The goal is to change the thought processes that lead to excessive drinking and to develop the skills necessary to cope with everyday situations that might trigger problem drinking.

• Motivational Enhancement Therapy is conducted over a short period of time to build and strengthen motivation to change drinking behavior. The therapy focuses on identifying the pros and cons of seeking treatment, forming a plan for making changes in one’s drinking, building confidence, and developing the skills needed to stick to the plan.

• Marital and Family Counseling incorporates spouses and other family members in the treatment process and can play an important role in repairing and improving family relationships. Studies show that strong family support through family therapy increases the chances of maintaining abstinence (stopping drinking), compared with patients undergoing individual counseling.

• Brief Interventions are short, one-on-one or small-group counseling sessions that are time limited. The counselor provides information about the individual’s drinking pattern and potential risks. After receiving personalized feedback, the counselor will work with the client to set goals and provide ideas for helping to make a change.

Ultimately, choosing to get treatment may be more important than the approach used, as long as the approach avoids heavy confrontation and incorporates empathy, motivational support, and a focus on changing drinking behavior.

What FDA-Approved Medications Are Available?

Certain medications have been shown to effectively help people stop or reduce their drinking and avoid relapse.

Current Medications The U.S. Food and Drug Administration (FDA) has approved three medications for treating alcohol dependence, and others are being tested to determine if they are effective. • Naltrexone can help people reduce heavy drinking. • Acamprosate makes it easier to maintain abstinence. • Disulfiram blocks the breakdown (metabolism) of alcohol by the body, causing unpleasant symptoms such as nausea and flushing of the skin. Those unpleasant effects can help some people avoid drinking while taking disulfiram. It is important to remember that not all people will respond to medications, but for a subset of individuals, they can be an important tool in overcoming alcohol dependence. Scientists are working to develop a larger menu of pharmaceutical treatments that could be tailored to individual needs. As more medications become available, people may be able to try multiple medications to find which they respond to best.

“Isn’t taking medications just trading one addiction for another?” This is not an uncommon concern, but the short answer is “no.” All medications approved for treating alcohol dependence are non-addictive. These medicines are designed to help manage a chronic disease, just as someone might take drugs to keep their asthma or diabetes in check.

Looking Ahead: The Future of Treatment Progress continues to be made as researchers seek out new and better treatments for alcohol problems. By studying the underlying causes of alcoholism in the brain and body, NIAAA is working to identify key cellular or molecular structures — called “targets” — that could lead to the development of new medications.

Personalized Medicine Ideally, health professionals would be able to identify which alcoholism treatment is most effective for each person. NIAAA and other organizations are conducting research to identify genes and other factors that can predict how well someone will respond to a particular treatment. These advances could optimize how treatment decisions are made in the future.

Current NIAAA Research — Leading to Future Breakthroughs Certain medications already approved for other uses have shown promise for treating alcohol dependence and problem drinking: • The anti-smoking drug varenicline (marketed under the name Chantix) significantly reduced alcohol consumption and craving among people with alcoholism. • Gabapentin, a medication used to treat pain conditions and epilepsy, was shown to increase abstinence and reduce heavy drinking. Those taking the medication also reported fewer alcohol cravings and improved mood and sleep. • The anti-epileptic medication topiramate was shown to help people curb problem drinking, particularly among those with a certain genetic makeup that appears to be linked to the treatment’s effectiveness.

Tips for Selecting Treatment Professionals in the alcohol treatment field offer advice on what to consider when choosing a treatment program. Overall, gather as much information as you can about the program or provider before making a decision on treatment. If you know someone who has first-hand knowledge of the program, it may help to ask about his or her personal experience.

Here are some questions you can ask that may help guide your choice:

❏ What kind of treatment does the program or provider offer? It is important to gauge if the facility provides all the currently available methods or relies on one approach. You may want to learn if the program or provider offers medication and if mental health issues are addressed together with addiction treatment.

❏ Is treatment tailored to the individual?

Matching the right therapy to the individual is important to its success. No single treatment will benefit everyone. It may also be helpful to determine whether treatment will be adapted to meet changing needs as they arise.

❏ What is expected of the patient?

You will want to understand what will be asked of you in order to decide what treatment best suits your needs.

❏ Is treatment success measured?

By assessing whether and how the program or provider measures success, you may be able to better compare your options.

❏ How does the program or provider handle relapse?

Relapse is common and you will want to know how it is addressed. For more information on relapse, see p. 12.

When seeking professional help, it is important you feel respected and understood and that you have a feeling of trust that this person, group, or organization can help you. Remember, though, that relationships with doctors, therapists, and other health professionals can take time to develop.

Additional Considerations Treatment Setting — Inpatient or Outpatient? In addition to choosing the type of treatment that’s best for you, you’ll also have to decide if that treatment is inpatient (you would stay at a facility) or outpatient (you stay in your home during treatment). Inpatient facilities tend to be more intensive and costly. Your health care provider can help you evaluate the pros and cons of each. Cost may be a factor when selecting a treatment approach. Evaluate the coverage in your health insurance plan to determine how much of the costs your insurance will cover and how much you will have to pay. Ask different programs if they offer sliding scale fees — some programs may offer lower prices or payment plans for individuals without health insurance.

An Ongoing Process Overcoming an alcohol use disorder is an ongoing process, one which can include setbacks.

The Importance of Persistence Because an alcohol use disorder can be a chronic relapsing disease, persistence is key. It is rare that someone would go to treatment once and then never drink again. More often, people must repeatedly try to quit or cut back, experience recurrences, learn from them, and then keep trying. For many, continued followup with a treatment provider is critical to overcoming problem drinking.

Relapse Is Part of the Process Relapse is common among people who overcome alcohol problems. People with drinking problems are most likely to relapse during periods of stress or when exposed to people or places associated with past drinking. Just as some people with diabetes or asthma may have flare-ups of their disease, a relapse to drinking can be seen as a temporary set-back to full recovery and not a complete failure. Seeking professional help can prevent relapse — behavioral therapies can help people develop skills to avoid and overcome triggers, such as stress, that might lead to drinking. Most people benefit from regular checkups with a treatment provider. Medications also can deter drinking during times when individuals may be at greater risk of relapse (e.g., divorce, death of a family member).

Mental Health Issues and Alcohol Use Disorder Depression and anxiety often go hand in hand with heavy drinking. Studies show that people who are alcohol dependent are two to three times as likely to suffer from major depression or anxiety over their lifetime. When addressing drinking problems, it’s important to also seek treatment for any accompanying medical and mental health issues.

Advice For Friends and Family Members Caring for a person who has problems with alcohol can be very stressful. It is important that as you try to help your loved one, you find a way to take care of yourself as well. It may help to seek support from others, including friends, family, community, and support groups. If you are developing your own symptoms of depression or anxiety, think about seeking professional help for yourself. Remember that your loved one is ultimately responsible for managing his or her illness. However, your participation can make a big difference. Based on clinical experience, many health providers believe that support from friends and family members is important in overcoming alcohol problems. But friends and family may feel unsure about how best to provide the support needed. The groups for family and friends listed on p. 14 may be a good starting point. Remember that changing deep habits is hard, takes time, and requires repeated efforts. We usually experience failures along the way, learn from them, and then keep going. Alcohol use disorders are no different. Try to be patient with your loved one. Overcoming this disorder is not easy or quick. Pay attention to your loved one when he or she is doing better or simply making an effort. Too often we are so angry or discouraged that we take it for granted when things are going better. A word of appreciation or acknowledgement of a success can go a long way.

Resources Professional help Your doctor. Primary care and mental health practitioners can provide effective alcoholism treatment by combining new medications with brief counseling visits. To aid clinicians, NIAAA has developed two guides: Helping Patients Who Drink Too Much, and for younger patients, Alcohol Screening and Brief Interventions for Youth: A Practitioner’s Guide. Both are available at www.niaaa.nih.gov/ publications/clinical-guides-and-manuals Specialists in alcohol use disorders. For specialty addiction treatment options, contact your doctor, health insurance plan, local health department, or employee assistance program. Other resources include:

Medical and non-medical addiction specialists American Academy of

Addiction Psychiatry

www.aaap.org

401–524–3076

American Psychological Association www.apa.org

1–800–964–2000 (ask for your State’s

referral number to find psychologists

with addiction specialties)

American Society of

Addiction Medicine

www.asam.org

301–656–3920 (ask for the phone

number of your State’s chapter)

NAADAC Substance

Abuse Professionals

www.naadac.org

1–800–548–0497

National Association

of Social Workers

www.helpstartshere.org

(search for social workers with

addiction specialties)

Treatment facilities Substance Abuse Treatment

Facility Locator

www.findtreatment.samhsa.gov

1–800–662–HELP

Mutual-support groups Alcoholics Anonymous (AA) www.aa.org 212–870–3400 or check your local phone directory under “Alcoholism” Moderation Management www.moderation.org

212–871–0974

Secular Organizations for Sobriety www.sossobriety.org

323–666–4295

SMART Recovery www.smartrecovery.org

440–951–5357

Women for Sobriety www.womenforsobriety.org

215–536–8026

Groups for family and friends Al-Anon Family Groups www.al-anon.alateen.org

1–888–425–2666 for meetings

Adult Children of Alcoholics www.adultchildren.org

310–534–1815

Information resources National Institute on Alcohol Abuse and Alcoholism www.niaaa.nih.gov

301–443–3860

National Institute on Drug Abuse www.nida.nih.gov

301–443–1124

National Institute of Mental Health www.nimh.nih.gov

1–866–615–6464

National Clearinghouse for Alcohol and Drug Information www.samhsa.gov

1–800–729–6686

Research shows that most people who have alcohol problems are able to reduce their drinking or quit entirely. There are many roads to getting better. What is important is finding yours. Understanding the available treatment options — from behavioral therapies and medications to mutual-support groups — is the first step. The important thing is to remain engaged in whatever method you choose. Ultimately, receiving treatment can improve your chances of success.

Notes

NATIONAL INSTITUTE ON ALCOHOL ABUSE AND ALCOHOLISM

NIH . . . Turning Discovery Into Health

NIH Publication No. 14–7974 Published 2014

How our understanding has changed Old Stereotypes

New Knowledge

People who were not “alcoholic” did not need to watch how much they drank.

Drinking can cause problems for anyone. So we focus on preventing these problems by educating everyone about alcohol use.

In the past experts thought…

Alcoholism was due to a lack of will power. It was not generally treated by doctors.

Now experts know...

What are the recommended limits?*

MEN

Per day: No more than 2 drinks on average, and no more than 4 drinks on any day Per week: No more than 14 drinks total

1 Drink =

An alcohol use disorder is a brain condition caused by many factors, including how much a person drinks.

Doctors had to wait until people with alcoholism wanted help.

Asking people about their alcohol use and giving them advice about it is part of high-quality health care for everyone.

There was a “one-size-fits-all” approach to alcohol treatment— and we only offered people group treatment based on the 12 steps of Alcoholics Anonymous (AA).

People with alcohol use disorders can choose from several proven treatment options: • Individual or couples counseling • Group counseling • Medications • Mutual help programs like SMART Recovery or AA

WOMEN

Per day: No more than 1 drink on average, and no more than 3 drinks on any day Per week: No more than 7 drinks total

12 OZ. beer 5 OZ. wine 1.5 OZ. liquor (a standard shot)

Drinking above these limits increases your risk of: • Weight gain • Insomnia • Forgetting medications • Medication interactions • Surgical complications • High blood pressure • Depression and anxiety • Liver or pancreatic disease

• Bleeding from the stomach • Stroke • Dementia • Seizures • Breast, prostate, colon and other cancers • Heart disease, including heart failure • Death

*Experts recommend no alcohol use for women who are pregnant, people who have liver disease, or people who have had problems due to drinking in the past.

Moving beyond stereotypes Experts no longer view drinking alcohol as a black and white issue, where people are either “alcoholic” or not. Instead, we use the term “alcohol use disorders” to describe a broad range of problems related to drinking. Experts have also stopped recommending that people drink for their health. Why? Because the health and social problems that drinking can cause far outweigh any potential health benefits.

Did you know

• About 1 in 4 adults drinks more alcohol than is recommended for good health. And about 1 in 12 has an alcohol use disorder. • People who drink above recommended limits are at risk for a variety of health problems. • The risk of death increases in women who have more than 7 drinks per week and in men who have more than 14 drinks per week.

Talk WithYour Doctor Even if you don’t want to stop drinking, treatment can still help you cut back. Ask yourself these important questions, then talk with your doctor about your answers. Have you had times when you drank more, or for longer, than you wanted to? Have you wanted to cut back or stop drinking more than once, but found that you couldn’t? Do you spend a lot of time drinking or feeling hung-over? Do you feel an urge to drink or a craving for alcohol? Has drinking or feeling hung-over made it harder for you to take care of your responsibilities? Have you continued to drink even when it was causing trouble with your family or friends? Have you stopped doing things you enjoy because of your drinking? Do you ever do dangerous things after drinking, such as drive a car or have unsafe sex? Have you continued to drink even when it made you feel depressed or anxious or caused other health problems? Do you need to drink more than you used to to feel the effect you want? Do you feel like you’re not yourself when you don’t drink—for example, do you feel irritable, have trouble sleeping, or notice other problems?

A ReThink of the Way we Drink https://youtu.be/tbKbq2IytC4

DL-108167 2015259

Alcohol and health... What you should know

FACES of CHANGE Do I have a problem with alcohol or drugs?

Alcohol and drug problems affect many people. Some people see that drinking alcohol or using illegal drugs is hurting them. But there are a lot of other people who don’t even know they have a problem. They ignore the warning signs, even when their friends and family tell them that they have a problem.

This booklet looks at five people: Eric, Sue, Yolanda, Derrick, and Don. They come from different backgrounds, but they all have a problem with alcohol or illegal drugs.

As you read about these five people, think about your own life and the role that alcohol or drugs may play in it. Could drugs or alcohol be causing problems that you weren’t even aware of? Could you or someone you know be in denial about a problem with alcohol or drugs? Look at what the characters do. Will their actions help or hurt? Would you do the same thing or something different? 2

ERIC

Eric drank and smoked pot (marijuana) and got high on it a lot in high school. He also went to “keg” parties where he drank a lot of alcohol. He dropped out of school in his senior year. Now Eric has a job at a repair shop. He hates it. Sometimes he thinks he has to have a few beers or smoke some pot at lunch just to get through the day. 3

Eric, this has to stop or I’m gone!

Eric’s girlfriend Julie complains that he spends too much time drinking and getting high with his friends. She says she’ll move out if he doesn’t stop.

My girlfriend is a nag!

Now some friends invite Eric to a party where there is beer and pot. Eric goes and gets drunk, even though he knows his girlfriend will be upset.

What could happen to Eric if he keeps drinking and using marijuana? •

Eric might be arrested for drunk driving or for having marijuana, and could be referred to treatment by the court.

•

His girlfriend might leave him.

•

His boss might smell Eric’s breath after lunch. Then he might be fired. Or his employer might have an Employee Assistance Program (EAP) that will send him to treatment.

SUE Sue is a wife and a mother. She also works at a museum part time and goes to school. As the semester goes by, she finds herself under a lot of stress.

A fellow student tells Sue that he can sell her “uppers” (amphetamines) that will help her stay awake and get more done. Sue doesn’t like doing something illegal, but she starts taking the pills.

Two months go by, and Sue is still taking the pills. She is becoming irritable. She slaps her child for asking for a cookie. Her husband is upset and worried about how Sue is acting, and he wants her to talk to a substance abuse counselor about the pills she takes. 5

I don’t know what to do!

Sue doesn’t think she needs treatment, but she wants to please her husband. She doesn’t want to stop taking her pills, but she admits to a friend that they might be creating problems. Now Sue has a test coming up at school. She thinks about what her husband said, but she takes some pills to stay awake and study. At the same time, she knows she’ll be tired the next day if she doesn’t sleep. Sue feels guilty and frustrated. She doesn’t know what to do about her situation. What kinds of things could a substance abuse counselor do to help Sue? •

Help her explore the pros and cons of taking the pills.

•

Describe the harmful effects of the pills.

•

Describe what other people have done in a similar situation.

•

Help her set goals for quitting.

•

Suggest ways she can find support from others.

YOLANDA

Yolanda drinks a lot when she comes home from work. She wakes up feeling “hung over” at least three times a week. She has quit drinking a few times, but always started up again. It’s making her late to work more and more often.

Yolanda has been thinking about what her life would be like if she stopped drinking. She would do better at her job, and she wouldn’t wake up with headaches and stomach aches all the time. Yolanda’s father is in recovery from an alcohol abuse problem. He has moved back to Mexico but she still calls him for advice. He explains that alcoholism often runs in families.

He tells Yolanda that she should think about treatment. He suggests that she create a Change Plan Worksheet, listing the pros and cons of not drinking.

Now Yolanda is watching TV at home. She wants to get a beer out of the fridge, but she knows that she’ll end up having more than one. She takes all of the beers and pours them down the sink. She fills out the Change Plan Worksheet that her father talked about.

DERRICK Derrick used to drink a lot and take drugs when he partied with his friends at the clubs. Then one night he got arrested for possession of an illegal drug. The judge told him he had to get treatment.

At first, Derrick didn’t like treatment. He didn’t want to talk about his drug use. There were times when he wanted to quit treatment because it was really hard. But this slowly changed.

I’m glad things are better for you now!

After time, Derrick started to trust his substance abuse treatment counselor. He helped Derrick to know the “triggers” that could cause him to start using drugs again. He encouraged Derrick to create a support network of family and friends who don’t use drugs.

Now Derrick’s old buddies still call him sometimes to go out partying. Derrick says no and goes to a 12-Step meeting instead. It lets him meet other people he has things in common with. He’s got a new job and he feels good about himself.

Together, Derrick and his counselor have come up with several things he can do whenever he thinks about drinking or using drugs: •

He can do volunteer work in his spare time. This can help Derrick connect with people who don’t do drugs.

•

He can spend more time with his family, and with friends who don’t use drugs.

•

He can work out at the gym or take a computer course. 10

DON

When he was younger, Don hung out with a tough gang at the reservation where he lived. They often used drugs. He was arrested and told to enter a drug treatment program. Even though treatment made him feel better about himself, Don ran into his old gang and slipped back into using “meth” (methamphetamines) every day. He got arrested again and was sent to prison.

With the help of the prison’s substance abuse treatment counselor, Don moved into a halfway house and joined a drug treatment program. Away from the gang, and without drugs in his life, Don was able to finish high school and find a good job. 11

Don is now 40. He has been married for six years and enjoys going camping with his wife and children. He hasn’t touched drugs in 10 years. He likes to work out at the gym, and he has made a new set of friends who don’t drink or use drugs. Some of his friends are also in recovery and go to 12-Step meetings with him. Now Don is thinking about a career change. He would like to become a counselor for people with drug problems like he had. He wants to work in the clinic back on the reservation. He knows he needs to get more education, though, and make sure his own recovery is stable before he makes the change.

Today is fine and tomorrow will be better.

Every day, Don practices the coping skills he learned in treatment: •

He’s aware of negative feelings. He talks with a trusted person about them.

•

He works out at the gym to relieve stress.

•

Don HALTs sometimes. HALT stands for Hungry, Angry, Lonely, Tired. When he feels these things he stops and thinks. Don knows that it is important to do something positive at these times. He knows drugs won’t solve his problems. 12

What Can You Do About Drugs And Alcohol In Your Life? Know if there’s a problem: •

Are drugs or alcohol affecting your work or health?

•

Do you feel like you need alcohol or drugs to get through the day?

•

Are your friends or family members telling you there’s a problem?

Avoid the personal “triggers” that could set off an urge to drink or use drugs: •

Don’t try to do too much and get stressed out.

•

Don’t ignore the negative feelings that drugs and alcohol can cause.

•

Avoid people, places, and activities where you usually use drugs or drink alcohol.

Think about the benefits of making a change: •

Being healthier and stronger without alcohol or drugs.

•

Having family and friends who know they can depend on you.

•

Having a future with lots of choices.

If you think you might have a problem with alcohol or drugs, fill out the Change Plan Worksheet on the next page. You can even cut it out and carry it with you, or give it to a friend if you think it could help. 13

Change Plan Worksheet The changes I want to make are:

The most important reasons I want to make these changes are:

I plan to do these things to reach my goal:

The first steps I plan to take in changing are:

Some things that could interfere with my plan are:

Other people could help me in changing in these ways:

I hope my plan will have these positive results:

I will know that my plan is working if:

A counselor or professional I can call if I think I have a problem is:

Please share your thoughts about this publication by completing a brief online survey at: https://www.surveymonkey.com/r/KAPPFS The survey takes about 7 minutes to complete and is anonymous. Your feedback will help SAMHSA develop future products.

Here are some helpful phone numbers and Web sites for more information about the warning signs of an alcohol or drug problem and how to get help: Substance Abuse and Mental Health Services Administration (SAMHSA) U.S. Department of Health and Human Services (HHS) 1-800-662-HELP http://www.findtreatment.samhsa.gov

Alcoholics Anonymous 212-870-3400 (literature) 212-647-1680 (meeting referral) http://www.aa.org Cocaine Anonymous 1-800-347-8998 http://www.ca.org Marijuana Anonymous 1-800-766-6779 http://www.marijuana-anonymous.org

NAFARE Alcohol, Drug, and Pregnancy Hotline 1-800-638-BABY Narcotics Anonymous 1-818-773-9999 http://www.na.org Women for Sobriety 1-800-333-1606 http://www.womenforsobriety.org

This list of resources is not exhaustive and does not necessarily signify endorsement by SAMHSA or HHS.

Check this box to see if a treatment center near you has listed its address and/or phone number.

All material appearing in this report is in the public domain and may be reproduced or copied without permission from SAMHSA. Citation of the source is appreciated. However, this publication may not be reproduced or distributed for a fee without the specific, written authorization of the Office of Communications, SAMHSA, HHS. This brochure was created to accompany the publication Enhancing Motivation for Change in Substance Abuse Treatment, #35 in SAMHSA’s Treatment Improvement Protocol (TIP) Series. The TIP series and its affiliated products may be ordered from SAMHSA’s Publications Ordering Web page at http://store.samhsa.gov. Or, please call SAMHSA at 1-877-SAMHSA-7 (1-877-726-4727) (English and Español). HHS Publication No. (SMA) 15-4174 Printed 2005 Reprinted 2006, 2007, 2008, 2009, 2011, 2012, 2013, 2014, and 2015

DETROIT BUSINESS INSTITUTE-DOWNRIVER CAMPUS CRIME AND SECURITY REPORT POLICY 2021 The Jeanne Clery Act These policies are published as required by the Jeanne Clery Disclosure of Campus Security Policy and Campus Crime Statistics Act (1998). In accordance with the guidelines set forth by the Jeanne Clery Disclosure of Campus Security Policy and Campus Crime Statistics Act (Clery Act), all institutions that participate in Federal Student Financial Aid programs are required to maintain and disclose information about crime on or near their campuses. These statistics and policies/procedures will be updated and distributed as required by the Act. The purpose of this safety and security report is to provide faculty, staff, students, and campus visitors with an overview of DBI-D security resources, policies, and procedures. Detroit Business Institute-Downriver (DBI-Downriver) has designated the School Director as the Campus Security Authority. Reporting crimes is on a voluntary, confidential basis. In order to ensure a safe environment, the institution encourages students and employees to report all police incidents, security or safety concerns to the School Director. The School Director is responsible to document the incident and report any crimes to local law enforcement agencies as required by law. All crimes committed on the campus by students, faculty or staff, may result in immediate dismissal. The following crimes committed on the DBI-campus, or within surrounding and adjacent areas, will be reported to law enforcement agencies.

Criminal Offenses Murder/Non-negligent manslaughter Negligent manslaughter Sex offenses - forcible Rape Fondling Sex offenses – non-forcible Incest Statutory rape Robbery Aggravated assault Burglary Motor vehicle theft Arson

VAWA offenses Domestic violence Dating violence Stalking

Arrests Weapons: carrying, possession, etc. Drug abuse violations Liquor law violations

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Referrals for disciplinary actions Weapons: carrying, possession, etc. Liquor law violations Drug abuse violations Notification of the availability of the School’s Annual Campus Security report is made annually to employees and enrolled students, prospective students and employers upon request, new enrolled students as part of the new student orientation.

SECURITY & ACCESS TO CAMPUS FACILITIES The institution is a commuter school and does not maintain off-campus facilities or student housing. The campus limits access to the facility to authorized personnel, enrolled students and visitors. Unauthorized visitors are not permitted on the campus. Students do not have access to the facility unless, at a minimum, one staff person is available on-site during the specific hours of operation. The responsibility of campus security then rests with the staff person, who is authorized to conduct the opening and closing procedures for the school. DBI-Downriver maintains a relationship with local police through collection of annual crime statistics and normal communications. The school’s safety procedures are enhanced by regular police patrols at the campus location and by a high level of police rapidity to requests for community assistance.

CRIME AWARENESS AND PREVENTION All new employees and students are instructed on crime awareness during orientation including a description of procedures for reporting criminal activity or an emergency. The information on crime awareness is readily available upon request and is updated and redistributed to all existing students and staff on an annual basis. Students are required to follow security guidelines for their own personal and property safety and are encouraged to report any suspicious activity. Students performing externship or clinical practice off-campus are expected to practice an extension of the school’s safety guidelines at the site as if they were on-campus. Students are also subject to adhere to the site’s safety and security guidelines.

CRIME INCIDENT REPORT The campus maintains a Daily Crime Log that records the date and time any crime occurs on campus. The School Director is responsible to make an entry into the Daily Crime Log within two business days of receiving the reported crime information. If you believe that you have been the victim of a crime at DBI campus report the situation immediately to the DBI staff (School Director, Front Desk). These individuals can be contacted through the receptionist in the front lobby if they are not immediately visible. The staff member will give you immediate assistance as required. The staff member will contact the local police regarding the incident, but you as an individual will be required to file a police report. The staff

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member will also take information for an internal Incident/Accident report for our records and follow-up. If follow-up action is required by DBI at the request of an individual or the police, we will gladly cooperate. Any pertinent information or assistance requested will be given to the Police. Changes in internal procedures will be made if an additional effort will alleviate a problem. We encourage any individual who believes that a crime has been committed to report this immediately to the staff and the Police. Only a law enforcement agency can make the determination that a reported crime did not occur. In such situations the disposition is noted as “unfounded” and an addition to the entry will be made. The Daily Crime Log includes the following information: • • • • • •

Date the entry was completed Incident report date Date/time of crime General location of the crime Nature of the crime/complaint Disposition of the complaint, if available

The above information may be withheld if there is evidence that the release of the information would: • Jeopardize an ongoing investigation or safety of an individual • Cause a suspect to flee or evade detection • Result in destruction of evidence The Daily Crime Log is open to public inspection during normal business hours for the most recent 60-day period. Any portion of the log prior to 60-days must be made available within two business days of a request for public inspection.

REPORTING CRIMES 1. Students and employees should promptly report criminal acts to the School Director and/or local police departments. 2. Reporting crimes is on a voluntary, confidential basis. 3. The School Director is responsible to document any criminal acts, as well as reporting crimes to the local authorities as required by law. 4. The institution is required to make a timely warning to members of the campus regarding the occurrence of crimes that are considered to represent a threat to students and employees. 5. If there is an ongoing investigation of a crime that would jeopardize, cause the suspect to flee, risk the safety of the individual, or result in destruction of evidence, the timely warning may be delayed. 6. The crime statistics are collected by the institution and submitted to the Department of Education on an annual basis.

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In the interest of public safety, we have gathered the following tips for general personal safety. We encourage individuals to take all necessary measures to prevent a crime from happening. In that vein, we offer the following suggestions: • • •

Do not walk alone after dark. Walk with a friend to your car or ask for an escort from the facilities staff. Walk confidently, look around and be aware of your surroundings. If you feel threatened in any way, contact a member of the Staff immediately.

If you sense a potential threat: • • • •

Try to get away from danger. Yell or make as much noise as possible to attract attention. Run toward a well-lit and populated area. Report any concern or problems to the Facilities staff and/or the local police.

Policies of DBI Conduct of Students, Employees and Visitors While on DBI property, a student, employee or visitor to DBI is in violation of DBI policy and subject to disciplinary action for the following offenses: 1. 2. 3. 4. 5.

Obstruction or disruption of teaching or other activities at DBI. Physical abuse or unlawful detention any person. Theft or damage to property of DBI or to property of a DBI employee, student or DBI visitor. Unauthorized entry or use of DBI facilities and equipment. Illegal use or unauthorized possession or distribution of alcoholic beverages, narcotics, or dangerous drugs. 6. Failure to comply with the directions of DBI officials, members of the faculty or other authorized individuals. 7. Illegal or unauthorized possession or use of firearms, explosives, or other weapons, chemicals or fire extinguisher. 8. Sexual harassment. Violations of any of the above policies should be reported immediately to the staff according to the reporting procedures outlined previously.

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DBI views all forms of sexual harassment as reprehensible and therefore prohibited to all in connection with any DBI related activity. Sexual harassment is unacceptable conduct; it undermines the integrity of the employment/learning relationship, debilitates morale, and interferes with the work productivity of the organization and its learning environment. All staff, faculty and students have a responsibility to maintain high standards of integrity, impartiality, and conduct, both personal and official, thereby ensuring proper performance of DBIs business and the maintenance of public trust. Sexual harassment violates those standards and is an act of misconduct. Therefore, specific acts of such misconduct may be subject to disciplinary action or even dismissal.

What Constitutes Sexual Harassment? Sexual harassment includes, but is not limited to, the following: 1. Influencing, offering to influence, or threatening the career, pay or job of another person or the educational program of a student in exchange for sexual favors. 2. Deliberate or repeated offensive comments, gestures, physical contact of a sexual suggestive nature or creation of hostile work, work-related or instructional environment. By way of further illustration, and not by way of limitation, any employee, student, faculty member, or continuing education instructor who uses implicit or explicit sexual behavior to control, influence, or affect the career, pay, or job of any employee or student, or to affect the instructional experience of any student is engaging in sexual harassment. Any employee, student, faculty, or continuing education instructor who makes deliberate or repeated offensive verbal comments, gestures, or physical contact of a sexual or suggestive nature in the work, work-related, or educational environment is also engaging in sexual harassment. For purposes of this paragraph, the term "student" includes any person enrolled in an academic course at DBI. The institution maintains a variety of information for students and employees that identifies the location of facilities which offer off-campus assault prevention programs and treatment centers for victims of sexual assault.

First Step, 44567 Pinetree Drive , Plymouth, MI First Step, 4400 Venoy, Wayne, MI 24 Hour Help Line (734) 722-6800 or (888) 453-5900 Haven, P.O. Box 431045 Pontiac, MI Telephone: (248) 334-1274 or Toll Free (877) 922-1274 Turning Point Inc., P.O. Box 1123, Mt. Clemens, MI Telephone: (586) 463-4430 Bystander Intervention Bystander intervention is very important in the prevention of sexual and relationship violence. Bystanders are individuals who observe violence or witness the conditions that perpetuate violence. They are not directly involved but have the choice to intervene, speak up, or do

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something about it. The following are some strategies for bystander intervention. (taken from Rape, Abuse, & Incest National Network, www.rainn.org). There are many things men and women can do to help prevent sexual violence. If you see someone in danger of being assaulted: • • •

Step in and offer assistance. Ask if the person needs help. NOTE: Before stepping in, make sure to evaluate the risk. If it means putting yourself in danger, call 911 instead. Don’t leave. If you remain at the scene and are a witness, the perpetrator is less likely to do anything. If you know the perpetrator, tell the person you do not approve of their actions. Ask the person to leave the potential victim alone.

Be an ally: • • •

When you go to a party, go with a group of friends. Arrive together, check in with each other frequently and leave together. Have a buddy system. Don’t be afraid to let a friend know if you are worried about her/his safety. If you see someone who is intoxicated, offer to call a cab.

If someone you know has been assaulted: • • •

•

• • •

Listen. Be there. Don’t be judgmental. Be patient. Remember, it will take your friend some time to deal with the crime. Help to empower your friend or family member. Sexual assault is a crime that takes away an individual's power, it is important not to compound this experience by putting pressure on your friend or family member to do things that they are not ready to do yet. Encourage your friend to report the rape to law enforcement (call 911 in most areas). If your friend has questions about the criminal justice process, talking with someone on the National Sexual Assault Hotline, 1-800-656-HOPE can help. Let your friend know that professional help is available through the National Sexual Assault Hotline, 1-800-656- HOPE and the National Sexual Assault Online Hotline. If your friend is willing to seek medical attention or report the assault, offer to accompany them wherever they need to go (hospital, police station, campus security, etc.) Encourage him or her to contact on of the hotlines, but realize that only your friend can make the decision to get help.

Warning Signs of Abusive Behavior Domestic violence, dating violence, and/or sexual assault can happen to anyone. Perpetrators of physical abuse use power and control over their victims. The following are a few warning signs of abusive behavior (taken from Rape, Abuse, & Incest National Network, www.rainn.org). • • • •

Controlling behavior Act possessive or jealous Use emotional abuse Does not trust their significant other and constantly checks up on them (e.g. reads text messages, checks their email and phone calls)

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Although not all victims of physical abuse act the same some common signs exhibited are as follows: • • • •

Will not look you in the eye Low self-esteem, if they use to be confident Always aware of their surroundings (e.g. knows where the perpetrator is at all times) Personality changes There are no clear-cut ways to prevent sexual assault and even though there are occasionally warning signs you may not recognize these warning signs and it’s important to remember sexual assault is never your fault.

No perpetrator of sexual assault is the same, but some techniques utilized in social settings in an attempt to isolate an individual are as follows: 1. Attempts to continuously offer alcoholic drinks to a person 2. Overly nice in an attempt to isolate (e.g., offers to walk you home, or escort you to the restroom, etc.) 3. Crossing your boundaries 4. Doesn’t listen to your opinions

I. Sex Offenders The Campus Sex Crimes Prevention Act requires schools to disclose to its students the location of sex registries. Students at DBI-Downriver may access the State of Michigan Public Sex Offender Registry web site at www.mipsor.state.mi.us or telephone (517) 241-1806. The act also requires registered sex offenders to provide a notice to any campus or higher education in which the offender is employed, carries on a vocation or is a student.

II. Sex Offenses If a sex offense occurs, the victim should immediately contact the School Director. Students have the option to report rape or sex offenses to law enforcement. The School Director will assist the student in reporting the offense, should the student select to do so. Students who report dating violence, domestic violence, sexual assault or stalking to the institution, will be provided with a written explanation of their rights and options, regardless of whether the offense occurred on campus. They will also receive a written notification for counseling, health, mental health, victim advocacy, legal assistance, visa immigration assistance, student financial aid, and other services available within the institution or in the community. The institution will revise an academic schedule for a student as a protective measure, provided a reasonable change can be implemented. be accommodated. In the event of an accusation of a sex offense, the complainant will provide a written complaint to the School Director within two days of the alleged offense. The School Director may select to meet with complainant to hear his/her account of the incident. A formal investigation may be initiated at which time the accused will meet with the School Director and submit a written statement (generally provided within five business days) in response to the allegations. A determination will be made whether or not to proceed with an internal disciplinary proceeding, based on sufficient information to believe sexual misconduct may have

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occurred. Both parties are entitled to have one individual accompany them during the disciplinary proceeding. Both parties are given timely and equal access to information that will be utilized within informal or formal disciplinary meetings and hearings.

III. Disciplinary Proceedings The Higher Education Opportunity Act (HEOA) requires schools to disclose, upon request to the victim of a crime of violence or a non-forcible sex offense, the written results of any disciplinary hearing related to the offense conducted by the campus against the student who is the alleged perpetrator of the crime or offense. The results of an institutional disciplinary hearing determine whether a student or employee committing an allegation of dating violence, domestic violence, sexual assault or stalking, will be subject to disciplinary action imposed by the school. The sanctions Imposed may include attendance at a mandatory counseling treatment center, discharge from employment or expulsion from school. Procedures for Institutional Disciplinary Action in Cases of Alleged Domestic Violence, Dating Violence, Sexual Assault, or Stalking. In the event that DBI institutes disciplinary proceedings concerning incidents of sexual assault, sexual offence, the victim shall have the same rights in the procedure as the accused, and the victim will be notified of the outcome of any disciplinary proceeding concerning the incident. Institutional disciplinary procedures may result in a range of sanctions for offenders including counseling, warnings, suspension, or dismissal from DBI. Where employees are the accused or respondent, complaints regarding rape, acquaintance rape, domestic violence, dating violence, sexual assault and stalking are to be reported to the School Director. The standard of evidence used during any institutional conduct proceeding arising from such a report is the preponderance of evidence. DBI protects the identities of victims, by removing personally identifiable information from reports and documents before those reports or documents are released to the public, to the extent permitted by law. Both the victim and the accused are entitled to have an advisor present during the proceeding, including the opportunity to be accompanied to any related meeting or proceeding by any advisor of their choice in accordance with institutional policies and procedures, which may be amended from time to time. Both the victim and the accused shall be simultaneously informed in writing of the result of any institutional disciplinary proceeding in a timely manner, that arises from an allegation of sexual offence, sexual assault, or stalking, the institution’s procedures for the accused and the victim to appeal the results of the institutional disciplinary proceeding, any change to the results that occur prior to the time that such results become final and when such results become final. If the alleged victim of such crime or offense is deceased as a result of such crime or offenses, the next of kin of such victim shall be informed of the outcome of the proceeding. These

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procedures will be followed regardless of where the alleged offense occurred. Compliance with this paragraph does not constitute a violation of the Family Educational Rights and Privacy Act (FERPA). A student or employee who reports to an institution of higher education that the student or employee has been a victim of domestic violence, dating violence, sexual assault, or stalking, whether the offense occurred on or off location, shall be provided with a written explanation of the student’s or employee’s rights and options.

Definitions: What Is Sexual Assault? Sexual assault is any physical sexual contact, as defined by Michigan law (Michigan Criminal Sexual Conduct Statute, Public Act No. 266 of 1974, as amended), to which you have not given consent. Unwanted sexual gestures or language are sexual harassment.

Sexual assault is not always violent. While in most sexual assaults, men are the perpetrators and women the victims, that is not always the case. Most sexual assaults occur between people that know each other. These instances of sexual assault are known as acquaintance rape. What Is Consent? Consent is "willingly and verbally agreeing to specific sexual contact or conduct." This means the individuals involved must state clearly what they do and do not want to occur between them. Under DBI policy: • • •

No one who is intoxicated can consent No one who is under duress can consent; and No one who has been threatened or pressured can consent.

DBI Policy No member of the DBI community shall engage in sexual assault as defined by Michigan law. DBI will treat any and/or all sexual assaults as a matter of the highest concern and seriousness. What is Rape? The penetration, no matter how slight, of the vagina or anus with any body part or object, or oral penetration by a sex organ of another person, without consent of the victim. What is Statutory Rape? Sexual intercourse with a person who is under the statutory age of consent.

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What is Fondling? The touching of the private body parts of another person for the purpose of sexual gratification, without the consent of the victim, including instances where the victim is incapable of giving consent because of his/her age or because his/her temporary or permanent mental incapacity. What is Incest? Sexual intercourse between persons who are related to each other within the degrees wherein marriage is prohibited by law. What is Domestic Violence? A felony or misdemeanor crime of violence committed by a current or former spouse or intimate partner of the victim; a person with whom the victim shares a child in common; a person who is cohabitating with or has cohabitated with victim as spouse or intimate partner; a person similarly situated to a spouse of the victim under domestic or family violence laws of the jurisdiction in which the crime occurred; any other person against an adult or youth from that person's acts under the domestic or family violence laws of the jurisdiction in which the crime of violence occurred. What is Dating Violence? Violence committed by a person who is or has been in a social relationship of a romantic or intimate nature with the victim. What is Stalking? Engaging in a course of conduct directed at a specific person that would cause a reasonable person to fear for their safety or the safety of others, or suffer substantial emotional stress.

Detroit Business Institute-Downriver Substance Abuse Policy Standards of Conduct Detroit Business Institute prohibits the unlawful possession, use, or distribution of illicit drugs and/or alcohol by students on its property or as part of any of its activities. No student will be permitted to attend class if he/she is under the influence, or suspected of being under the influence, of alcohol or illegal drugs. Disciplinary Sanctions Any student who sells, manufactures, distributes, or has in his/her possession an illicit drug will be immediately terminated and all evidence will be turned over to the proper authorities.

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DBI will support activities and requirements of the Drug Free Workplace Act and Drug Free Schools and Campuses Act. Employees who are convicted of any criminal drug statute may be subject to disciplinary action up to and including termination of employment and/or be required to satisfactorily complete an approved drug abuse program at the employee’s expense. DBI will provide information regarding the dangers of drug abuse and referrals for assistance programs.

DETROIT BUSINESS INSTITUTE-DOWNRIVER CAMPUS SECURITY STATISTICAL REPORT 2018 2019 2020 Murder/Non-negligent manslaughter 0 0 0 N/A N/A 0 0 0 0 0 0 0 0

Negligent manslaughter Sex offenses-forcible Rape Fondling Sex offenses-Non-forcible Incest Statutory Rape Robbery Aggravated assault Burglary Motor vehicle theft Arson

0 0 0 N/A N/A 0 0 0 0 0 0 0 0

0 0 N/A 0 0 N/A 0 0 0 0 0 0 0

HATE CRIMES 2018 2019 2020 Murder/Non-negligent manslaughter Sex offenses-forcible Rape Fondling Sex offenses-Non-forcible Incest Statutory Rape Robbery Aggravated assault Burglary Motor vehicle theft Arson Updated 09/21

0 0 N/A N/A 0 0 0 0 0 0 0 0

0 N/A 0 0 N/A 0 0 0 0 0 0 0 Page 11 of 12

Simple assault Larceny-theft Intimidation Destruction/damage/vandalism of property

0 0 0

ARRESTS 2018 2019 2020 Weapons: carrying, possessing, etc. 0 0 0

Drug abuse violations Liquor law violations

0 0 0

DISCIPLINARY ACTIONS 2018 2019 2020 Weapons: carrying, possessing, etc. 0 0 0

Drug abuse violations Liquor law violations

0 0 0

INCIDENTS REPORTED 2018 2019 2020 Domestic violence N/A 0 0 Dating violence N/A 0 0 Stalking N/A 0 0 UNFOUNDED CRIMES 2018 2019 2020 N/A N/A 0 Title IX coordinator for the 2020 Campus Safety and Security Survey: Jayaa Singh, Director, jsingh@dbidownriver.edu (734) 479-0660 ext. 12

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2021 Annual Notification Consumer report + EEP + Drug Prevention

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Cost of Attendance

Campus Security Statistical Report