Probation

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Latest post 05-19-2007 1:30 PM by JamyeP. 12 replies.
  • 05-14-2007 10:45 AM

    Question [=?] Probation

    Can a probation officer prevent you from seeing your medical professional? Can a probation officer make you stop taking any medications?
  • 05-14-2007 12:38 PM In reply to

    Feedback [*=*] re: Probation

    Sounds like there's more behind your question than you have described.

    Probation officials are charged with carrying out the probation order imposed by the court. I don't see a judge ordering a probationer to refrain from his/her medical professional.

    Probation officers can normally supervise your ability to take non-prescribed medications. Particularly if you are on probation for a drug- or alcohol-related offense, your use of drugs and medication becomes especially relevant.

    Of course, if your PO is restricting these abilities, your options would be 1) violate the PO's directives and end up before the judge -- who could rule on the reasonableness of the PO's directive -- and potentially revoke your probation, if he finds the PO acted correctly, 2) petition the court for a clarification of the probation order (you woud probably need a lawyer to do this), 3) discuss your concerns with the PO and see if some accomodation could be reached. (I like option 3.)

    No one here can advise you with certainty about your rights in this matter. Only a local attorney (in the state of your probation) can give you real and adequate advice about these issues.
  • 05-14-2007 1:16 PM In reply to

    More [=+=] re: Probation

    My dad is on drug offender probation. The PO said that he would not give permission for my dad to go see his doctor. If he did, then he would arrest him, "for violating probation." The PO wants to refer my dad to "one of our (DOC"s) own" doctors for treatment, "to make his (PO's) life easier." My dad has been going to this doctor for many years, prior to him being put on probation. The PO does not, and I quote, "think that this doctor is appropriate in treating your mental conditions. It is just all in your head."

    My dad is on prescribed medications for Bi-Polar and mild Schizophrenia and has been on the same medications for many years, as this is what works for him and has allowed him to remain mentally stable, however, the PO again, "feels that he does not need them and needs to be reevaluted" by one of the PO's chosen psychiatrists. Until then, the PO wants him to stop taking the prescribed medications. The particular medication (Marinol) contains THC, which prevents the drug test from being negative when tested. However, the PO threatens to violate my dad in the event the drug test becomes positive again and then states, "I don't care if you become mentally ill again, I just have to have a clean drug test." The PO even referred my dad to the drug treatment classes, etc.; there, he was evaluated and told that he did not need to be there and not to come back.

    I realize that you may not be able to give me adequeate advise, but I am just trying to get any advice at this point to help my father. Thought more information may help, if not, then thank you for you time and advice already given. It is greatly appreciated.



  • 05-14-2007 1:39 PM In reply to

    Feedback [*=*] re: Probation

    Marinol is not approved as a treatment option for bi-polar disorder or schizophrenia. Your father's mental condition should not be effected should he stop taking that drug. It's inappropriate for a doctor to be prescribing medicine which contains a controlled substance that is not approved as a treatment for the patient's condition especially when that patient is a convicted drug offender on probation. Therefore, the PO may well be on solid ground in requiring another doctor handle your father's treatment.
  • 05-14-2007 8:19 PM In reply to

    Disagree [)*(] You cannot know that !

    "It's inappropriate for a doctor to be prescribing medicine which contains a controlled substance that is not approved as a treatment for the patient's condition..."

    ALL prescription drugs, by definition, contain controlled substances. That's why you need a prescription.

    "Off-label" prescription - ie prescribing a medication for a purpose for which it is not approved is, in addition, widespread and perfectly legal and ethical. Some googling indicates that Marinol is in fact widely prescribed for bipolar disorder.

    ONLY the patients own doctor, who knows him, knows his medical history, and knows how he has responded to other treatment regimens can possibly say whether a specific off-label prescription is appropriate or not. That is not to say that I can't see the PO making a strong case for requiring the patient to get a second opinion from a Dr that the PO trusts if he suspects wrongdoing in the prescription.

    However, for a layman to instruct a patient to discontinue taking a legal and properly prescribed prescription drug is - IMHO - perilously close to opening the door to an allegation of practicing medicine without a license.

    I would advise the poster's father to discuss this issue with his Doctor and his lawyer, and see if he can at least get the PO to agree to allow him to remain on his meds until a Dr satisfactory to the PO can review his case.

    Ordering a patient suffering from schizophrenia and biplor disorder to suddenly cut off his meds is as intelligent a move as to give a two year old a meat cleaver and say "Play nicely". From a practical point of view, this PO has absolutely no business being in his business.

    Richard
  • 05-14-2007 8:48 PM In reply to

    Feedback [*=*] re: Probation

    This is a very interesting medico-legal situation. (interesting for those who read and post here; probably not so interesting for you and your father)

    Marinol's indicated uses are for 1) nausea secondary to cancer treatment and various other causes, and 2) appetite stimulation in HIV/AIDS patients with anorexia.

    It is certainly "psychoactive" in the sense that it causes changes in the sensorium, mood, and in proprioception. It has been studied in several types of psychiatric illness, but none of the (few) studies were sufficiently large or structured in a way to provide conclusive (or, really, even suggestive) data. There is much controversy surrounding the drug because it is a cannabinol (e.g. marijuana) related substance; drugs screens for marijuana will usually be positive for this reason.

    Although I hasten to add that I am not a psychiatrist, there is no physiologic mechanism known or legitimately theorized (that I can discern) which might justify its use in bipolar disorder or schizophrenia. Currently it seems to be classed as a Schedule III (relatively low risk of abuse) controlled substance. Some physicians have used it "off-label", although there are legal risks (mainly, from state medical boards) to doctors who use their prescribing authority n this manner.

    This complex problem appears to to me to be one that should be worked out -- with your father's lawyer -- under the supervision of the court. Ideally, your father's physician would be called as a witness to testify about his/her qualifications and the reasons for his/her selection of this particular drug. I see no other way out of the morass (unless the PO can be convinced).

    I will say that, as a physician, I would be very suspicious of the use of Marinol in this off-label fashion. If I were a PO (which obviously I'm not) I would probably have made the same call your father's PO did -- that is, requiring a second opinion.

    Again, this is neither legal nor medical advice. No one here can advise you properly in the matter online. Do not stop or start any medicines based upon what you read here. You should consult a local attorney and your physician to learn your rights and your best options.

    Best of luck.
  • 05-14-2007 10:06 PM In reply to

    Feedback [*=*] Very well said.

    k
  • 05-15-2007 1:53 AM In reply to

    Disagree [)*(] re: You cannot know that !

    Actually I do know. I've been doing this a long time. Marinol is sometimes prescribed by general practitioners as treatment for mild to moderate anxiety. It is not a proper nor effective medication for the treatment of truly diagnosed bi-polar disorder nor schizophrenia. Further, it is not a drug that a psychiatrist with knowledge that a patient has a drug conviction history would ever consider prescribing. That tells me that the diagnosis was likely made by a family doctor, not a psychiatrist AND that the defendant has not told his doctor of his conviction or probation status. IF a psychiatrist has by some stroke of questionable treatment prescribed this medication and is monitoring him as he is required to do, a simple phone call or formal letter to the PO would take care of the problem. Otherwise, the defendant needs to go to the doctor designated by the PO for a true evaluation and he will obtain a script for the proper prescriptions that are actually needed to treat his disorders, not just the ones he wants to take.
  • 05-16-2007 11:58 AM In reply to

    Feedback [*=*] re: You cannot know that !

    Marinol was given to my neighbor, while I still Lived in California. He had full blown AIDS and the Marinol was prescribed to curtail some of the side effects from the cocktail that he had to take 3 times per day.

    The US Food and Drug Administration (FDA) approved MARINOL to treat nausea and vomiting associated with cancer chemotherapy in patients who have failed to respond adequately to conventional treatments.

    The FDA also approved MARINOL to treat appetite loss associated with weight loss in people with acquired immunodeficiency syndrome (AIDS). If you have HIV/AIDS, your health care professional may prescribe MARINOL to help stimulate your appetite.

    The active ingredient in MARINOL is dronabinol.

    The principal psychoactive substance present in Cannabis sativa used therapeutically to control nausea and vomiting associated with cancer chemotherapy.

    It is legal marijuana in the form of capsules. They look like vitamin E capsules.

    I have never heard of it treating bipolar disorder.

    I am not a doctor, however I do have extensive experience with mental illness.
  • 05-16-2007 2:47 PM In reply to

    Feedback [*=*] He can either obey his probation officer . . .

    or face probation violations and the potential of going to jail or prison.

    It is NOT a good idea to be taking any meds that are going to result in hot UAs. Bad, bad, bad idea. Even worse if the drug isn't indicated for the treatment of the condition.

    POs are going to be suspicious. Taking some drug that will result in a hot UA is going to likely be seen as a cover for actual drug use.
  • 05-17-2007 5:26 PM In reply to

    Question [=?] Liability question.....

    The poster indicated that the PO had ordered the probationer to discontinue his meds until he was evaluated by the Dr that the PO wished to choose.

    If the probationer obeys his PO and stops his meds cold and, as a result, his schizophrenia erupts into a full blown psychotic break, might there be any civil liability attached to the PO for ordering a probationer off meds he'd been prescribed by a Dr?

    Let's say, for example, I was to be assaulted by the probationer while he was off his meds but still waiting for the appointment with the PO's chosen Dr. Might I have grounds to sue the PO for giving medical instructions, when he's not medically trained, that resulted in the psychotic outbreak?

    Were the probationer to commit (or attempt) suicide while off his meds per the PO's orders, could he or his family have grounds to sue the PO?

    Finally, if the probationers treating Dr were to be sufficiently annoyed by a PO with no medical qualifications questioning his judgement and ordering a mental patient off his meds to file a complaint, could such an order to stop taking prescribed meds be prosecuted as practicing medicine without a licence?

    Richard
  • 05-18-2007 12:44 PM In reply to

    Feedback [*=*] re: Liability question.....

    "If the probationer obeys his PO and stops his meds cold and, as a result, his schizophrenia erupts into a full blown psychotic break, might there be any civil liability attached to the PO for ordering a probationer off meds he'd been prescribed by a Dr?"

    I doubt it. The defendant's CHOICE to discontinue his meds would likely be an intervening factor of his own negligence.

    "Let's say, for example, I was to be assaulted by the probationer while he was off his meds but still waiting for the appointment with the PO's chosen Dr. Might I have grounds to sue the PO for giving medical instructions, when he's not medically trained, that resulted in the psychotic outbreak? "

    Anyone can sue for anything. The defendant's TWO intervening acts - stopping the meds and attacking you - would tend to eliminate liability.

    "could such an order to stop taking prescribed meds be prosecuted as practicing medicine without a licence?"

    That's a question of state law. Since POs are part of the system, I doubt anyone would be prosecuted or otherwise brought to task.
  • 05-19-2007 1:30 PM In reply to

    re: Liability question.....

    Interesting discussion. You are all assuming, as gemini pointed out that the drug is necessary let alone critical to care. I agree with gemini that it isn't. If, in fact, this drug was prescribed by a psychiatrist vs. the family doctor attempting to diagnose a mental disorder he's not qualified to diagnose, the defendant simply has to inform his psychiatrist of the PO's orders and the matter can be handled. The psychiatrist can either formally notify the PO of the necessity of the drug or change the prescription to one that does not contain THC. Since it appears the defendant has neither discussed nor informed his doctor of the problem, it does lead one to believe that he knows the doctor isn't qualified to diagnose the problem in the first place or that the drug isn't necessary for his condition, or both.
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