We concluded Part 2 of this article with the general notion that anyone claiming or even trying to be "Sober" should not be using any potentially addictive or mind and/or mood altering medication. In this third installment about prescription medications in a Michigan Driver's License Restoration Appeal, we'll look at how the presence of these medications is detected beyond a person simply admitting such use. In particular, we'll review the urine test that is a required part of any Michigan Driver's License Appeal. While the urine test is used to provide the state with an assay of the substances in a person's system, including prescription medications, there is more to it than just testing "clean" or not.
In the last installment, I noted that, as a Michigan Driver's License Restoration Attorney, I had better be the first person to learn that a person is on, or has (detectably) used the potentially addictive or mind and/or mood altering medications that is the focus of our inquiry. Here's where that "strategy" to which I alluded in Part 1 of this article comes into play, and I must take a "diplomatic pass" and trust the reader will understand that, outside of the confines of my Office, I can say little more about what happens once I learn about such use. Suffice it to say here that while the strategy varies from case to case, the key element of any such strategy is planning. Each plan, in turn, depends on the unique facts of any particular case.
I am often asked about the logistics of the urine test; some people think it is collected separately from the Substance Abuse Evaluation. It is not, at least for my Clients. The Clinic to which I refer my Clients for the required Substance Abuse Evaluation is located a few blocks from my Office, and collects their urine for the lab test. This is particularly helpful for the roughly one-half of my Clients who come from out-of-state. For those who live either out of state, or across the state, we'll arrange for their first appointment with me (which takes about 3 hours) to be scheduled the same day as their Substance Abuse Evaluation. This way, they can go right from my Office to their Evaluation.
The urine test serves several purposes beyond just showing that a person has or has not been puffing on a joint in the last few weeks.
To begin, the urine test can't just be any old urine test. The $10 do-it-yourself home test, even administered by the Substance Abuse Evaluator, will not cut it. In order to pass muster in a Michigan License Reinstatement (Restoration) Appeal, a urine test must be a "10-panel" test with at least 2 "integrity variables." Integrity variables are very much what they sound like; things that are examined in the test to make sure he sample is unadulterated or diluted.
Dilution is a big problem. If a person drinks too much water, their test will come back "diluted." Dilution is usually determined because the level of creatinine in a person's urine is lower than what's considered clinically normal. Creatinine is present in everyone's urine, and there is a guideline range that dictates what is normal, and what is not. When the level of creatinine falls below a certain amount, the urine sample is considered dilute, and therefore considered invalid. Thus, the real implication of a diluted sample is "invalid," as in adulterated, or hiding something. This can completely derail an otherwise winning License Appeal.
While it is extremely important for me, as the Lawyer handling a License Appeal, to make sure that the urine test is "negative" for any illegal substances like cocaine or marijuana, it is equally important that the test itself is not called into question because of some deficiency with any of the integrity variables. The urine test must be sound and valid. It must not be dilute. If caught immediately, some of these problems can be remedied by a subsequent test done right away, assuming those results are better..
Within the context of prescription drugs, a person's urine test results should present no surprises to anyone. As a Lawyer who specializes in Michigan License Restorations, I will be asking my Clients, at our first face-to-face meeting, if they are on any kind of medication. If they disclose that they're on a prescription for any kind of potentially addictive or mind and/or mood-altering drug, then we'll need to plan around that. And most of the time, we can do just that. However, for me to discover any of this as a result of a positive urine test means we have to start back from square one.
Here again, I will only point out that knowing exactly how to handle these situations is what separates me from those Lawyers who claim to "do" License Appeals. It is this precisely this attention to detail that allows me to offer a first time win Guarantee. In that regard, each situation is unique. Let's look at a few real-life situations from my Practice to illustrate this point:
In once case, a Client told both the Substance Abuse Evaluator and I that he had obtained a prescription for Xanax about a year and half before his evaluation He told her that he had only used about a dozen of the pills in the intervening eighteen months. The Evaluator dutifully disclosed this within the Evaluation, and also recommended that the Client obtain a letter from his Doctor clarifying and explaining his use of this drug.
I was already ahead of that one, and had a letter out to the Client's Doctor the Evaluation was finished. I got pretty much what I wanted in response. "Pretty much" because it was the PA, or Physician's Assistant who sent the letter indicating that they knew about my Client's alcohol problem, and monitored his use of Xanax, and concluded by noting something to the effect that a "dozen pills in a year and half hardly constitutes abuse."
I felt good about that part of our case going into the Hearing.
At the Hearing, the Hearing Officer began asking my Client about those times when he did take the Xanax, and my Client explained that those occasions were preceded by serious anxiety attacks.
Fast-forwarding a bit, the Hearing Officer then expressed his satisfaction with the information in the letter we produced. However, he also expressed concern about whether m Client's anxiety attacks might be too severe to make him a safe driver. I got the Hearing Officer to give us 4 weeks to get a follow-up from the Client's Doctor, explaining that any such determination would probably be best from the Physician rather than his or her Assistant. In the end, I got the Doctor's letter in a matter of days, and the Client won his case.
In another case, a Client was taking a potentially addictive medication for a mental health issue. He was being treated by a rather large institution, and had been under the care of the same Doctor for years. As luck would have it, just as he geared up for his Restoration Appeal, and we need a letter from his Doctor about his treatment, that Doctor left the institution, and a new Doctor took over his treatment.
It is important to stop here for a moment and understand what I mean by a "letter." In no case do I send the Client to the Doctor and just "ask for" a letter. Nor do I just write the Doctor and ask for a letter. Doctors are busy, so I will often enclose an unsigned "draft" version of what I need the letter to say, asking the Doctor, it he or she agrees with it, to have it re-typed on his or her letterhead and forwarded to me, or, if there are changes that need to be made, to make such corrections and then send it back to me. Of course, there is often a fee for the Doctor's time to do these letters, but in order to get it done right, this can be the best $15 to $30 a person can spend.
Getting back to our example, the new Doctor, not having known my Client for even a month, was understandably unwilling to provide any letter. This had the effect of stopping us dead in our tracks. The old Doctor was nowhere to be found, so getting a letter from him wasn't an option, either.
What to do...?
My Client (who fortunately lived in the Detroit-area) and I knew that if he had his Evaluation done anytime soon, the drugs would show up in his system. We needed a plan.
My Client decided that he has spent enough time medicating his depression, and decided to try make it without medication of any kind. He took some time to let the drugs clear out of his system, and beyond putting himself in a position to win a License Appeal, became able to deal with life on life's terms without the use of medication to get over any roughs spots. He later said he never felt better than he did after chucking his meds in the garbage.
The point here is that a person cannot just plow forward into a License Appeal like a bull in a china shop. Planning, as in developing a winning strategy, is an important part of preparing a License Appeal.
In the prior installment of this article, we noted how some Doctor's don't' fully understand alcoholism. These Doctors must be guided in the letter writing process, or, if that cannot be done, then another plan of attack devised. Because I have a comprehensive and detailed background in the diagnosis and treatment of alcohol and substance abuse problems, I can draft the kind of Doctor's letter that I need. Others may just accept what the Doctor gives them, having no idea that it falls pitifully short of what's needed to be of any help in a License Appeal.
This all circles back to my observing that, in order to properly handle or manage a Michigan License Reinstatement case, I need to learn about the use, past or present, of any potentially addictive or mind and/or mood-alerting medications BEFORE anyone else. While it doesn't happen when I handle a case, about the worst possible scenario that can occur in this regard is for the Hearing Officer, at the Hearing itself, to discover the use of these "risky" medications. When this happens, then a person's Appeal is pretty much dead in the water. No matter what else, the failure to have learned and planned around that falls squarely upon the Lawyer. If this happens when a person tries a License Appeal on their own, without a Lawyer, then at least they got precisely the degree of expert Legal help for which they paid. Regardless of who is at fault, this becomes just one more error to be fixed next year, when a person can try again.
In Part 4 of this article, we'll conclude our examination of the issue of prescription medication in a Michigan Driver's License Appeal. We'll look at some final and miscellaneous considerations, including the importance of planning in any case where there is or has been the detectable use of potentially addictive or mind and/or mood altering medications.