In Part 1 of this article, we began our inquiry into the potential dangers or prescription drug use in a Michigan Driver’s License Restoration Appeal. We clarified that we were not talking about things like blood thinners or heart medications, but the kind of prescriptions upon which people can become dependent. Let’s continue our discussion…
Reduced to its most basic level, alcoholism and drug addiction are really an addiction to getting a buzz. Alcoholics and addicts are hooked, in large part, on changing the way they feel. After a while, being “sober” is not the norm, or at least not the desired norm. Changing one’s consciousness can become a psychological and/or physiological habit in some people, but not in others.
It is interesting that every Substance Abuse Counselor in the world considers this basic stuff, yet many Physicians aren’t particularly well versed in it. Doctors are trained to cure diseases, treat illness and fix injuries. It is actually a somewhat rare medical specialty (not surprisingly called addiction medicine) that treats alcoholism and addiction. Other than that, about the only professional contact most Doctors have with alcoholism and addiction is when someone shows up in the ER suffering any of the many consequences of such abuse, from accidents to liver failure to overdose. And the best (and really only) advice they can give is for the person to stop and get some help. That help comes from someone who treats alcohol and substance abuse issues. With the exception of those few Doctors specializing in addiction medicine, this will almost always be a Substance Abuse Counselor.
Because they spend their time fixing injured people, and helping sick people get well, many, if not most, Physicians don’t have any detailed knowledge of the proper treatment protocol for the diseases of alcoholism and addiction, and how cross-addiction and substitution are inherent risks in the addiction AND Recovery process. Besides, Doctors are usually very busy; they have limited time with each patient. Come in with a broken leg, and you’ll have it set and get discharged with instructions and a prescription for painkillers.
This is a complication. This is actually a complication within other complications…
It seems that the more we analyze or talk about this, the farther reality moves away from theory…
Theoretically, it would seem that anyone whose drinking is causing problems would realize, as the saying goes, that “anything that causes a problem is a problem,” and stop. Yet in reality, this is clearly not the case. The cold, hard truth is that most people with a drinking problem do not Recover from it.
Life would be great if Recovery was absolute, and that learning about one’s Recovery and Sobriety were as easy and predictable as learning how to manage one’s diabetes. Unfortunately, that’s not the way things work. Yet even among those who do Recover from an alcohol or substance abuse problem, in most cases, once they learn enough to just not drink anymore, they will (with good reason,) leave it there. They don’t feel an overwhelming need to become an expert on Sobriety beyond just stopping the destructive cycle of drinking. And in many cases, that’s just fine.
Doctors know that alcohol and drug abuse are unhealthy. And while they frequently have to treat the consequences of such abuse, only a rare few specialize in treating the disease that gives rise to those consequences. Instead, they leave that process to those specific treatment protocols supervised by other highly trained professionals (i.e., Substance Abuse Counselors) who make their entire in the Recovery field.
This means that many people who have an alcohol problem and have been able to successfully quit drinking for a couple of years may not understand (to whatever extent) that they cannot use potentially addictive or mind and/or mood altering medication unless there is no suitable medical alternative.
There are, of course, cases where the use of potentially addictive or mind and/or mood altering medications IS necessary. A person, for example, who undergoes open-heart surgery and who has their chest sawed open will simply not get by, at least right after the surgery, with anything less than some serious (e.g., potentially addictive) painkillers. Those situations are determined on a case-by-case basis. Even when necessary, however, such use must be closely monitored by both the person in Recovery and their treating professionals.
In many cases, because something is a medical emergency, and there is little time for discussion, this means that a person will be unlikely to tell their treating Physician about their alcoholism and subsequent Recovery, and equally unlikely to ask for a “safe”,” meaning non-addictive or non-mind an/or mood altering medication. In other cases, a person may just forget, or be embarrassed to dredge up a past that they don’t feel is reflective of who they’ve grown to be.
Then the Doctor, for his or her part, has NO reason to take any alcoholism into account as they treat the patient, because they were NEVER told of it.
Worse yet, in many cases, even if a Doctor IS told about a person’s alcoholism, the Doctor will just send them out with a prescription for a limited amount of medication, and/or no refills.
This is not a knock against Doctors, either. You can “ditto” this for Dentists and Podiatrists. How many people want to tell their Dentist that they’re a Recovering alcoholic? Until a dental emergency, how is that even relevant?
Yet we can easily imagine a situation where a person goes into the Dentist with a toothache, and leaves with an extraction, a supply of gauze, and a ‘script for Vicodin.
Within my Criminal Practice, I have handled loads of cases involving Prescription drugs like Vicodin, ranging from Possession to Fraudulent Prescription charges, all of which began with a legitimate prescription that subsequently evolved into a dependence on the medication, or triggered a relapse in someone who was in recovery from an alcohol or drug problem. This happens all the time, and is NOT exceptional.
Now, let’s bring this home, to a Michigan Driver’s License Restoration Appeal. To do that, we’ve got to rewind again….
The most important issue, or thing that needs to be proven (by “Clear and Convincing Evidence,” no less) in a Restoration Appeal is that the person’s “alcohol or substance abuse problems…are under control, and likely to remain under control.” In numerous other articles, I have shown how that really means that a person must show that they are a safe bet to never drink (or use, or get high, or drunk, or buzzed, or whatever) again. They must prove, by Clear and Convincing Evidence, that they are likely to remain completely clean and Sober for the rest of their days.
The state (and every Substance Abuse Counselor in the world) views that as being SERIOUSLY put at risk if a person uses any medication which has the potential to be addictive, or can otherwise alter their mind and/or mood.
Therefore, when a person files a License Appeal, and comes in and makes proof and gives testimony about how dramatically their life has changed since they quit drinking, and how Sobriety has been the best thing that’s ever happened to them, and how they’ve accomplished so much as a result of becoming alcohol-free, all that “Sobriety” talk is rendered questionable, at best, when the person also admits to something like taking Xanax for anxiety, or Vicodin for pain. Remember, if a person spends enough time in Counseling, or enough time at AA, they will learn they should not be using these medications unless there is no suitable medical alternative.
Accordingly, even though their abstinence from alcohol thus far may be well-established, putting them back on the road under the assumption that they’ll forever remain Sober is not a “likely” proposition, at least as far as the state is concerned.
In a very real way, the state concludes that the person is not sufficiently grounded in Recovery. Stories like this are not uncommon when I meet a Client who has previously tried a License Appeal and lost, either winging it on their own, or going in with some Lawyer who didn’t know better, but obviously should have.
The state, for its part, learns about a person’s prescription drug use in one of several ways. Sometimes, these medications show up in the urine test that is a required part of every Michigan Driver’s License Restoration Appeal. Other times, use of potentially addictive, or mind and/or mood altering medications, whether current, or in the distant, or even recent past, is revealed in the actual Substance Abuse Evaluation process. In the worst-case scenario, such prescription drug use is first revealed at the actual Hearing, much to the dismay of the Lawyer, and the rather unpleasant surprise of the Hearing Officer.
This is an area that MUST be examined by and with the Lawyer long before a person ever walks in to have their Substance Abuse Evaluation completed or a urine sample provided. As a Michigan Driver’s License Restoration Lawyer, I MUST be the first person in the Driver’s License Restoration process to learn about this, so I can plan accordingly. If the use of any of these medications was not disclosed to and evaluated by the Lawyer first, then one can correctly say the case is not being handled properly. Period. A Lawyer who learns about his or her Client’s prescription medication use after, and not before, the Substance Abuse Evaluation has been completed has screwed up. It’s that simple.
In Part 3 of this article, we’ll shift our focus to how this potentially problematic prescription drug use is discovered, and we’ll see how it is my role, as the License Restoration Attorney, to resolve any potential problems before they become actual problems.