Possession, use, or distribution of illegal drugs is prohibited by federal law. There are strict penalties for drug convictions, including mandatory imprisonment. There are strict penalties for drug convictions, including mandatory prison sentences for many crimes. The following information, while not complete, is an overview of federal penalties for first convictions.
All penalties are doubled for any subsequent drug convictions. Michigan has no laws on the books that prohibit a person from being present when using illegal drugs. However, that comes with some caveats. OWPD (Operating with Presence of Drugs) is operating a motor vehicle with any amount of a controlled substance in the body.
No specific amount is required and medications don't have to affect driving. An official website of the United States government. does gov mean it's official. Federal government websites typically end in.
Gov or. grand. Before sharing sensitive information, make sure you are on a federal government site. A Service of the National Library of Medicine, National Institutes of Health.
Because substance use disorders carry such stigma, primary care physicians who evaluate their patients for substance abuse inevitably intrude on their autonomy and privacy. Whether doctors perform laboratory tests or administer behavioral questionnaires, they are looking for very personal information. When doctors use this information to suggest or urge patients to receive treatment, or share this information with others, patients may feel that their autonomy is threatened and their privacy invaded. Physicians generally conduct substance abuse screenings and evaluations, either to improve management of current conditions or to encourage patients to accept treatment.
However, patients, accustomed to doctors' respect for their autonomy, may not see it that way. A patient in denial may not realize, or want to realize, that they need to reduce or stop using alcohol or other drugs, and may find the doctor's questions and suggestions intrusive. A patient may also be concerned about the social stigma that comes with admitting a substance use problem. It is common for people with these problems to face stigmatization and discrimination if those problems become public knowledge.
These patients may find it difficult or impossible to get coverage for hospitalization costs if an insurance company or health maintenance organization (HMO) learns that their traumatic injuries were related to alcoholism. Or, patients' employers may have a bleak view of their admission to drug treatment. Relationships with a spouse, parent, or friends may be affected. Adverse consequences such as these may discourage patients with substance use problems from seeking treatment.
A doctor who is faced with evidence of a patient's substance abuse is caught between respect for his patient's autonomy and his duty to ensure the health of his patient. Should the doctor raise the problem and then drop it at the slightest hint of patient resistance? Or should it intervene more forcefully, with arguments, or involving the family? To meet his ethical responsibility for the health of his patient, the doctor must do more than simply raise the issue. You should give the patient all the relevant information, engage them in a conversation, and follow up on future visits. Testing patients' urine for drugs is not a daily practice in primary care, but a doctor may want to use that test, especially when treating teens for substance abuse problems.
Should or should a physician obtain the patient's consent before requesting a drug screening test? Such a decision should be guided by restrictions on trust and privacy, because the law only addresses the case of doctors who report pregnant women who abuse substances to child protective services or the criminal justice system. Usually, a doctor doesn't ask a patient to give consent before sending their urine or blood for other tests. However, requesting laboratory tests to screen patients for substance abuse problems is different than screening for, for example, diabetes. Patients expect to be screened for blood sugar and cholesterol, but not for alcohol and other drugs.
A patient who is faced with the results of a test that he did not know and did not consent to may feel betrayed by the doctor and that the doctor has shown a lack of respect for his right to make his own decisions about medical tests and care. Feeling that they can no longer trust the doctor and angry that they have been deceived, the patient may refuse to participate in any further discussion of their substance use problem. For the sake of a more productive doctor-patient relationship, the best practice is to ask the patient before performing any laboratory tests. A second reason doctors must obtain a patient's consent before testing urine or blood for alcohol or other drugs is patient privacy.
If the doctor orders a test, the patient's health insurance company will know and perhaps the result as well. Doctor's decision to request a drug test tells the third payer a good deal, even if the result is negative. The patient must decide if he is willing to let his insurance company learn this information. The patient's third party payer may not cover drug screenings as a matter of course.
The advent of managed care has narrowed the range of tests that a doctor can routinely request. If the patient's insurance or HMO does not cover the test, the patient should have an opportunity to decide if they are willing to pay for the test out of pocket, a decision they must make before the test is performed. Unfortunately, it is very likely that if the doctor consults the patient and asks for his consent, he will refuse to accept the test. However, this exchange leaves the door open for further discussion with the patient about their potential substance use problems (see chapter.
The patient may be more willing to examine their own behavior after refusing a test than if they thought the doctor acted behind their back. The doctor might start the conversation by asking, in a neutral way, why the patient doesn't want to get a drug test. Concerns about privacy and confidentiality are fueled by the widespread perception that people with substance use disorders are weak or have a moral disability. A patient whose substance use problem becomes known to his employer may lose an expected promotion or his job.
If you have marital problems, information about your substance use could have an impact on divorce or custody proceedings. Or your health insurance could be canceled. Federal law and regulations severely restrict communication about identifiable patients from programs that provide diagnosis, treatment, or referral for substance use treatment (42 CFR §2, 1). The purpose of the law and regulations is to reduce the risk that information about people in recovery will be disseminated and that they will be discriminated against, which should also encourage people to seek treatment for substance use disorders.
In most primary care settings, federal confidentiality laws and regulations don't apply. For many years, there was confusion over whether general health care settings, such as primary care clinics or hospital emergency rooms, were subject to federal law and regulations because they provided substance abuse diagnosis, referral, and treatment as part of their services. In 1995, DHHS revised the definition of the types of programs subject to regulations, making it clear that regulations do not generally apply to a general health care facility unless that facility (or person) is deemed to provide, and provides, diagnosis, treatment, or referral for treatment (42 CFR §2, 1). However, professionals should be aware that if a health care office includes someone whose primary function is to provide evaluation or treatment for substance abuse and if the office benefits from federal assistance, 3 that office must comply with federal law and regulations and implement rules.
special tools to handle information about patients who may have substance abuse problems. Because of the potential to harm patients, physicians should always handle that information with great care. While federal rules don't restrict the way most primary care physicians collect and handle substance abuse information from patients, there are other rules that may limit how such information can be handled. State laws offer some protection to medical information about patients.
Most doctors, and patients, think of these laws as the doctor-patient privilege. Strictly speaking, doctor-patient privilege is a test rule that governs whether a doctor can be asked or compelled to testify in a court case about a patient. In many States, however, laws offer broader protection. Some states have special confidentiality laws that explicitly prohibit professionals from disclosing information about patients without their consent.
States often include such prohibitions in professional licensing laws; such laws generally prohibit licensed professionals from disclosing information about patients, and make unauthorized disclosures grounds for disciplinary action, including license revocation. Covered professionals depend on the state in which the doctor practices. California, which gives its citizens an inalienable right to privacy in its Constitution, has what may be the broadest protection for medical information (including mental health). California law protects communications with a wide variety of professionals, including licensed doctors, nurses, and psychotherapists (including clinical social workers, psychologists, and marriage and family counselors), as well as many communications with trainees who practice under the supervision of several of these professionals.
A California court has held that information provided to an unlicensed professional by an uneducated patient may be privileged if the patient reasonably believes that the professional is authorized to practice medicine. In Missouri, for example, protection is limited to communications with psychologists, clinical social workers, professional counselors, and state-licensed physicians. Even within a single State, the type of protection afforded to medical information can vary from profession to profession. Physicians should know if any confidentiality laws of the State in which they practice apply to their profession.
State laws also vary greatly in this area. Some states limit protection to covering only information that a patient communicates to a professional privately during a medical consultation. Information disclosed to a doctor in the presence of a third party, such as a spouse, is not protected. Other states, such as California, protect all information that the patient tells the doctor or that the doctor obtains during the exam.
California provides even greater protection for communications between patients and psychotherapists, a term that encompasses a wide range of professions. Communications to and from the patient are protected, as well as information communicated by the patient's close family members to therapists and psychiatric staff 8. California also protects information that a patient discloses in the presence of a third party or in a group setting. Understanding what health information is protected requires primary care physicians to know if state law recognizes the confidentiality of medical information in the many contexts in which the doctor acquires it.
Some States protect medical information only when that information is requested in a court proceeding. If a doctor discloses information about a patient in any other setting, the law of those states will not recognize that there has been a violation of the patient's right to privacy. Other states protect health information in many different contexts and can discipline professionals who violate their patients' privacy, allow patients to sue them for damages, or penalize conduct that violates patient privacy. The diversity of state standards in this area exacerbates the difficulty physicians face in knowing the rules that apply to them.
All States also require notification of certain infectious diseases to public health authorities and child abuse to child protective services agencies, although definitions of infectious disease and child abuse vary. And most states require health professionals and mental health counselors to report threats patients make to harm others to law enforcement. There are states that allow or require health professionals to share information about patients with other health professionals without patient consent, but some limit the scope of disclosure of certain diseases, such as HIV. Most States provide for disclosure of information to health insurance or managed care companies.
Many of the situations primary care physicians face on a daily basis, such as processing health claims, are covered by one of these exceptions. To fully understand the rules related to the privacy of health information, primary care physicians should also be aware of exceptions to those rules. These exceptions are generally found in law books, either in the sections on testing or in the professional licensing sections, or both. The state licensing authority, as well as professional associations, can generally help answer those questions.
The push toward computerizing medical records will complicate the problem of maintaining the privacy of sensitive information in medical records. Currently, there is protection offered by the cumbersome and inefficient way in which many, if not most, medical records are passed from one doctor in one office to a doctor in another. When medical records are stored on computers, retrieval can be much more efficient. Computerized logs can allow anyone with a disk and access to the computer where the information is stored to instantly copy and carry large amounts of information without anyone knowing.
Modems that allow communication about patients between the different components of a managed care network expand the possibility of unauthorized access to anyone with a modem, passwords and necessary software. The ease with which computerized information can be accessed can lead to casual gossip about a patient, particularly one of importance in a community, making privacy difficult to preserve. One of the most complicated questions is whether and how doctors should communicate with others about patients' substance use problems. The Consensus Panel suggests that the physician gather information from other sources or seek help for a patient who is struggling to recover under various circumstances.
Talking to family members (including parents), doctors and other health and mental health professionals, employers, or schools may seem at first glance to pose no risk to the patient's right to privacy, especially if the person or organization that approached for information referred the patient to the doctor or doctor seeks help for patient. However, gathering information, answering questions about a patient's problems from their spouse, school, or employer; or making a referral to a substance abuse treatment program may involve explicit or implicit disclosure to an outsider that the doctor believes the patient has an abuse problem. of substances. And the doctor who makes such a revelation may be inadvertently stepping on a landmine.
A doctor who examines or evaluates a patient for substance abuse problems may very well want to ask a family member (including parents), a previous doctor, or a mental health provider what they have observed about the patient's use of alcohol or drugs. Such information may confirm the physician's judgment that the patient needs help or may be useful in persuading a reluctant patient that treatment is necessary. However, before going elsewhere for information, it is best to obtain patient consent for reasons of trust, privacy, and autonomy already discussed. And, if the doctor's conversation with a third party proves harmful, there will be a record that the patient consented to the communication.
The doctor has persuaded the patient to try outpatient treatment and knows the director of an excellent program in the immediate area. Instead of simply picking up the phone and letting the director know that you have referred the patient, you should consult the patient about the specific treatment center. Although it may seem that consent to general treatment is the same as consent for a facility, it takes very little time to obtain patient consent, demonstrates respect for the patient and protects the doctor if, for example, the director of the treatment program is the cousin of the patient's boss or someone connection of this type. Suppose a doctor believes that a patient's problem requires intensive treatment, available only in another county or in a residential facility.
The patient's employer must be notified that she will be away for a period of time to receive treatment. Patient expresses concern about being fired if employer learns she has a substance use problem. How should the doctor proceed? Physicians should listen when patients express concern that an employer will not be sympathetic to the substance use problem or the decision to start treatment. The patient may well have an accurate picture of her employer's attitude.
If the doctor's communication to the employer directly or indirectly reveals the patient's substance use problem and the patient loses her job, the doctor may face an unpleasant lawsuit. Traditional health insurance programs that provide reimbursement to patients for doctors' fees generally require patients to sign claim forms that contain language that consents to the disclosure of information about their care. The patient's signature authorizes the physician to release such information. While HMOs do not require patients to submit claim forms, both physicians and patients understand that the HMO or MCO can review clinical records at any time and can review the records if they question the doctor's care.
Should a doctor rely on the patient's signed consent on the health insurance form or HMO contract and disclose what they have in their medical record (or a neutral version of that information)? Or should I consult the patient? The best practice is for the physician to discuss frankly with the patient what information he intends to disclose and the possible consequences of alternatives open to the patient: disclosure and refusal to disclose. Will the information the doctor sends explicitly or implicitly reveal the nature of the patient's problem? Does the patient's medical history contain a diagnosis of substance abuse? Once again, the doctor is faced with the question of how such information should be plotted. Have you balanced the need for precision with discretion and respect for patient privacy? Finally, even if the chart contains explicit information about the patient's substance use problem, can the physician characterize the information and its diagnosis in more neutral terms when disclosing information to the third payer? Once the patient understands what type and amount of information the physician intends to send to the third payer, they can decide if they agree to the disclosure. The doctor should explain that refusing to comply with the insurer's request for information may result in the loss of coverage for at least some related services.
If the patient expresses concern, you should not deceive them, but confirm that once their insurer finds out that they have had a substance use problem, they may lose their insurance coverage and be unable to obtain other coverage. It's quite possible that you'll decide to pay out-of-pocket. Or you can agree to the limited disclosure and ask the doctor to let you know if more information is requested. As managed care becomes more prevalent across the country, physicians are finding outside payers who increasingly demand information about patients and the treatment provided to those patients in order to monitor care and contain costs.
Physicians should be sensitive to the amount and type of information they disclose, because there is a risk that the insurer will use this information to deny benefits to the patient. For example, if, in response to an insurance claim, the doctor publishes the patient's complete medical history, the insurer can learn from the doctor's notes that the substance abuse included alcohol and illegal drug use. The insurer can then deny the benefits, arguing that, since its policy does not cover treatment for drug abuse other than alcohol, it will not reimburse treatment for alcohol and drug abuse. Insurers have been known to use information that a patient started drinking at age 11 to deny them benefits because the alcohol problem is a pre-existing condition.
The table notes may also contain detailed and very personal information about family life that may be unnecessary for a third party payer to review to determine if it should be covered and what type of treatment. If a doctor receives a call from a lawyer asking about a patient or a visit from a police officer requesting to see the records or a summons to testify or produce medical records, what should he do? As with other privacy and confidentiality issues, (consult the patient, (use common sense and (as a last resort, consult state law (or an attorney familiar with state law). The doctor should then ask the patient if they know what information the caller is looking for and if the patient wants them to disclose that or any other information. You should leave the conversation with a clear understanding of the patient's instructions, whether to disclose the information and, if so, in what quantity and of what type.
It may be that the lawyer is representing the patient in a case and the patient wants the doctor to share all the information they have. Alternatively, the lawyer may represent the patient's employer or some other party with whom the patient is not eager to share information. There's nothing wrong with refusing to answer a lawyer's questions. However, if the doctor answers questions from an attorney who does not represent the patient (but the patient has consented to the disclosure of certain information), the physician should listen carefully to each question, choose his words carefully, limit each answer to the question asked, and be careful not to offer unsolicited information.
The doctor should then talk to the patient to find out if the patient is aware of the subject of the officer's consultation, if he wants the doctor to disclose information, and if so, how much and of what type. The doctor may end the conversation by asking if there are particular areas that the patient would prefer not to discuss with the officer. When a law enforcement officer comes armed with a search warrant, the answer is different. In this case, the doctor has no choice but to hand over the records contained in the order.
One is an order that requires a person to testify in an out-of-court statement or in a trial. The other, known as the duces tecum citation, requires a person to appear with the records contained in the summons. Depending on the state, the summons may be signed by an attorney or a judge. In this case, the doctor's first step should be to call Roger Smith, the patient he is being asked to testify about or whose record is being requested, and ask what the summons is about.
The subpoena may have been issued by Roger's attorney or on his behalf with Roger's consent. However, it is equally possible that the subpoena was issued by or on behalf of an adverse party's attorney. If that's the case, the doctor's best option is to consult with Roger's lawyer to find out if the lawyer will object (ask the court to set aside the summons) or if the doctor simply must obtain the patient's consent to testify or turn over her records. An objection can be based on several grounds and can be raised by any party, including the person whose medical information is being requested.
Often, the doctor can assert the patient's privilege for the patient. Brooks is an independent consultant in Montclair, New Jersey. Tulare County Superior Court, 166 Ca3d 485, 212 Cal. Interestingly, Luhdorff was a criminal case in which the prosecution sought the records of an unlicensed social worker who interviewed the defendant, diagnosed his problem, determined appropriate treatment, and treated him for 3 months.
The social worker worked under the supervision of a licensed person. The defendant thought the social worker was a psychiatrist. California Code of Evidence Section 451 codifies physician-patient privilege. Los Angeles Superior Court, 42 Ca 3d 502, 140 Cal.
Please note that the extent of protection may vary depending on the physician's profession. Los Angeles Superior Court, 72 Cal. Some States prohibit insurance companies from discriminating against individuals who have received treatment for substance abuse; however, such discriminatory practices continue. Insurance companies routinely share information about life and disability insurance applicants through the Office of Medical Information, a database maintained by a private organization and backed by industry.
In fact, in some states, depending on the physician's profession, patients' identities and medical records are protected. Therefore, doctors must find out whether disclosing a patient's name or recognizing that the person the lawyer asks about is a patient would be considered a violation of the patient's right to confidentiality. A firm but polite tone is best. If you are faced with what could be characterized as lockdown, an attorney may be tempted to cite the information you are requesting and more.
The doctor will not want to provoke the lawyer to take action that harms the patient. The only exception to this advice would be if the doctor knew that the patient was a fugitive and was being sought by law enforcement. In that case, in some States, refusal to provide assistance or provide information to officers could constitute a criminal offence. As stated above, in those states where patients' identities and medical records are protected, the doctor must give a non-binding response, for example, I will have to review my records to see if I have such a patient.
Your browsing activity is empty. National Library of Medicine8600 Rockville Pike Bethesda, MD 20894 Web Policies FOIAHHS Vulnerability Disclosure. In five states (California, Colorado, Idaho, Kansas, and West Virginia) it is illegal for certain known drug addicts or regular drug users to drive a motor vehicle. If you are in a meeting where illegal drugs are being used and your belongings are used to facilitate drug use (e).
Massachusetts declares it illegal to be in a place where heroin is stored and to be “in the company of a person known to possess heroin.”. Anyone in the presence of heroin at a private party or in a bedroom risks a serious drug conviction. Under federal and some state laws, participation in drug-related criminal activity may result in the seizure or confiscation of personal property and other assets used in conjunction with or derived from the proceeds of illegal activity. Constructive possession means that you did not own the drugs, but you knew of your presence in the area where the police found them.
Realistically, law enforcement officers could use your presence at a party where illegal drugs were used to search your car, backpack, or whatever else you're carrying. If the police didn't have “probable cause” to search your home, car, or person for drugs, then it was an illegal search and the evidence would not be taken into account. These include proving that you didn't know the drugs were present; that you didn't know the drugs were illegal (maybe they were prescribed by a doctor); or that the police lacked the legal right to search you or your property. Driving under the influence of drugs, including prescription drugs and illegal drugs, can also lead to DUI charges.
Mixing drugs and driving, whether it's medical marijuana or legally prescribed muscle relaxants, is as illegal as drunk driving and can also constitute a DUI offense. Three of these states (Nevada, Ohio and Virginia) have certain limits for the presence of intoxicating drugs, while the other 12 have a zero-tolerance policy. In addition to the disciplinary sanctions imposed by the University, all students, faculty, and staff should be aware that federal, state, and some local laws treat the illegal use, possession, sale, distribution, or manufacture of drugs or alcohol as felonies. Meanwhile, North Carolina and South Dakota make it illegal for anyone under the age of 21 to drive with any detectable amount of an illicit or prohibited drug while driving.
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