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Probation Officers Should Not Direct Addicts on Probation to Take Methadone – There are Better Options

As an Attorney who defends drug cases in Portland and Gresham, I deal with many clients who use methadone to prevent opiate withdrawal.  Methadone has been available in the United States since 1947.  This drug is a synthetic narcotic that is used, primarily, as a replacement drug for people addicted to heroin, morphine or other opiate drugs.  It is also used for long term management of chronic pain.  Methadone has a  potential for abuse and addiction that is similar to heroin or morphine.

An entire industry has arisen around methadone in its use to control withdrawal symptoms in opiate addicts.  Methadone clinics serve thousands of addicts on a daily basis, administering doses of the drug directly to clients.

Used in a proper treatment model, methadone can be quite useful.  When an addicted person transfers their need for heroin to methadone, engages in treatment and gradually reduces the dose of the drug (called titration) the person can end up drug free and clean and sober after a period of time.  Proper titration can take months.

The problem is that many programs simply administer methadone, fail to have clients engage in meaningful treatment and continue people on methadone indefinitely.  This is an incredibly bad idea for a number of reasons.

First, methadone is dangerous.  The drug is a powerful respiratory and cardiac depressant.  Mixing methadone with other depressant drugs, like Xanax or alcohol, can cause a person to pass out and stop breathing.  Used long term, methadone can build up in a person’s body fat.  When the body fat becomes saturated it “dumps” the excess methadone into the blood stream and can cause an overdose, even when a person is taking their prescribed dose.

Second, methadone is not a cure for addiction.  Heroin addicts who switch from heroin to methadone are just as addicted to opiates as they were before.  They experience euphoria when they dose and they experience the same symptoms of withdrawal as the dose wears off, the most common of which is extreme fatigue (called “the nods”) which people experience in the afternoon.  People who replace heroin with methadone without treatment will still think like an addict and act like an addict.  It is very common for a methadone patient to use the drug as a bridge between heroin doses.

Third, the methadone clinic milieu is a culture of addiction, not recovery.  The environment itself can lead to relapse and new criminal activity.  Heroin dealers know that methadone clinics are a good place to sell heroin and they frequent the areas around the clinics.  This environment and easy access to drugs, is dangerous for addicts trying to recover.

Some probation officers feel that addicted probationers perform better on probation when they are using methadone.  Even if that is partly true, the truth is that methadone patients are always at a high risk for opiate relapse.  Once in relapse they will return to all of the drug acquisition behaviors that led them into legal trouble in the first place.

Methadone is an old drug.  There are new, more sophisticated, alternatives that can actually help people become completely clean from opiates.  Treatment is a necessary component  in this process.  As a Portland Drug Crimes Lawyer I believe that new medication and treatment modalities that actually get people clean from drugs are preferable to the use of methadone.  I see too many of my clients who use methadone relapse into drug use and criminal activity.

False Positive U/A’s and DUII Diversion Revocations and DUII Probation Violations

As a Portland DUII Attorney, I represent many people who are facing revocation of their Diversion or a Probation Violation because of a “dirty U/A.”  U/A testing is a mandatory part of any certified treatment program required to complete Diversion or a DUII Probation.  A minimum of two U/A’s must be administered during treatment.  However, most treatment programs administer them more frequently and do so on a random basis.

A U/A is generally performed using Gas Chromatography/Mass Spectrometry.  Minute amounts of alcohol or controlled substances can be detected using this process.  The laboratories that perform this testing have thresholds over which a sample is deemed “positive.”  One problem we often see is that the labs are setting their thresholds lower than accepted standards, raising the risk of false positive tests, as will be discussed later.  A person who tests “dirty” can ask for a re-test and is usually asked to pay for the re-test if it confirms the initial positive result.

buy phentermine hcl online http://www.rajtent.com/images/prod/lol994/ buy phentermine on ebay The Problem of False Positives

 

Well run treatment programs will give their client’s a list of items to avoid consuming during treatment because they risk having a false positive or innocent positive U/A.  People are told to avoid mouthwash or liquid medication that contain alcohol, as well as alcohol based hand sanitizers.

There are other substances that cause false positives that may come as a surprise.  1).  Poppy seeds.  As little as one teaspoon of poppy seeds can result in a positive test for opiates, codeine and/or morphine for two to three days.  2).  Prilosec.  This acid reducer can cause a false positive for marijuana, 3).  Cold Medicines and Anti-Depressant Medications.  These can cause false positive results for amphetamine.  3).  Zoloft.  This can cause a false positive for benzodiazepines like Valium and Ativan.

Not all treatment programs are aware of the variety of substances that can cause false positives.  As a result, they do not ask the right questions about other substances that may have caused a false positive result.  The same is true of testing laboratories, who often do not inform the treatment providers of possible false positive results.   Not all testing laboratories use the proper thresholds for determining the presence of prohibited substances.

In a recent case, we represented a person who supposedly tested positive for codeine/morphine and THC but who in fact had not taken opiates or used marijuana.  The lab that tested his sample was using outdated thresholds for opiate testing that were far lower than those recommended by the testing industry and the U.S government.  What our client’s sample really indicated was that our client had consumed  poppy seeds which explained the positive for codeine/morphine and was taking Prilosec which caused the false positve for THC.  Neither the treatment program did not ask our client any questions about the consumption of any substances that might cause a false positive result.  The treatment center then discharged our client from treatment and reported a failed U/A to the Court.  Fortunately, we were able to show the Court that the level of opiate drugs detected in the U/A was consistent with poppy seeds and the postive test for THC was a result of Prilosec.  The client’s  Diversion was not revoked and the client was referred to a different treatment program which, hopefully, will be more diligent in its testing procedures.

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As a DUI Defense lawyer in Gresham and Portland I thoroughly investigate allegations that my client’s have failed a U/A.  Often, there are innocent explanations for allegedly dirty U/A’s.  I have the staff available to assist me in these investigations, including a retired pharmacist with an extensive knowledge of drug chemistry.

DUII Enforcement – Saturation Patrols and How People Get Pulled Over For DUII

As a Clackamas County DUII attorney, I have noticed the increased use of certain tactics by police agencies to detect and arrest DUII drivers.  Many of these tactics are funded by the federal government.  For many years the federal government has offered block grants to individual states to be used as the states see fit to enforce DUII laws.  Many states use the dollars to pay the cost of road blocks used as “sobriety checkpoints” to detect drunk drivers.  Under the Oregon Constitution, however, roadblocks are not permitted because they constitute an unlawful detention without probable cause of wrongdoing.

The Oregon solution to this problem is to use the federal money to finance “saturation patrols.”  These patrols work one of two ways.  On days or weekends that are popular for drinking, like New Years Eve or Super Bowl Sunday, police agencies will put as many police officers as they can on the street and those officers actively look for anyone who appears to be a DUII driver.  When federal funds allow, police agencies will combine forces and flood particular areas with patrol vehicles on weekend nights without regard to whether it is a “drinking” holiday.  During these patrols, an Oregon City policeman may travel out of his jurisdiction and patrol areas in Milwaukie.  Generally, the focus of these patrols is between the hours of 10:00 p.m. and 6:00 a.m. and are the most aggressive during the hours that bars are closing.

The most common tactic of a saturation patrol is to pull over every car they can for the most minor traffic violation.  Using traffic violations as a “pretext” for investigating a DUII is allowed in Oregon.  The common pretext violations are: license plate lights that are out; broken tail lights, tinted windows; and cracked windshields. Experienced DUII patrol officers have their own thoughts about certain infractions that are indicators that someone is under the influence, the most common of which is driving at night without headlights.  These officers believe that a not noticing that one’s headlights are off is a sign of impairment.

As a DUII Attorney practicing in Oregon City and Gresham, I caution all of my clients to avoid driving after drinking at all times.  If a person does drink and drive, the hours of 10:00 p.m. and 3:00 a.m. are the absolute worst times to be driving after having consumed alcohol.  Even if a person is not driving poorly, they can be pulled over for the numerous equipment violations listed in the Oregon Vehicle Code.

“Aid and Assist” and Fitness to Proceed to Trial Hearings in Portland, Oregon

I know that a person charged with a crime must have the mental capacity to stand trial.  A person must understand the nature of the charge, the possible punishment for the crime, have a basic knowledge of the legal system and be able to work with an attorney in order to assist in the defense of the case.

There are times when a person is does not possess the minimum ability to stand trial.  Sometimes this is due to mental illness.  Other times it is due to developmental disability.  The inability to stand trial may be temporary, such as in cases of treatable mental illness.  There are also times when a condition is permanent.  Oregon law sets out the procedure for determining whether or not a person is “fit to proceed” and sets out a procedure for determining whether or not a person’s incapacity is permanent.

It is particularly important for a criminal defense lawyer to consider whether or not a client is fit to proceed when defending a Measure 11 case.

When a defense lawyer or a Judge has reason to believe that a person charged with a crime is not fit to proceed “aid and assist” proceedings are initiated.  The decision as to whether or not a person is capable of proceeding to trial is left entirely to the Judge presiding over the case.  The Judge selects an expert to evaluate the defendant and offer an opinion on the person’s fitness to proceed.  Generally, these evaluations are done at the Oregon State Hospital.  A person is usually transported to the Oregon State Hospital for a period of 30 days for an evaluation.  However, the Court is not required to send a person to the State Hospital and can direct the defendant to an appropriate placement in the community subject to monitoring and supervision.

 

These evaluations are designed to measure a person’s baseline intellectual ability and are designed to detect a person who is faking or exaggerating their disability.  Different tests are used depending on the persons age and the nature of their disability.  Some testing is specifically designed for people who are afflicted with mental retardation and developmental disabilities.

After the evaluation, the expert renders an opinion on the defendant’s fitness to proceed.  If a person is not fit to proceed, the expert advises the Court on possible plans to assist a person in regaining the ability to stand trial.  In cases with mental health issues, medications can sometimes help restore a person’s mental capacity.  Cases of low intelligence and developmental disabilities are more challenging.  There are types of education that can be attempted, focusing on how the legal system works and how a lawyer can help the defendant.  These efforts to “treat until fit” can last from 90 to 180 days.

After the evaluation is complete a hearing is held.  The expert testifies and is subject to cross examination.  If the prosecution or the defense disagree with the conclusions of the expert they can request that another evaluation be performed by a different expert.  If a second evaluation is performed the Court sets another hearing in 30 days and refers the defendant for the evaluation.  Once the evaluations are complete the Court decides whether or not a person is fit to stand trial or whether other measures must be taken to assist the defendant.

If it is determined that a person will never be capable of standing trial the Judge can dismiss the case and commence civil commitment proceedings.  If the person does not qualify for civil commitment, the Court can order the defendant to be discharged.

For example, suppose a person with serious developmental disabilities commits a serious crime and is awaiting trial.  A person with this kind of disability cannot have their capacity “restored” because they never had the requisite mental capacity to stand trial.  The Court can order the “treat until fit” education, which may improve the person’s understanding of how the legal system functions.  But, a person who suffers from serious cognitive impairments may never develop the ability to intelligently make the decisions that only a defendant can make in the defense of a criminal case.  These decisions are especially critical when a person is charged with a Measure 11 crime carrying the possibility of long prison sentences.

In cases of mental illness there are other difficulties.  Suppose you have a person who suffers from severe schizophrenia who has auditory and visual hallucinations.  This person would respond to medications, but refuses to take medications.  The Court can, in some circumstances, force a person to be medicated.  But, in cases where a persons capacity cannot be restored, even with medications.  People in this position are generally subject to civil commitment and long term hospitalization.

As Portland Criminal Defense Lawyer, I recognize that it is necessary to understand the full range of events that can transpire in a criminal case.  Determining a client’s fitness to proceed is a critical issue, particularly in serious felony cases.

Purchasing Prescription Drugs Over the Internet Can Lead to Serious Criminal Drug Charges

As a Portland Drug Crimes Lawyer, I have seen people get into trouble by acquiring prescription drugs through the internet.  It may seem like a good idea to purchase prescription drugs over the internet or purchase them in foreign countries.  After all, they advertise steep discounts on common drugs and delivery to your home by mail, which is convenient.  However, there are some clear reasons that people should avoid internet drug sales and purchasing drugs in foreign countries.

First, the vast majority of internet drug transactions are illegal.  More importantly, the DEA constantly monitors these companies and takes action against them, both at home and abroad.  They ultimately discover a companies customer list.  If a person has purchased narcotic drugs that transaction constitutes a felony possession of a controlled substance if the drug is a schedule II opiate.  If one gives or sells the drug to another person, that can be a felony drug delivery with serious legal consequences.  If a person delivers drugs to another person and that person overdoses and dies, the seller can be liable for serious Federal charges under the Len Bias Law and a long prison sentence.

Second, a person ordering these drugs has no idea of what they are actually receiving.  Pills that purport to be oxycodone could be another kind of opiate or contain no medication at all.  These drugs are almost never the product of mainstream drug manufacturers.  The drugs are made on commercial pill presses and the makers can imitate the markings of real drugs.  It is common for a drug to purport to be hydrocodone (Vicodin) and actually turn out to be Darvon, a drug that can be dangerous for people who suffer from cardiac arrhythmia or cardiac abnormalities.  Codeine is another cheap and common substitute for any drug that purports to be an opiate.

These illicit “prescription” drug manufacturers make their products in an unmonitored environment with no quality control.  The substitutions of ingredients they make can cause problems for individuals who are allergic to the substituted compound or people who have other health problems that are aggravated by the substituted drug.  These suppliers use crude binders, such as lactose, that can cause gastrointestinal problems.  No one knows the conditions under which the drugs are made and other contaminants are often present in the “offshore” drugs.

As a Portland Criminal Defense Attorney, I caution my clients not to use these sites to acquire drugs.  Obtaining of drugs through these sites is illegal and the risk of getting something other than you ordered is substantial.