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Your Right to Refuse Medication in Prison

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In general, all inmates have the right to refuse to take medication. You are considered to refuse a medication if you refuse to take it within 30 minutes of it first being offered to you.

In some situations, though, the prison can force you to take psychotropic medication against your will. This is sometimes called “forced medication.”

Forced medications in an emergency

In an emergency situation, your doctor can order forced medication for up to 72 hours (3 days). Each of these conditions must exist for your doctor to order forced medication:

  • You have a mental illness;
  • You are receiving mental health treatment in the prison; and
  • Either
    • Not treating your illness would create an imminent substantial threat of injury or death to you or others; or
    • Your records and medical history demonstrate that your illness has been deteriorating for a prolonged time, it is getting worse and, if not treated, it is likely to create a condition that would endanger the life or safety of you or others
  • The medication is a generally accepted treatment for your illness;
  • The treatment is substantially likely to effectively reduce the symptoms of your illness; and
  • The medication is the least intrusive of the treatment
  • The medication shall not exceed the dosage expected to accomplish treatment and you are monitored for adverse reactions and side effects.

If the emergency continues to exist, and another doctor who is not involved in your treatment agrees, your doctor can renew the order for up to 144 more hours (6 days).

After 9 days of emergency forced medication, the doctor must follow the procedures for forced medication in a non-emergency situation.

Forced medications in a non-emergency

In a non-emergency situation, you can also be forced to take psychotropic medication.

The doctor must consider your reasons for refusing the medication, and speak with you about the risks and benefits of the medication, as well as the risks and benefits of other treatment options. Your treatment team may also talk with you about this. If you still refuse the medication, your doctor must refer the matter to the Involuntary Medication Committee.

Involuntary medication committee

The involuntary medication committee will meet to review your case. You have the right to participate in the meeting, either in person or through an interview with a Committee representative. You also have the right to be represented at the Committee meeting by a member of your treatment team. You may present evidence and call witnesses to support your position. However, if your clinical condition makes your attendance at the hearing “not feasible,” you may be interviewed in another location. Witnesses may present written testimonials, and some witnesses maybe excluded due to security risk.

The Committee will first determine if each of these conditions exist:

  • You have a mental illness;
  • You are receiving mental health treatment in the prison; and
  • Either
    • Not treating your illness would create an imminent substantial threat of injury or death to you or others; or
    • Your records and medical history demonstrate that your illness has been deteriorating for a prolonged time, it is getting worse and, if not treated, it is likely to create a condition that would endanger the life or safety of you or others.

    If one of these conditions does not exist, you cannot be forced to take the medication. If all of these conditions exist, the Committee will then consider whether:

  • Medication is a generally accepted treatment for your illness;
  • Treatment is substantially likely to effectively reduce the symptoms of your illness; and
  • Medication is the least intrusive of the treatment

If these conditions exist as well, the Committee can authorize forced medication for up to 30 days. A majority of the Committee must agree with the decision.

After 30 days of non-emergency forced medication, your doctor may ask the Committee to renew its decision. The Committee can authorize forced medication for up to 90 additional days. The Committee can authorize forced medication for additional periods of up to 90 days, as long as it reviews the situation first.

View 10A N.C.A.C. 26D .1104: Involuntary Administration of Psychotropic Medication

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