Worried a Loved One Will Refuse Medication? Get Clear Answers Before the Next Crisis

Short Answer: A Marchman Act Order Does Not Automatically Settle Medication Decisions

The answer depends on the order, the treatment provider’s medical process, and whether your loved one can understand and decide about their own care.

Maybe you’re worried about a son, daughter, or sibling who keeps turning down medicine. Another crisis may be close. You want to know what the court can actually do.

The Marchman Act is Florida’s civil law for substance use. It sits in Chapter 397 of the Florida Statutes. It is a route to assessment and treatment, not a list of medicines. The statute also says that mere refusal to receive services, by itself, is not evidence of lack of judgment about his or her need for such services (Fla. Stat. § 397.675). Fla. Stat. § 397.675 reads: “(b) Without care or treatment, is likely to suffer from neglect or refuse to care for himself or herself; that such neglect or refusal poses a real and present threat of substantial harm to his or her well-being; and that it is not apparent that such harm may be avoided through the help of willing, able, and responsible family members or friends or the provision of other services, or there is substantial likelihood that the person has inflicted, or threatened to or attempted to inflict, or, unless admitted, is likely to inflict, physical harm on himself, herself, or another.”

How the Marchman Act Works for Substance Use

A Marchman petition goes to the court, the person is assessed, and the court decides on treatment. The petition must be filed with the clerk in the county where the person is located, and the clerk may not charge a filing fee (Fla. Stat. § 397.681). An adult’s spouse, legal guardian, relative, or service provider may file. So may an adult with direct personal knowledge of the person’s substance abuse impairment and prior course of assessment and treatment (Fla. Stat. § 397.68112).

Assessment usually comes first. The court must hear and review all relevant evidence, including the results of the assessment completed by the qualified professional in connection with this chapter (Fla. Stat. § 397.6957). In nonemergency situations, if the person was never assessed or refused one, and the evidence makes it reasonably appear that the person qualifies for involuntary treatment, the court must issue an involuntary assessment and stabilization order. The respondent’s assessment by a qualified professional must occur within 72 hours after his or her arrival at a licensed service provider, subject to the exceptions in the statute. Fla. Stat. § 397.6957 reads: “The respondent’s assessment by a qualified professional must occur within 72 hours after his or her arrival at a licensed service provider unless the respondent shows signs of withdrawal or a need to be either detoxified or treated for a medical condition, which shall extend the amount of time the respondent may be held for observation until such issue is resolved but no later than the scheduled hearing date, absent a court-approved extension.” That order is valid for 90 days.

Stabilization is where clinicians address immediate medical and psychiatric needs. The hearing decides whether the person’s petition is dismissed or whether the person is ordered to receive treatment from his or her chosen licensed service provider if possible and appropriate (Fla. Stat. § 397.6957). Day-to-day clinical choices come after that, from the treating team.

What the Court Order Does and Does Not Say About Medication

In general, a court order sends the person to a licensed provider for treatment. Medicine choices are then made through the provider’s medical process and its consent steps. Ask the provider how those decisions are made and written down.

Some rights still apply during treatment. Florida law says a person receiving services keeps their dignity and any constitutional rights. Treatment records are also confidential. A provider generally cannot share them without the person’s written consent, with limited exceptions. Family members do not automatically receive them.

Medicine questions often turn on capacity. Under Florida’s surrogate statute, a principal is presumed to be capable of making their own health care decisions unless they are determined to be incapacitated. Incapacity may not be inferred from a hospital stay for mental illness (Fla. Stat. § 765.204). A written medication plan and consent records show what the team decided and why.

Can a Doctor Refuse to Treat Someone With an Addiction?

A treatment provider can decline to admit or keep a person it cannot safely manage. The law sets steps it must follow first. Under Fla. Stat. § 397.6751, when a service provider decides a person presented for involuntary admission should not be admitted because of his or her failure to meet admission criteria, because his or her conditions are beyond the provider’s safe management capabilities, or because of a lack of available space, services, or financial resources, it must attempt to contact the referral source and, within one workday after completing those efforts, report in writing to the referral sources, in compliance with federal confidentiality regulations.

If the medical conditions or behavioral problems of an involuntary person become such that they cannot be safely managed by the service component, the provider must discharge the person and, within 72 hours after completing its efforts to secure more appropriate services, report the reason in writing to the referral source (Fla. Stat. § 397.6751). Discharge planning also matters. The plan must document, at a minimum, follow-up appointments, how to get prescribed medicines, living arrangements, and transportation, and referral to recovery support opportunities, including connection to a peer support professional (Fla. Stat. § 397.6977). Ask the team for that plan in writing before your loved one leaves care.

A common mistake is assuming discharge ends the court’s role. Court-ordered treatment lasts 90 days, after which the respondent is automatically discharged unless a motion for renewal of the involuntary services order has been filed with the court (Fla. Stat. § 397.6977). The court keeps jurisdiction to monitor compliance (Fla. Stat. § 397.697).

Emergency Situations, Law Enforcement, and Immediate Risk

If your loved one is in immediate danger, call 911 or local emergency services first. A court petition takes time that a crisis may not allow.

Florida’s involuntary admission standard looks at real risk. It also asks whether willing, able family members could prevent that harm. The standard also covers a substantial likelihood of physical harm to self or others (Fla. Stat. § 397.675).

Police involvement has limits. Individuals receiving services who are not accused of a crime or delinquent act may not be detained or incarcerated in jails, detention centers, or training schools of the state, except for protective custody in strict accordance with this chapter (Fla. Stat. § 397.501). Families often describe the same warning signs: refused medicine, dangerous behavior, and an inability to meet basic needs like food, housing, and bills.

When Guardianship May Address Medical Decisions

Guardianship is a separate court route. It can address medical decisions when a person cannot make safe decisions. Florida’s emergency temporary guardianship is the fastest option. A court may appoint one after a petition for determination of incapacity has been filed, or on its own motion if no petition for appointment of guardian has been filed at the time of entry of an order determining incapacity. The court must find imminent danger that the person’s health or safety will be seriously impaired without immediate action (Fla. Stat. § 744.3031).

Notice must reach the person and their attorney at least 24 hours before the hearing. The only exception is when the petitioner demonstrates that substantial harm to the alleged incapacitated person would occur if the 24-hour notice is given. The court must list the guardian’s powers in its order. The authority lasts 90 days. It may be extended for another 90 days if the emergency continues, or it ends when a guardian is appointed.

Plenary, limited, and mental health guardianship are other types. Each fits different facts about what the person can and cannot do. The right type depends on the case.

What Families Can Document Before Speaking With an Attorney

Clear records help. Note the dates of medicine refusals, what was said, and any dangerous incidents. Add missed meals, unpaid bills, and other signs of unmet needs. Keep discharge papers, medication lists, treatment plans, and the names of providers. A timeline lets a lawyer or the court see the facts in order.

The petitioner carries the burden. In J.C. v. State, the Fifth District addressed a Marchman Act proceeding in which the petitioner was absent from the court’s handling of the matter. In doing so, the court failed to follow the applicable statute by essentially functioning as the absent petitioner (J.C. v. State). In C.W.R.K. v. Stewart Marchman Act Behavioral Healthcare, the trial court failed to follow the governing statute when, in the absence of the petitioner, it called and questioned the health care professional who executed the involuntary services certificate.

A respondent has the right to counsel at every stage of a Marchman proceeding, but may waive that right if present and the court finds the waiver is made knowingly, intelligently, and voluntarily. If the person cannot afford a lawyer and wants one, the person has the right to court-appointed counsel.

For more depth, read our Marchman Act medication guide. For doctors’ authority, see whether a doctor can force addiction treatment.

Questions about medication in a Marchman Act case

How long does court-ordered treatment last? Up to 90 days. It ends automatically unless someone files a motion to renew it.

Talk With Robinson Casey About Your Loved One’s Situation

If your loved one keeps refusing medicine after a crisis, you may be carrying that fear every day. Robinson Casey limits its practice to Marchman Act and guardianship matters, serving families across South Florida and statewide. Your first consultation is free, confidential, and comes with no obligation to continue. Call (561) 849-4149 or use the contact page to ask about your family’s situation.