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I'm not quite sure I understand your problem. The kid is apparently willing to allow the doctor to do weekly blood draws to monitor the medication she is not taking, but she will not take the meds? Ask your doctor to train you in giving IM injections, (not difficult, we teach parents this sort of thing all the time), and have your doctor write the three of you a contract stating that if the child refuses to take her medications or takes her medications but has serum levels suggesting that she threw them up, then she will go on daily IM injections administered by you for the next week. If she refuses the IM injections, call the doc and have the nurse chart this, with the written understanding that she will be admitted for hospitalization if his serum levels continue negative for more than one week regardless of whether or not she recants. If the problem is that she doesn't like the taste, the taste can usually be effectively disguised in food, or the meds can be placed in a syringe and squirted into the back of the throat where the taste is minimal if you then immediately drink something using a straw. What is her reason for not taking the meds anyway? It might be possible to work with her.
You don't need to disrupt an adoption to win a power struggle with your kid. As her parent you can make her sleep on the floor, give all her CDs and electronics to the poor children, remove the door to her room so she has no privacy, restrict her clothing to two hideous but complete outfits washed daily so that she looks like a dork and is ashamed to leave the house, and/or serve her three healthy. nutritious meals a day consisting exclusively of things she dislikes but is not allergic to. What you do need to do is (1) WIN DECISIVELY and (2) BE CALM ABOUT IT. Remember, your angst is in itself a reward if you let her see you pulling out your hair. At the moment it sounds like she has you just where she wants you. The household is revolving around her and there is no penalty for her being a brat. BTW, if you have to enact a penalty for rotten behavior, I wouldn't rescind it just because she decided that she would take her pill again. Explain that the length of time the penalty will last cannot be shortened, but it sure as heck can be extended for crummy behavior. Similarly, if you give her Gameboy to Goodwill, don't go getting another just because she decided to act nice for an evening. Tell her if she keeps up the good behavior, you'll get her another for Christmas.
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