The Department of Justice, along with the DEA have increased their focus on heroin and opioid prescription painkillers trafficking with the “360 Strategy.”
According to the Center for Disease Control and Prevention, there were 18,893 overdose deaths related to prescription opioid medicines, and 10,574 overdose deaths related to heroin in the United States in 2014. As a response to the growing numbers of heroin and prescription opioid deaths, in November 2015 the Drug Enforcement Administration rolled out its “360 Strategy.” The plan is called “360” because in addition to an increase in law enforcement efforts, the plan also increased DEA efforts to work with community agencies focused on preventing heroin and opioid pill abuse. Pittsburgh was the DEA’s pilot city for the program, followed by Saint Louis, Milwaukee, and then Louisville.
As we mentioned on Facebook last month, the Obama Administration designated September 18-23, 2016 as “Prescription Opioid and Heroin Epidemic Awareness Week” to raise awareness about the rising number of opioid and heroin drug overdoses.
In addition to raising awareness of these overdoses, the Department of Justice is ramping up its prosecution of heroin trafficking. For fiscal year 2017, the DOJ has requested an additional $12 million plus funding for 42 new DEA positions for increased prosecution of heroin trafficking. The funding would be used to create four new “heroin enforcement groups.”
However, heroin addiction often starts with the misuse and abuse of prescription painkillers. When a person cannot afford pills, or cannot gain access to the number of pills needed to feed their ever-increasing need for the prescription drugs, they turn to heroin as a supplement or as a replacement for their addiction. In fact, four in five new heroin users started out misusing prescription painkillers.
For this reason, the Department of Justice is not only increasing its investigation and prosecution of street level distributors of opioids and heroin, but is now targeting for prosecution the physicians who are “over” prescribing prescription painkillers, and pharmacists who are filling those prescriptions. In most cases, the DOJ is alleging the physician is over prescribing, prescribing without a legitimate medical purpose, prescribing with knowledge that the patient is redistributing, or is prescribing to a patient who has been doctor shopping for prescriptions, all of which can be, in the right circumstances, a violation of federal laws.
U.S. v. Lang is a well-known case where pain clinic employees were charged with illegal distribution of Oxycodone. In Lang, Faith Blake pled guilty to conspiracy to distribute Oxycodone outside the scope of professional practice and not for a legitimate medical purpose. She was sentenced to 44 years in prison. Faith’s mother, Barbara Lang, co-owned a clinic with Faith, and was charged in one of the conspiracies. Barbara Lang was found guilty after a trial, and was sentenced to 240 years. A physician who was the director of one Faith Blake’s clinics pled guilty and was sentenced to 5 years, and a nurse practitioner pled guilty and was sentenced to 13 years. Lang is a case often used by the DOJ and DEA to educate law enforcement on the red flags to look for when investigating medical professionals. One of the most common red flags for any criminal investigator is patients paying with cash.
In fact, patients paying cash for cursory examinations and then receiving prescriptions was one of the red flags cited in a DOJ press release in California for a doctor and two physician assistants indicted in June 2016. According to the DOJ, the doctor was allegedly “seeing ‘patients’ – some of whom were addicted to drugs, and some of whom were undercover law enforcement officers – and issuing prescriptions outside the usual course of professional practice and without a legitimate medical purpose.” The DOJ alleges that the doctor “wrote prescriptions for at least four people who died from drug overdoses within days of seeing the doctor.”
Just last month in Alabama, the DOJ charged a doctor with one count of conspiring to execute a health care fraud scheme against Medicare and Blue Cross Blue Shield of Alabama. The DOJ’s press release described the doctor as “the nation’s highest Medicare prescriber of opioid painkillers at the height of his practice.” The doctor pled guilty with an agreement for a sentence of 15 years in federal prison, but that sentence must still be accepted by the federal court.
Our firm has experience representing physicians and medical personnel in these kinds of cases, and is familiar with the “red flags” that the DOJ relies on in forming criminal allegations. Not only do the federal laws allow DOJ prosecutors to indict medical professionals, but they often also target clinic owners and non-medical staff. We have represented both individuals and the medical businesses, against charges of heroin and prescription painkillers trafficking, and also with fraud related to the prescribing of opioids. If you are contacted by law enforcement or are served with a subpoena regarding your medical practice, you should contact attorneys knowledgeable with these issues. We are here to help.
Center for Disease Control and Prevention, National Center for Health Statistics, National Vital Statistics System, Mortality File. (2015). Number and Age-Adjusted Rates of Drug-poisoning Deaths Involving Opioid Analgesics and Heroin: United States, 2000–2014. Atlanta, GA: Center for Disease Control and Prevention. Available at http://www.cdc.gov/nchs/data/health_policy/AADR_drug_poisoning_involving_OA_Heroin_US_2000-2014.pdf.
American Society of Addiction Medicine, “Opioid Addiction 2016 Facts and Figures” (citing Jones CM. Heroin use and heroin use risk behaviors among nonmedical users of prescription opioid pain relievers – United States, 2002-2004 and 2008-2010. Drug Alcohol Depend. 2013 Sep 1;132(1-2):95-100. doi: 10.1016/j.drugalcdep.2013.01.007. Epub 2013 Feb 12).