Scores of medical professionals across seven states were charged by federal prosecutors on Wednesday with schemes to illegally distribute millions of pain pills — in some cases exchanging opioid prescriptions for sex, in others for cash with an added “concierge fee”, and in one case routinely prescribing opioids to friends on Facebook.
Officials called the case the “single largest prescription opioid law enforcement operation in history”.
The indictments, unsealed in federal court in Cincinnati on Wednesday, accuse 60 people, including 31 doctors, seven pharmacists and eight nurses of involvement in the schemes, which included opioid prescriptions issued for gratuitous medical procedures like unnecessary tooth-pulling.
In some cases doctors simply handed out signed blank prescription forms.
“These cases involve approximately 350,000 opioid prescriptions and more than 32 million pills — the equivalent of a dose of opioids for every man, woman and child across the states of Ohio, Kentucky, Tennessee, Alabama and West Virginia combined,” Brian Benczkowski, an assistant attorney general in charge of the Justice Department’s criminal division, said at a news conference.
Most of the charges were filed against people in those five states; one person was charged in Pennsylvania and one in Louisiana.
Nationally, more than 70,000 deaths in 2017 were attributed to drug overdoses, with about one-quarter of them caused by prescription opioids.
States wholly or partly in Appalachia recorded some of the highest rates of drug overdose deaths that year: West Virginia was first in the nation, Ohio second and Kentucky fifth.
“The opioid epidemic is the deadliest drug crisis in American history, and Appalachia has suffered the consequences more than perhaps any other region,” Attorney General William Barr said in a statement.
Prosecutors accused the medical professionals who were charged on Wednesday of conducting a wide range of schemes.
Some involved small leagues of doctors and their office staffs, while in other cases, people acted alone, according to the indictments.
Some doctors performed unneeded medical procedures to justify the pills they prescribed, prosecutors said, while others simply passed out prescriptions without going to the trouble of disguising their purpose.
One of the doctors facing charges in Ohio had at one time prescribed more controlled substances than anyone else in the state, prosecutors said.
A pharmacy in Dayton, Ohio, was accused of dispensing more than 1.75 million pills.
And a doctor in Tennessee who called himself the “Rock Doc” was accused of prescribing hundreds of thousands of pills in exchange for sex.
A doctor in Alabama, federal prosecutors said, “allegedly recruited prostitutes and other young women with whom he had sexual relationships” to become his patients, and allowed them to use illicit drugs at his home.
In some cases, the quantity of drugs prescribed to the same patients at short intervals indicated that they could have been taking as many as 15 pills a day, prosecutors said.
The charges announced Wednesday include unlawful distribution of controlled substances and conspiracy to obtain controlled substances by fraud.
Prosecutors said that the charges could result in sentences of up to 50 years in prison.
The indictments stem from four months of investigative work by the Appalachian Regional Prescription Opioid Task Force, a group of prosecutors, federal agents and data analysts that was created in December 2018 to find patterns suggesting that doctors were prescribing inordinately high numbers of pain pills, and then follow up with traditional law enforcement techniques, including the use of informants and undercover investigators.
Cases like this have been prosecuted before, including a Justice Department operation in June that resulted in charges against 162 defendants, including 76 doctors, for fraudulently prescribing and distributing opioids.
Those cases were handled within the larger health fraud unit at the Justice Department.
The Appalachian task force is different, Benczkowski said, because it is exclusively concerned with corrupt medical professionals, and is “doing it in a region of the country that is probably the hardest hit.”
The New York Times