Doctors Accused of Trading Opioid Prescriptions for Sex and Cash – The New York Times

PITTSBURGH — Last summer, a woman in northern Alabama who law enforcement officials said was a prostitute typed a message to a doctor: “Can u get any Xanax.”

The doctor replied: “What makes you think I know a Xanax source?” Just below, he added a smiley face, and then described his home as the “Fun House.”

The doctor was one of the scores of medical professionals across seven states who were charged by federal prosecutors on Wednesday with schemes to illegally distribute millions of pain pills. Opioid prescriptions were exchanged for sex in some cases, and for cash with an added “concierge fee” in others. One doctor was accused of routinely prescribing opioids to friends on Facebook.

Prosecutors said the doctor in northern Alabama “recruited prostitutes and other young women with whom he had sexual relationships” to become his patients. He also opened his home to people using heroin, methamphetamine, cocaine and marijuana, they said, in a criminal complaint, adding that police officers had been to the house several times concerning overdoses and other complaints.

Officials called the indictments, which were unsealed in federal court in Cincinnati on Wednesday, the “single largest prescription opioid law enforcement operation in history.”

The indictments accuse 60 people, including 31 doctors, seven pharmacists and eight nurses, of involvement in the schemes, which included prescribing opioids for gratuitous medical procedures like unnecessary tooth pulling. In some cases, prosecutors said, 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 P. Barr said in a statement.

Prosecutors accused the medical professionals who were charged 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 nurse practitioner in Tennessee who called himself the Rock Doc was accused of prescribing hundreds of thousands of pills in exchange for sex.

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 last 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, Mr. Benczkowski said in an interview, because it is aimed at corrupt medical professionals, rather than users, and is “doing it in a region of the country that is probably the hardest hit.”

Officials said they were taking care to make sure the patients of people indicted in the investigation would get help.

“When a doctor who has been prescribing opioids is arrested and his customers show up to find the clinic shuttered, public health and safety officials will be on site to get those folks the kind of help and treatment that they need,” Benjamin C. Glassman, the United States attorney for the Southern District of Ohio, said at the news conference.

“Enforcement and treatment are both critical, as of course is prevention, if we are to turn the tide of this opioids crisis,” he said.

Mr. Benczkowski said the operation was part of what would be a more aggressive and focused federal law enforcement crackdown on corrupt medical professionals who illicitly distribute pain pills.

It is far from the only outlet for remedy, as the opioid epidemic rages on.

Across the state, in a courtroom in Cleveland, a federal judge is considering nearly 1,600 lawsuits brought on behalf of cities, counties and Native American tribes against makers and distributors of the painkillers. A test case in that litigation is scheduled go to trial in October.