In recent years, there has been increasing news coverage regarding the “opioid epidemic,” alleged “pill mills” and unscrupulous providers. This has increased the risk that well-meaning providers to be charged under the Controlled Substances Act for prescribing more than guidelines would recommend to, say, a patient suffering from intense pain who has developed a tolerance to lower doses. Such charges can be devastating not only to the medical practices involved, but to the life and future of the doctors who take on the responsibility of caring for individuals with severe pain.

The Controlled Substances Act: What Is It?

Under the Controlled Substances Act (CSA), all substances regulated by the Federal government are sorted into one of five schedules, based on a variety of factors. These include their potential for abuse versus the benefit of their accepted medical use, if there is an accepted medical use in the United States. Schedule V drugs and substances, such as certain cough suppressants, have accepted medical uses and are unlikely to lead to addiction or abuse. On the other end of the spectrum are Schedule I drugs, which are deemed highly addictive and have no accepted U.S. medical use, such has heroin and LSD.

Then there is Schedule II, which encompasses drugs with a medical purpose that nonetheless have been deemed to have a high potential for abuse. Opioids and methadone fall into Schedule II.

If a healthcare professional writes or dispenses a prescription for an opioid that is outside the legally-undefined ‘usual course of professional practice’—in the opinion of prosecutors—and does so without ‘legitimate medical purpose’—again, in the opinion of prosecutors—he or she can face decades in jail for violating the CSA. Doctors, physician assistants (PAs), registered nurses (RNs), pharmacists, and any other healthcare professional who prescribes or dispenses controlled substances can be accused of running afoul of the CSA for trying to treat their patients as they deem best.

However, a recent Supreme Court ruling was decided in favor of healthcare providers who act in good faith.

The Supreme Court Rules in Favor of Good Faith

Since we last covered prosecutions of medical professionals under the Controlled Substances Act, the Supreme Court took up a case in which the defendant healthcare providers used the defense of ‘good faith.’ In June 2022, the Court unanimously ruled in Ruan v. United States that prescribers acting in subjective good faith do not face criminal liability under the CSA. In light of this ruling, prosecutors must prove beyond a reasonable doubt that the defendant knowingly and intentionally acted as a drug dealer, rather than a doctor, in prescribing a controlled substance.

While it has only been a few months since the ruling, this will undoubtedly make it more difficult to prosecute healthcare providers under the CSA. Already, there have been a number of acquittals and dismissals in the wake of the recent decision.

Healthcare Providers Facing CSA Charges Need Proactive Defense

If you are facing charges related to the prescribing of a controlled substance, Burnham & Gorokhov has experience and a well-developed strategy for defending healthcare providers charged under the CSA. We rely on expert testimony as well as a deep understanding of the medical and legal facts of a case to construct our defense of our clients in the healthcare profession. Contact our office as soon as possible to discuss your situation.