White Collar Courier: Delivering News and
Providing Guidance in White Collar Matters
By Adam Overstreet
November 28, 2017
The new DOJ initiative – aggressively investigating and prosecuting
pain management practitioners
Part Two: What’s At Stake for Medical Professionals In ‘Pill Mill’ Cases
In part one of this series, I detailed how the U.S. Department of Justice has focused its attention on the
aggressive investigation and prosecution of “pill mill” cases. See “Part One: DOJ Devotes Resources,
Vows to Come After ‘Pill Mills.’” In this installment, I discuss the varied consequences doctors and other
medical professionals potentially face as a result of a “pill mill” investigation.
I. CRIMINAL PROSECUTION
A litany of criminal charges can be heaped on medical professionals at the conclusion of a “pill mill”
investigation. Exactly what charges the government pursues will obviously depend on the facts and
circumstances of each particular case. One charge that will inevitably be included in every “pill mill”
indictment is an alleged violation of the Controlled Substances Act (“CSA”). The CSA governs the
distribution and dispensing of various listed drugs, including narcotics, that are prescribed by doctors
and other licensed medical providers. To issue a controlled substance, a doctor must be licensed to
practice by a state authority and must have a DEA registration number.
Under the CSA, controlled substances are placed into one of five “schedules” based on whether they
have a currently accepted medical use in the United States, their relative abuse potential, and their
likelihood of causing dependence when abused. The schedules are summarized as follows:
• Schedule I – these drugs have no acceptable medical use and a high potential for abuse.
Examples include heroin and LSD, among others.
• Schedule II – these drugs have acceptable medical uses and a high potential for abuse. Most
opioids are Schedule II drugs. Examples include: morphine (e.g., Avinza®); oxycodone (e.g.,
OxyContin®); hydrocodone (e.g., Lortab®); hydromorphone (e.g., Dilaudid®); and fentanyl (e.g.,
Subsys®).
• Schedule III – these drugs have acceptable medical uses and a potential for abuse that is less
than schedule I and II drugs. One example is buprenorphine (e.g., Suboxone®).
