Currently there is a case before SCOTUS Ruan v. United States
that is trying to resolve this Issue: Whether a physician alleged to have prescribed controlled substances outside the usual course of professional practice may be convicted of unlawful distribution under 21 U.S.C. § 841(a)(1) without regard to whether, in good faith, he “reasonably believed” or “subjectively intended” that his prescriptions fall within that course of professional practice.
Within the Controlled Substance Act (CSA), it is illegal for a person to obtain a controlled substance without a valid medical reason. Historically, the DEA tried to trace back a OD/dead body back to a prescriber, didn’t seem to matter that the person that OD had not be seen by the prescriber for up to a year OR MORE. The DEA charged the prescriber for prescribing opiates for someone without a valid medical necessity. Opiate Rxs peaked in 2011-2012 and they have been reduced by abt 60% since then. Apparently “dead bodies’ that could be attached to a prescriber and opiate Rx, the DEA shifted to doing data search of those prescribers who were “believed” to be prescribing opiates for non-medical reasons. The DEA – apparently to justify their conclusion – would publish how many doses of opiates – typically in millions – over a period of time – typically YEARS – and how many pts – typically in thousands…the prescriber had prescribed.
People – like me – would reverse engineer the numbers the DEA provided and in many instances … it would calculate that the “average pt” may have received a SINGLE DOSE every DAY OR TWO and I would share my findings on my blog and other places on the internet.
Over recent years, I have not seen any person that the DEA claimed the prescriber was providing opiates to that did not have a valid medical necessity getting arrested and sent to jail. There have been rumors over the years, that the DEA would find a “bogus pt” in a particular practice and promise that person a free “get out of jail card” if they testify against the prescriber precisely what the DEA wants to be said under oath when the DEA takes the prescriber to Federal court.
Of course, the DEA is mostly interested in using the Civil Asset Forfeiture Act to confiscate all the prescriber’s assets. So the prescriber has no income and no assets and the DEA has GROSSLY OVER CHARGED the prescriber, so going to trial with a public defender and facing so many years that a guilty verdict would pretty much means a LIFE SENTENCE… so the prescriber has no choice but to plead guilty to a SINGLE CHARGE and 20 yrs in jail and the bogus pt doesn’t have to perjure themself at trial and can’t admit to what they have done.
And all those legit pts in the prescriber’s practice is left “out in the cold”, because no other practice who wants to take a chance of accepting one of those pts from a “dirty practice” into their practice. Is the manner in which the DEA is enforcing the CSA, actually interfering with those pt’s medical care?
If you notice, 42 USC 1395 was added to our FEDERAL LAW in 1965 – FIVE YEARS before the CSA was signed into law and EIGHT YEARS before the DEA was created to enforce the CSA. Does this suggest that the Congress that passed the CSA and was signed into law by Pres “Tricky Dick” Nixon was technically signing into law a unconstitutional bill ?
42 USC 1395: Prohibition against any Federal interference
https://uscode.house.gov/view.xhtml?req=(title:42%20section:1395%20edition:prelim)
§1395. Prohibition against any Federal interference
Nothing in this sub chapter shall be construed to authorize any Federal officer or employee to exercise any supervision or control over the practice of medicine or the manner in which medical services are provided, or over the selection, tenure, or compensation of any officer or employee of any institution, agency, or person providing health services; or to exercise any supervision or control over the administration or operation of any such institution, agency, or person.
(Aug. 14, 1935, ch. 531, title XVIII, §1801, as added Pub. L. 89–97, title I, §102(a), July 30, 1965, 79 Stat. 291 .)
Statutory Notes and Related Subsidiaries
Short Title
For short title of title I of Pub. L. 89–97, which enacted this subchapter as the “Health Insurance for the Aged Act”, see section 100 of Pub. L. 89–97, set out as a Short Title of 1965 Amendment note under section 1305 of this title.
Protecting and Improving Guaranteed Medicare Benefits
Pub. L. 111–148, title III, §3601, Mar. 23, 2010, 124 Stat. 538 , provided that:
“(a) Protecting Guaranteed Medicare Benefits.-Nothing in the provisions of, or amendments made by, this Act [see Short Title note set out under section 18001 of this title] shall result in a reduction of guaranteed benefits under title XVIII of the Social Security Act [42 U.S.C. 1395 et seq.].
“(b) Ensuring That Medicare Savings Benefit the Medicare Program and Medicare Beneficiaries.-Savings generated for the Medicare program under title XVIII of the Social Security Act under the provisions of, and amendments made by, this Act shall extend the solvency of the Medicare trust funds, reduce Medicare premiums and other cost-sharing for beneficiaries, and improve or expand guaranteed Medicare benefits and protect access to Medicare providers.”
Filed under: General Problems
[…] Is how the DEA enforces the CSA… in violation of this federal law ? […]
Okay, I normally find some truth in your posts, but this one is a stretch. I personally know of 2 former patients who have been arrested for “doctor/pharmacy shopping,” and I do not work/live in a large metropolitan area. One was a former police officer who was charged with using his position as a LEO to “coerce” doctors into writing rxs for large quantities of norco. He even tried flashing his badge in the pharmacy where I worked to get us to fill one of these & basically threatened my PIC when she refused to fill based on the fact that he had filled 3 other rxs within the past 10 days. (He took a plea for “disorderly conduct.”) The other was my best friend, who passed away prior to trial from a health issue caused by her abuse of these meds.
You’re also misreading 42 USC 1395. It means that the code cannot be used to place an officer or employee in a position of power at a medical facility where treatment is being provided.
I also doubt there have been doctors arrested on the word of a SINGLE “bogus patient,” unless the behavior of the doctor was egregious. At least, searching brings up No cases where a doctor was convicted on the testimony of ONE patient. Do they go after the doctors rather than patients to seize assets? It’s possible as many patients have little or no assets and the investigations are costly. However, doctors are legally forbidden from issuing prescriptions for which there is no legitimate medical purpose. A friend was a jury member on a trial for a convicted “pill mill” doctor. When the prosecutor asked what the “legitimate medical purpose” was for rxs issued to one patient, the doctor actually replied “treating his addiction…I mean his affliction.”
thank you for reading my blog … if you noticed, the title of this post was a QUESTION ??? Here is a press release from the DOJ this week… https://www.justice.gov/usao-ma/pr/newton-physician-resolves-allegations-improper-prescribing-practices-concerning to me .. it appears that this DOJ office is doing some serious DATA MINING in the state’s PDMP $100,000 settlement for ALLEGATIONS… because a prescriber failed to check the PDMP 51 times over 2 yrs… allegations of diversion, pt harm, and on and on … Just this week, I have heard THREE DIFFERENT ATTORNEYS – on three different stations – one being local for me – that 90% of people taken to FEDERAL COURT are found GUILTY. I suspect that this prescriber agreed to settle because he would spend a larger sum in legal fees trying to fight ALLEGATIONS. Maybe this DOJ office needed a extra $100,000 because federal fiscal year ends Sept 30th. if they had chargeable facts… they would have charged him with 51 counts of violating the CSA… used the Civil Asset Forfeiture Act to confiscate all his assets and shut down his practice… then offer to wave 50 charges if he pleads guilty to one count and he could got to prison for 20 yrs… or use a public defender in Federal court – where 90%+ are found guilty and he will get 51 times 20 yrs prison term. One Of those those attorneys who stated that 90%+ of people taken to federal court are found guilty…also states that some bureaucratic entities depend on using CAF to cover up to HALF of their annual budgets. anyone who doubts this… just do a web search for “civil asset forfeiture abuse” and see how many results come back
OK,,TRY AGAIN,,,,IN 2020 A DR,HAHN CHANGED BY EXECUTIVE ORDER THE DEFINITION OF ESSENTIAL MEDICINE OPIATES FOR ACUTE PURPOSES ONLY,,AND ONLY CHANGED IN AMERICA,,,,MEANING THE U.N..AND THE WHO MOSTLY KEPT THEIR DEFINITIONS,,PERSONALLY I THINK THEY CHANGED THIS RECENTLY TO BE ABLE TO CONTINUE TO CHARGE/GO AFTER INNOCENT DOCTORS WHO DEAL W/LONG TERM PHYSICALLY PAINFUL MEDICAL CONDITIONS,,,,ITS $$$$$$$FOR THE DEA,,,,FURTHERMORE,,SINCE THIS CHANGE,,THEY CAN CLAIM THEY ARE NOT PRACTICING MEDICINE IS OPIATES ARE NO LONGER A MEDICINE IN AMERICA,,LIKE A LEGAL LOOP HOLE FOR THE DEA,,,,,JUST MY OPINOIN,,,SICKENING ON THEIR BEHALF,,BUT THEY CARE NOTHING FOR THE MEDICALLY ILL,,ONLY THEIR $$$$$$
Steve – hasn’t the DEA been in charge of US opioid quotas from pharmaceutical manufacturers since 1994? I ask because I find it strangely compelling that the people managing the numbers of legitimate pharmaceutical narcotics have taken on the role of policing physicians for prescribing those self-proscribed volumes. The fox that feeds the hens it later slaughters. .Am I correct in what I have stated? If the DEA is responsible for controlling the quotas why have they gone through the process of a War on Opioids when they could have implemented their own agenda and drastically reduced availability themselves? Is there law out there that they must follow when setting yearly quota goals that come from an independent source? For example; some kind of forecasting tool used by medicinal providers based on yearly patient needs?
you are correct, the DEA sets pharma production quotas for each opiate, and opiate Rxs peaked in 2011-2012 and production quotas have been cut by some 60% since then and the number of people ODing is up some FOUR TIMES, because China is producing illegal Fentanyl…. Mexican Cartels are buying that product and they have tablet presses and making tablets that look like Oxycodone 30 mg and Xaxax 2 mg .. it has been reported that illegal fentanyl has been found in illegal Methamphetamine, Cocaine and MJ. According to Wikipedia, there is some 400 different analogs of Fentanyl and only ONE that is FDA approved for human use. fentanyl is a “synthetic opioid… created via a chemical reactions, unlike Heroin that has to be grown, harvested and processed. the only limit to the amount of illegal fentanyl that can be produced is the ability to get the primary components. I have read that since our SW border has been so “open” that so much illegal Fentanyl getting into our country – the “street price” of illegal Fentanyl has dropped dramatically. What the media shows that has been confiscated is just a few percent of what actually gets into our country. The CDC claims that 100K+ die from drug overdoses – which is actually ALL DRUG OVERDOSES – including an estimated 15,000 who die from GI bleed from the use/abuse of NSAIDs. After that single statement, they start talking about opiate OD’s and implying that all those deaths from opiates… Right now it is being reported that some 70K-75K die from illegal Fentanyl ODs… putting that number in place… that is more than all the soldiers that died in all the years of the Vietnam war, 911 and Pearl Harbor TOGETHER. AND abt 100,000 die from the use/abuse of the drug ALCOHOL and 450,000 die from the use/abuse of the drug Nicotine … Recently the media was reporting the “sad fact” that abt 1,000,000 people have died from COVID-19… and in the same time frame a similar number who died from the use/abuse of the two legal drugs Alcohol & Nicotine… never seems to be mentioned by the media – maybe because those two legal drugs produce a very healthy “sin tax” revenue stream. I guess that those deaths are “socially acceptable” because of the revenue that they produce for the bureaucrats
Thank you for this PhSteve. Shared on FB.