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Georgia Focusing Hard on “Pill Mills”

On January 28, 2013, the United States Atttorneys Office for the Northern District of Georgia published a “press release” describing how four people were arrested “for operating a Pill Mill”. See

And on February 11, 2013, HB 178 passed a key House committee in Georgia. It aims to put pain management clinics under the regulation of Georgia’s medical board, and that as of June 30th, any new pain clinic would have to be physician owned – a requirement similar to other states.

The federal government has also recently been quoted as saying prescription pain killers are the nation’s number one drug epidemic.

Clearly, one of the areas federal prosecutors are focusing time and resources on today are Pill Mill Cases. What are Pill Mill Cases? They involve doctors who prescribe painkilling drugs to patients with chronic pain. So why, you may ask, is it ever illegal for a doctor to prescribe painkillers such as Percocet and Hydrocodone to patients? How can a licensed medical doctor writing a prescription to a patient be against the law?

Federal law states that a doctor goes from being a physician to a drug dealer when he prescribes these drugs for patients who are not necessarily in pain, but simply addicted to the prescription pain killing drugs. These patients have become drugs addicts – addicted to prescription pain pills – and the doctor uses their addiction for his own financial benefit just as a drug dealer pushing cocaine uses his customers cocaine addiction to reap illegal profits.

Pain management doctors prosecuted for “prescription drug fraud” argue that an overly zealous federal government who is meddling in their professional expertise is hounding them. Part of the dilemma is that the source of a patient’s pain may not be obvious through medical diagnosis. Hence, whether a person is in need of long-term pain management medication is up to the professional opinion of the doctor. At the same time, however, the doctor cannot simply write out a script for a potentially highly addictive painkiller without properly diagnosing that patient. To do so is to prescribe narcotic pain killing drugs for no legitimate medical reason, which is against federal law.

One type of proof the government uses in these cases to prosecute doctors is whether the patient had been prescribed pain medication but had no history of current use. Here the doctor could be helping someone who has been getting painkilling drugs on the black market, or managed to “kick the habit,” continue his addiction. Another red flag is if the patient fails a drug test for illegal narcotics and the doctor writes that person a prescription anyway. Also key is whether the doctor spent time with the patient and how the doctor reached his diagnosis.

Another red flag is the way the doctor operates the practice. For example, some doctors accept cash from pain patients. This is not in itself illegal, but what did the doctor do with the money? Was it deposited into the bank. Was a proper tax return filed with all income reported? This is, of course, a separate crime – tax evasion – but it also casts doubt on whether the doctor is concealing the money because she knows she is writing scripts for no legitimate medical reason and using the desperation that comes from a person’s drug addiction to make money for herself.

These cases are interesting as they raise the social policy issue of where is the line between a doctor doing his or her professional best to help patients in pain versus a doctor turned drug dealer who is pushing prescription pain killing drugs on drug addicts who are in need of real medical help and not just another “fix” of prescription drugs from a licensed doctor turned drug dealer.

The trend right now for the federal government is to go after these types of cases hard and the sentencing guidelines for these type of cases can be severe.

With the political nature of these types of cases, it is imperative to get legal counsel immediately. 

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