Last week, the U.S. Department of Justice (DOJ) released information about the “largest prescription opioid enforcement effort ever undertaken.”
Armed federal agents carried out search warrants and arrested dozens of medical professionals in connection with the illegal distribution of prescription drugs, a driving factor of the opioid epidemic. It is estimated that more than 130 people die each day in the United States after overdosing on opioids.
The takedown was orchestrated by the Appalachian Regional Prescription Opioid (ARPO) Strike Force, which was created to investigate health care fraud and illegal opioid prescriptions in the region. The charges brought by ARPO involve 11 federal districts, more than 350,000 prescriptions for controlled substances and over 32 million pills.
In total, 60 people have been charged with crimes relating to their “alleged participation in the illegal prescribing and distributing of opioids and other dangerous narcotics and for health care fraud schemes.” Fifty-three of those accused are medical professionals, including 31 doctors, seven pharmacists and eight nurse practitioners.
ARPO Ramps Up Pressure on Rural White-Collar ‘Drug Dealers’
The ARPO Strike Force is a joint law enforcement effort that was created by the DOJ in October 2018 to address illegal opioid prescriptions, which continue to devastate rural America. ARPO brings together resources and expertise from several government agencies, including:
- Federal Bureau of Investigation (FBI)
- S. Drug Enforcement Administration (DEA)
- DOJ Health Care Fraud Unit in the Criminal Division’s Fraud Section (HCF Unit)
- The Department of Health and Human Services Office of Inspector General (HHS-OIG)
- S. Attorneys’ offices for 10 federal districts in six states
Other state and local law enforcement officials participated in the takedown, which resulted in charges against individuals in Alabama, Kentucky, Louisiana, Ohio, Pennsylvania, Tennessee and West Virginia.
“The opioid epidemic is the deadliest drug crisis in American history and Appalachia has suffered the consequences more than perhaps any other region,” said Attorney General William Barr in a DOJ press release. He touted the takedown as an important step forward and congratulated the team agents and prosecutors working on the investigation.
Trading Prescription Drugs for Money and Sex
In the indictments, which were unsealed last week, there were plenty of sickening stories. Authorities claim doctors routinely provided deadly combinations of powerful drugs to patients despite numerous red flags and warnings from family members. Many would allow prescriptions to be written by uncertified staff, often while they were out of the office.
These doctors weren’t just being forgetful — they deliberately looked the other way in order to enrich themselves.
“We will not stand by and allow the harmful and oftentimes deadly practice of over-prescribing highly addictive drugs to continue unchecked,” said FBI Executive Assistant Director Amy Hess. “The FBI will pursue medical personnel who misuse their positions of trust to blatantly disregard others’ very lives for their own financial gain.”
Although the schemes varied, they all caused tremendous damage. Some of those arrested were fraudsters who used bogus opioid prescriptions to defraud Medicare of money, sending thousands of powerful pills onto the streets for illicit use and resale.
Others preyed on vulnerable patients who sought care from a supposedly trustworthy licensed medical specialist. A nurse practitioner in Tennessee, who called himself the “Rock Doc,” is one of several professionals accused of trading opioid prescriptions for sex.
Between 2014-2017, the Rock Doc allegedly “used the power to prescribe controlled substances to promote his television pilot and his podcast, and to have sex with women, including women who were his patients.”
Along with other reprehensible behavior, he is alleged to have prescribed a pregnant woman opioids for no legitimate purpose. Her baby was born addicted to opioids with Neonatal Abstinence Syndrome.
In Kentucky, a doctor prescribed opioids to his Facebook friends, who would come pick up the drugs at his house. In the same state, there was a dentist who needlessly extracted his patients’ teeth and wrote opioid prescriptions that had no legitimate medical purpose.
ARPO Keeps Eye on Victims of Opioid Epidemic as it Cuffs the Crooks
As satisfying as it may be to see armed federal agents banging on the doors of “white-coated drug dealers,” the truth is that the opioid epidemic is not solved by simply arresting bad doctors. Removing the pills does not address the damage caused by flooding a community with drugs.
ARPO has recognized this and been deliberate about making resources available to patients impacted by the law enforcement action. Information about treatment and assistance is available for those with medical needs. Getting illicit pills off the street is important, said Alex Azar, secretary of Health and Human Services (HHS), but:
“It is also vital that Americans struggling with addiction have access to treatment and that patients who need pain treatment do not see their care disrupted, which is why federal and local public health authorities have coordinated to ensure these needs are met in the wake of this enforcement operation.”
Support services for patients and their families need to be available in the immediate aftermath of any strike force action, especially in rural communities with limited access to care.
Federal Crackdown Is Part of a Larger Battle for Public Health
While the ARPO action is no doubt a step in the right direction, it does little to address the costs that communities have had to shoulder due to the opioid epidemic. According to the Center for Disease Control and Prevention (CDC), prescription opioid misuse in the United States results in an estimated economic burden of $78.5 billion a year.
These costs come from healthcare, lost productivity, addiction treatment and criminal justice involvement. The resources of states, cities, towns, tribes and others have been depleted by a needless public health crisis. This is why communities across the country are joining the Opioid MDL to hold the manufacturers and distributors of this crisis responsible.
After all, the manufacturers told doctors and the public that their pills were not addictive. Without that deliberately crafted lie, these drugs never would have been prescribed as widely as they were. Distributors made billions of dollars in profits by shipping these pills without any working safeguards to prevent fraud and over-prescription.
As more information comes out through opioid lawsuits, more bad behavior has been exposed. The Sackler family, essentially the godfathers of OxyContin, are now facing legal action for knowingly downplaying the risks associated with their drugs.
New civil suits from New York, Vermont and Washington accuse distributors like McKesson, Cardinal Health and AmerisourceBergen of intentionally helping pharmacies evade government oversight to beef up sales.
The Fight for Justice Is Just Beginning
ARPO prosecutors have a long, hard road ahead. There are law firms dedicated to helping discredited medical professionals fight “pill mill” charges, and the complex nature of proving prescription-drug crimes provides the defense many ways to have charges dropped.
The scandalous content from the Rock Doc’s indictment, along with the number of white-collar criminals busted, provided plenty of attention-grabbing headlines. But what will happen next?
On the same day the DOJ announced the takedown, the Rock Doc made bail and returned to work, although he is not allowed to prescribe opioids due to a prior settlement.
It’s hard to find bright spots in the story of the opioid epidemic, but scattered through the indictments there are reasons for hope. Some of these criminals were ultimately brought to justice from a single tip: an employee at a pharmacy or family member who realized something wasn’t right. It probably wasn’t easy to speak up, but it was brave, and it saved lives.
Hundreds of thousands of people have died as a result of drug overdoses since OxyContin was first marketed as a safe option for doctors to prescribe. Now it’s time for honesty.