A Unanimous SCOTUS Lifts The Fear Of Prosecution For Physicians Prescribing Pain Medication In Good Faith

Legal Insurrection ^ | June 30, 2022 | Ilana Cutler

[T Ruth]

… In the consolidated cases of Ruan v. United States and Kahn v. United States, the Court delivered a 9-0 opinion, written by Justice Breyer, ...

Drs. Ruan and Kahn were convicted under a provision of the Controlled Substances Act (codified at 21 U. S. C. §841) which makes it a federal crime to prescribe a controlled substance, “except as authorized.” A prescription is only authorized when it is a prescribed “for a legitimate medical purpose… acting in the usual course of his professional practice.”

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… Following his conviction, Dr. Ruan was sentenced to over 20 years in prison and was ordered to pay millions in restitution and forfeiture. Dr. Kahn was sentenced to over 25 years in prison.

The question before the Supreme Court was what state of mind the government has to prove in order to convict a doctor for dispensing controlled substances not as authorized. The Court held as follows:

“We now hold that §841’s “knowingly or intentionally” mens rea applies to the “except as authorized” clause. This means that once a defendant meets the burden of producing evidence that his or her conduct was “authorized,” the Government must prove beyond a reasonable doubt that the defendant knowingly or intentionally acted in an unauthorized manner.”

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This was critical per the Court because “[a] strong scienter requirement helps to diminish the risk of “overdeterrence,” i.e., punishing acceptable and beneficial conduct that lies close to, but on the permissible side of, the criminal line.” …

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… This decision gives physicians “a day to celebrate,” Nelson said. As they’re “prescribing in good faith,” doctors “don’t have to be worried about criminal prosecution.”

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[T Ruth]

This should help doctors who are intimdated into not prescribing Ivermectin and Hydroxychloroquine.

[RummyChick]

They are terrified to prescribe Oxy.

I was in such pain after a surgery. The drug might as well have been Gold. I think I got 6 or 8 pills

[taxcontrol]

I had not even considered your perspective but I agree.

[drSteve78]

Likely not, as these are not Scheduled medications. However for those needing some Scheduled Medications/ Controlled Substances for chronic or low level maintenance use, it removes the specter of Pill Pusher from the doctors acting in good faith.

Pain centers, diet centers, doctors on the margins of practice, of course should still be under scrutiny. But a GP or Family Practice doctor doesn’t have to panic when refilling Xanax.

[drSteve78]

terrified to prescribe

ANYTHING, however appropriate. Changes the nature of “good practice” to “fear practice “.

[Rural_Michigan]

Yet on the flip side I know a guy who’s life was ruined because doctors prescribed him medications.

[escapefromboston]

I thought a lot of Americans were on pain killers I didn’t know doctors were afraid of prescribing them to people. Though honestly I never looked into the subject that much.

[T Ruth]

That's what malpractice claims and tort law are for.

I know such claims are often not practical, but the threat of them is some check on incompetent doctors.

[RummyChick]

There is even a problem getting gabapentin because people have been abusing it. some states require it to be reported and some states consider it a controlled substance

[RummyChick]

btw, I had an overnight stay for a surgery that is typically done outpatient. Thank goodness I stayed in the hospital.

I was in such pain but I had difficulty getting meds. I should have been saying my pain level was 9. I had some kind of pain block put in my spine before the surgery. It knocked me out before I even made it to the table. It really made a difference.

It shouldnt be that hard to get pain meds when you have had major body parts removed

[Nifster]

Doctors…. Was he doctor shopping? Did he take as prescribed or otherwise?

Some people think one should have zero pain. That’s wussy nonsense. Use ice and aspirin or Tylenol.

Not all pain is bad

[Brian Griffin]

This is 2022.

There are millions of doctors worldwide.

The proper prescribing of painkillers should be well defined by now.

[Glennb51]

Exactly!!!

Prescribed opiates are intended to take the sharp edge off, not relieve all pain.

[Rdct29]

Our government told doctors they had to treat pain or they could be sued. That's when they put out the smiley face and frown face pain guidelines. Around the same time they approved oxycontin and told doctors it was less addictive. After getting millions of people on oxy for pain the government started arresting doctors for treating people in pain. That's when doctors were forced to prescribe different medications. At the same time the government opened our southern border and let tons of heroin and fentanyl into our country. Another job well done by our idiots in DC.

[lizma2]

Broke my foot jumping out of bed one morning and asked my ortho doc for 6-8 pills so I could at least get a couple nights of sleep.

Told no.

That’s nuts.

[RummyChick]

I looked at one of my prescription bottles. I got 10 pills of hydrocodone after having a radical hysterectomy. They arent even as strong as Oxy

[Ex gun maker.]

Why?
It does not get you high, it does not impair, even its efficiency as a nerve medication seems to be marginal.

[RummyChick]

people overdosing on it

https://www.pewtrusts.org/en/research-and-analysis/blogs/stateline/2018/05/10/abuse-of-opioid-alternative-gabapentin-is-on-the-rise

[RummyChick]

Btw, I had a script for this gabapentin. Didn’t do any good at a low dose. A higher dose caused side effects. I said forget it.

[Do_Tar]

I get Gabapentin for neuropathy. Due to an insurance change I got a 3 month supply and the Rx is for 540 capsules.

I jokingly asked the pharmacist if she knew the “street price”.
After a few seconds of very strained laughter, she said something along the lines of “You are so funny. Do not ask that again!”