The Supreme Court today unanimously sided with two physicians who were convicted of drug trafficking based on opioid prescriptions that federal prosecutors portrayed as medically inappropriate. Six justices said the government is required to prove that a doctor "knowingly or intentionally" exceeded the authorization for medical use of controlled substances. Three justices disagreed with the majority's legal analysis but concluded that a doctor cannot be convicted of drug trafficking if he acted in "good faith."
The decision in Ruan v. United States sends both cases back to the lower courts so they can assess the defendants' arguments that the instructions received by the juries that convicted them misstated the law seriously enough that they are entitled to new trials. But whether or not they prevail on those claims, the ruling represents an important limit on prosecutions that have long had a chilling effect on pain treatment. Physicians who prescribe opioids based on an honest belief that they are practicing good medicine now have less reason to fear that they will nevertheless face federal charges that could send them to prison for decades.
