Doctor Pays $153,000 to Resolve Allegations of Overprescribing Opioids at his Escondido Clinic
SAN DIEGO –Escondido pain clinic doctor Bradley Chesler, M.D., has paid the United States $153,000 to resolve allegations that he overprescribed opioids. Dr. Chesler is a board-certified physiatrist who operates a pain clinic in Escondido, California. This settlement stems from the United States’ investigation into whether Dr. Chesler illegally prescribed opioids to his patients in violation of the Controlled Substances Act.
Pursuant to the Controlled Substances Act, doctors may write prescriptions for opioids only for a legitimate medical purpose while acting in the usual course of their professional practice. Based on its investigation, the United States alleged that from January 1, 2014 to August 31, 2019, Dr. Chesler wrote opioid prescriptions that violated the Controlled Substances Act, which included prescriptions for fentanyl, hydromorphone, methadone, and oxycodone. The United States further alleged that Dr. Chesler prescribed opioids while he concurrently prescribed benzodiazepines, and he prescribed to some patients a combination of at least one opioid, one benzodiazepine, and one muscle relaxant. Drug abusers colloquially refer to the opioid, benzodiazepine, and muscle relaxant combination as the “Trinity” because of its rapid euphoric effects. These drug combinations are known to increase the risk of abuse, addiction, and overdose.
The investigation exemplifies the Department of Justice’s willingness to investigate doctors who may be overprescribing opioids while treating patients who suffer painful conditions. Health care providers treating patients who suffer from pain must still only prescribe opioids in accordance with recognized and accepted medical standards. Indeed, public health experts have long warned health care providers that overdose risk is elevated in patients receiving medically prescribed opioids, particularly those receiving high dosages. As such, it has been recommended that health care providers carefully track the potency of opioids prescribed to patients by noting the Morphine Milligram Equivalent (MME, also commonly referred to as Morphine Equivalent Dose or MED) of prescribed opioids. Among other things, tracking MMEs advances better practices for pain management by reinforcing the need for providers to consider alternatives to using high-dosage opioids to treat pain, and to appropriately justify decisions to use opioids at dosages that place patients at high risk of addiction, abuse, and overdose. Furthermore, prescribing high dosages increases the risk that patients will divert opioids to people who were not prescribed them.
Based on its investigation, the United States alleged that Dr. Chesler prescribed large quantities of opioids to his patients that reached high daily MME levels (sometimes even exceeding 180 MME). The United States further alleged that Dr. Chesler failed to properly address aberrant urine drug test results when prescribing opioids.
DEA Special Agent in Charge John Callery said, “Although 99 percent of medical professionals abide by DEA guidance and federal law, we will investigate those who put illicit profits before their oaths and bring them to justice.”
“Doctors have an important responsibility to properly treat their patients and not overprescribe opioids,” said U.S. Attorney Robert Brewer. “When doctors or other health care providers illegally prescribe opioids outside of the law, my office will pursue the appropriate legal remedy and protect our citizens. As we have consistently demonstrated, our prosecutors will continue to use all available tools to combat the serious opioid epidemic.”
To report a tip directly to a DEA representative regarding medical personnel writing suspicious opioid prescriptions and pharmacies dispensing large amounts of opioids, call (571) 324-6499, or visit the DEA’s website and click on “Report Illicit Pharmaceutical Activities.”