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Supreme Court to Hear Alabama Pill Mill Case

The U.S. Supreme Court has agreed to hear the appeal of an Alabama pain doctor convicted of running a pill mill, a case that could change how federal prosecutors handle opioid cases, AL.com reports. A federal judge sentenced Dr. Xiulu Ruan to 21 years in prison for several charges including drug distribution and money laundering related to operations at Physicians Pain Specialists of Alabama. Ruan appealed his conviction last year to the 11th U.S. Circuit Court of Appeals but lost. Ruan prescribed fentanyl for patients with cancer pain. The law does not set a limit for the amount of opioids a patient should receive, although professional groups and government agencies have created guidelines.


Ruan’s attorney wrote that Physicians Pain Specialists of Alabama did not operate as pill mills. The clinics only accepted patients with insurance, refused cash payments and used diagnostic tools to find the sources of patients’ pain. Only patients with intractable pain received fentanyl, Ruan testified at his trial. Ruan and another practitioner at the clinic, Dr. John Patrick Couch, were among the nation’s top prescribers of fentanyl painkillers. Attorneys for the U.S. Department of Justice said Ruan prescribed much higher rates of opioids than other doctors and earned more than $4 million as a result. Ruan and his partner issued almost 300,000 prescriptions for controlled substances. Arguments in Ruan’s case are scheduled for March 1.



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