Operating A Pill Mill Clinic


The Controlled Substances Act (CSA) governs the manufacture, distribution, and dispensing of controlled substances in the United States. The CSA sets forth which drugs and other substances are defined by law as “controlled substances”, and assigns those controlled substances to one of five schedules
(Schedule I,II,III,IV, or V) depending on their potential for abuse, likelihood of physical or psychological dependency, accepted medical use, and accepted safety for use under medical supervision.

A controlled substance assigned to Schedule II means that the drug has a high potential for abuse, the drug has a currently accepted medical use in treatment in the United States or a currently accepted medical use with severe restrictions.

Hydrocodone is classified as a Schedule II controlled substance. Hydrocodone is sometimes prescribed under brand names including Norco, Lortab, and Vicodin. It is used to treat severe pain and as with other opioids, it is highly addictive.

Chapter 21 of the Code of Federal Regulations governs the issuance of prescriptions and provides, among other things, that a prescription for a controlled substance “must be issued for a legitimate medical purpose by an individual practitioner acting in the usual course of his professional practice.”

A “Pill Mill” is a fake medical clinic, or front. It is set up for the purpose of illegally issuing prescriptions for pain killers, like Vicodin. The federal government actively investigates suspected pill mills. It is not unusual for the federal government to indict and prosecute individuals who are allegedly involved in pill mill clinics. I have defended a number of clients charged in federal court with operating pill mills.

Anyone who knowingly aids a pill mill in illegally distributing controlled substances is subject to federal criminal prosecution. Individuals who conspire to operate a pill mill clinic are typically charged with Conspiracy to Unlawfully Distribute and Dispense Controlled Substances under 21 U.S.C. Section 846. The penalties for being involved with a pill mill can be very severe.

There are a number of ways a person might be charged with conspiring to operate a pill mill clinic. For example:

  • Where individuals without a medical license or DEA Registration allegedly pose as doctors in an effort to assist the Pill Mill clinic in its operation;
  • Where doctors allegedly prescribe controlled substances without a legitimate medical purpose and outside the scope of professional practice;
  • Where individuals, pretending to be patients, allegedly pay a fee to obtain a prescription even though there is no legitimate medical necessity for the issuance of the prescription;
  • Where individuals allegedly recruit drug addicts to act as patients to obtain large amounts of controlled substances, where there is no legitimate medical need for the issuance of the prescription;
  • Where doctors allegedly sign prescriptions in blank to be used by the Pill Mill to illegally sell controlled substances;
  • Where doctors or other individuals allegedly complete fake documentation for a non-existent or phony patient’s file in order to justify prescriptions issued.


Every client should have the facts of his case carefully analyzed. There are defenses to Pill Mill cases. For example, a person may work at a pill mill, believing that the pill mill is a legitimate medical clinic. Most pill mills look like legitimate clinics and some employees may work at such a place without ever knowingly joining a conspiracy. This defense may apply to different people who work in a clinic.

The law does allow for legitimate pain management clinics. There are requirements that must be met to operate a legitimate pain management clinic. An employee may believe that they are working at a legitimate pain management clinic. Each client’s circumstance must be carefully studied in order to determine how best to defend a client charged with operating a pill mill.

All Federal Drug Conspiracy charges are serious. In Federal Court the Government works hard to put cases together. The Defense, therefore, must work very hard to fight the Government. I have fought for clients in Federal Court for many years. I have won Federal Drug Conspiracy Cases. If you want me to fight for you, call me at 713-655-7400.

COVID 19 ALERT: Due to the current emergency and to ensure client safety, Robert Fickman offers video chat and conferencing via FaceTime, Skype & Zoom.