Arkansas DEA Investigation Lawyer

Arkansas DEA Investigation Lawyer: The Pain Clinic Doctor Who Killed a Patient, 3,332 Pills Per Person, and the State With the Second Highest Prescription Rate

Dr. Cecil W. Gaby owned and operated the Hinderliter Pain Clinic in Barling, Arkansas. He was 71 years old when he pleaded guilty to acting outside the usual course of professional practice without a legitimate medical purpose in dispensing oxycodone, thereby causing the death of an individual. His prescriptions didn’t just create addiction risk. His prescriptions didn’t just violate regulations. His prescriptions killed someone. Between January 2016 and November 2018, Gaby issued more than 11,000 prescriptions for opioids and/or benzodiazepines.

The specific number that reveals the operation: Gaby prescribed approximately 1,156,044 dosage units of Schedule II controlled substances to 347 patients. Do the math. That’s 3,332 pills per patient over the course of two years. Three thousand three hundred thirty-two pills. Per patient. Approximately 4.5 Schedule II controlled substance pills per day for two straight years – for every single patient at the clinic. The DEA received several anonymous complaints in May 2017 that Hinderliter was operating a “pill mill.” The complaints stated that Hinderliter and his associate, Dr. Gaby, charged cash and prescribed hydrocodone and benzodiazepines in the same amount to patients regardless of a particular patient’s prognosis or need.

Arkansas has the second highest opioid prescription rate in the nation – 72.2 prescriptions per 100 persons, behind only Alabama. In 2022, there were 457 drug overdose deaths in the state. Fentanyl was a contributing factor in 251 of those deaths – more than half. The shift from prescription opioids to fentanyl has been dramatic: in 2016, only 4% of Arkansas overdose deaths involved fentanyl. By 2021, that number was 59%. The prescription monitoring system exists. The enforcement apparatus exists. And Arkansas still has one of the highest prescription rates in America.

3,332 Pills Per Patient

Heres what 3,332 pills per patient looks like in practice. Dr. Gaby saw approximately 347 patients at the Hinderliter Pain Clinic between January 2016 and November 2018 – roughly two years. He prescribed 1,156,044 dosage units of Schedule II controlled substances to those patients. Thats not total pills across all schedules. Thats Schedule II specifically – the highest risk category of commonly prescribed controlled substances.

Think about what that prescribing pattern means clinicaly. Over two years, every patient averaged more then four pills per day of Schedule II controlled substances. Not some patients who had severe pain conditions. Every patient. The uniformity of prescribing – “the same amount to patients regardless of a particular patient’s prognosis or need” – demonstrates that medical judgment wasnt driving the prescriptions.

The anonymous complaints arrived in May 2017. Multiple complainants identified the clinic as a “pill mill” that charged cash and dispensed medications without regard to individual patient needs. The investigation that followed documented the prescribing patterns. The prosecution focused on the death of an individual caused by Gaby’s prescribing.

The Gaby case demonstrates the ultimate consequence of pill mill prescribing: death. Not addiction. Not overdose survival. Death. When federal prosecutors charge a physician with prescribing that caused death, the exposure increases dramaticaly. Gaby didnt face charges for mere distribution without legitimate purpose. He faced charges for distribution that killed someone.

1.2 Million Dosage Units

Dr. Lonnie Joseph Parker of Texarkana, Arkansas operated separately from the Hinderliter clinic. His numbers were even larger. In the two-year period analyzed by investigators, Dr. Parker prescribed approximately 1.2 million dosage units of opiates, including oxycodone and hydrocodone, to approximately 1,508 patients.

The DEA Little Rock District Office initiated the investigation in 2018 after recieving complaints from local law enforcement about a suspected pill mill and possible overdose death of a patient. The pattern is consistent: complaints trigger investigation, investigation documents prescribing patterns, prosecution follows.

A federal grand jury indicted Parker on nine counts of prescribing without a legitimate medical purpose outside the scope of professional practice. A federal jury convicted him on four counts:

• Two counts of Distribution of a Schedule II Controlled Substance Without an Effective Prescription
• Two counts of Distribution of a Schedule V Controlled Substance Without an Effective Prescription

Parker was sentenced to more then seven years in federal prison. The DEA announcement described the sentence: “Texarkana Physician Sentenced to More Than 7 Years in Federal Prison for Prescribing Controlled Substances Without a Legitimate Medical Purpose.” The sentence length reflects the volume – 1.2 million dosage units to over 1,500 patients represents industrial-scale diversion.

The Second Highest Prescription Rate

Arkansas has the second highest opioid prescription rate in the country. The CDC reports 72.2 opioid prescriptions per 100 persons – meaning approximately seven prescriptions for every ten residents. Only Alabama has a higher rate at 74.5 per 100 persons.

Heres the paradox this creates. Arkansas isnt a state were opioid prescribing flies under the radar. Its a state were prescribing is intensely scrutinized precisely because the rates are so high. Federal prosecutors in Arkansas – both the Western and Eastern Districts – have prioritized opioid enforcement. The Gaby and Parker cases occured against the backdrop of a state with documented overprescribing.

In 2017, 24 defendants were charged in Arkansas as part of the largest nationwide health care fraud enforcement action in Department of Justice history. The Acting U.S. Attorney stated that “the abuse of prescription medication, particularly opioids, is one of the largest health and crime problems Arkansas is facing” and emphasized the need to stop criminal doctors and medical professionals from writing medically unnecessary prescriptions.

The high prescription rate dosent mean lax enforcement. It means heightened enforcement. Arkansas practitioners operate in a state were federal authorities have publicaly identified opioid prescribing as a priority problem requiring aggressive prosecution.

Certified Investigators and Annual Reports

Arkansass prescription drug monitoring program has features that structure law enforcement access differently then many states. Only certified law enforcement prescription drug diversion investigators can access the database. Not any law enforcement officer. Certified specialists with specific credentials.

The access requires a search warrant. Law enforcement needs judicial approval to query prescription records – a higher barrier then states that allow access with just an active investigation or administrative request.

But heres the feature that makes Arkansas unusual. Qualified law enforcement agencies must submit annual reports of all data accessed by there certified investigators. The reports must include written verification that inquiries were part of lawful prescription drug diversion investigations. Each query must be tied to a case number.

Failure to submit the verification form results in immediate suspension of access. The law enforcement agency loses database access until the Arkansas Department of Health determines whether to allow continued access. The system builds accountability into law enforcement use of prescription data.

This accountability structure cuts both ways. It provides practitioners some assurance that database queries are tied to legitimate investigations. But it also means that when law enforcement does access your records, theyve demonstrated to the department that the access is part of a documented investigation. The query is already connected to a case.

59% Fentanyl – From 4% to Majority

The composition of Arkansas overdose deaths has transformed completely. In 2016, only 4% of overdose deaths involved fentanyl. By 2021, 59% involved fentanyl. In 2022, fentanyl was a contributing factor in 251 of 457 drug overdose deaths – 55%.

This shift from 4% to majority status happened in five years. The substance that barely registered in 2016 now causes more then half of all overdose deaths. The prescription monitoring program tracks Schedule II through V controlled substances dispensed through legitimate channels. Fentanyl deaths primarily involve illicitly manufactured fentanyl that never touches the prescription system.

Arkansas achieved something that might look like progress: a 13.8% decrease in opioid overdose deaths between December 2022 and December 2023, compared to only 3.0% decrease nationwide. Arkansas outperformed the national trend. But the 2022 baseline was 457 deaths – still a catastrophic number.

The legislative response has included:

• Act 584, the Fentanyl Enforcement and Accountability Act, which creates “death by delivery” felony offenses when someone delivers fentanyl or another controlled substance that causes another person’s death
• Act 811 requires that by January 2024, each public high school campus have a clearly visible opioid overdose rescue kit
• The Arkansas Opioid Recovery Partnership has funded a state Naloxone Bank

The Death That Triggered Investigation

The complaints that led to the Parker investigation mentioned not just suspected pill mill activity but “possible overdose death of a patient.” The Gaby prosecution specifically charged him with dispensing that caused death. Deaths trigger investigations. Deaths elevate prosecution priority. Deaths change the nature of charges.

This pattern matters for understanding how these cases develop. Federal prosecutors have limited resources. They cant investigate every practitioner with unusual prescribing patterns. What moves a case from potential investigation to active prosecution often involves a death – either the death that triggers the initial complaint or deaths discovered during investigation.

The Hinderliter clinic complaints arrived in May 2017. The charges against Gaby encompassed conduct through November 2018. The investigation documented prescribing patterns over nearly two years after the complaints. That timeline shows how investigations develop – complaints start the process, but building a federal case requires time to document the pattern.

For Arkansas practitioners, this means that deaths in your patient population attract attention. If patients with your prescriptions appear in overdose death investigations, your prescribing becomes relevant to those deaths. The connection between your prescriptions and patient outcomes matters for wheather you face investigation.

What Actually Protects Arkansas Practitioners

If your prescribing controlled substances in Arkansas, your operating in the state with the second highest opioid prescription rate in the nation, were a doctor prescribed 3,332 pills per patient and pleaded guilty to causing death, and were federal prosecutors have publicaly identified opioid prescribing as one of the largest problems facing the state. What actualy protects you?

First: Understanding that Arkansass high prescription rate increases scrutiny, not decreases it. The fact that prescribing is common dosent make your prescribing invisible. It makes enforcement a stated priority for federal prosecutors who have called opioid prescribing “one of the largest health and crime problems Arkansas is facing.”

Second: The 3,332 pills per patient standard provides a reference point. Gaby prescribed Schedule II controlled substances at that rate to every patient. If your prescribing patterns approach anything comparable – high volume, uniform across patients regardless of diagnosis, cash payment – the prescribing looks like what resulted in federal prosecution.

Third: Deaths elevate investigation priority. The Parker investigation started with complaints mentioning “possible overdose death.” The Gaby prosecution charged him with prescribing that caused death. Patient outcomes – particularly fatal outcomes – connect your prescribing to enforcement priority.

Fourth: The PDMP access structure means law enforcement queries are documented and tied to case numbers. When investigators access your prescribing history, that access is part of a certified investigation that will be reported to the department. The query isnt casual – its connected to formal investigative process.

Fifth: Anonymous complaints trigger investigations. Both Hinderliter and the Parker investigation involved complaints – some anonymous – that identified pill mill activity. Anyone can file a complaint. Staff, patients, competitors, neighbors, pharmacies, insurance companies. The source of the initial complaint might never be identified.

Sixth: Multi-defendant prosecutions demonstrate coordinated enforcement. The 2017 action charged 24 defendants in Arkansas as part of nationwide enforcement. Arkansass position as a high-prescribing state makes it a target for large-scale enforcement initiatives that sweep up multiple practitioners in single operations.

Seventh: Immediate counsel upon any federal contact. Dr. Gaby was 71 years old when he pleaded guilty. The timeline from complaint to prosecution spanned years. Early legal strategy shapes wheather you face Gabys outcome – pleading to causing death – or some other resolution.

Thats the reality of prescribing controlled substances in Arkansas in 2025. A 71-year-old doctor who prescribed 3,332 pills per patient and caused a death. A Texarkana physician sentenced to more then seven years for 1.2 million dosage units. The second highest opioid prescription rate in the country – with federal prosecutors who have identified this as one of the states largest problems. Fentanyl involvement rising from 4% to 59% of deaths. And a PDMP system were law enforcement access is certified, documented, and annually reported. What protects you is prescribing that can withstand scrutiny from investigators who are actively looking for patterns that resemble what landed Gaby and Parker in federal prison.