Criminal Defense Lawyers

How Can I Protect My Practice from a DEA Investigation?

Last Updated on: 14th December 2025, 10:50 pm

The protection you need happens before you know you need it. That’s the uncomfortable truth about DEA investigations that nobody wants to hear. By the time agents appear at your practice with a Notice of Inspection, they’ve already gathered prescription data, compared your prescribing patterns to other doctors in your specialty, and quite possibly sent undercover agents posing as patients to test how easy it is to get controlled substances from you. The question isn’t how to respond to a DEA investigation. The question is what you built before they showed up.

Welcome to Spodek Law Group. Our goal is to give you the information that most medical practice compliance guides won’t tell you – the reality of how these investigations actually work, what triggers them, and how the decisions that determine your fate get made while you’re still seeing patients completely unaware. Todd Spodek has represented physicians facing DEA scrutiny for years, and the pattern is always the same: doctors who prepared survived, doctors who assumed it wouldn’t happen to them didn’t.

Here’s what the medical associations and compliance consultants leave out of their presentations. The DEA doesn’t need probable cause to show up at your door. They don’t need evidence of wrongdoing. They need an administrative inspection warrant, which requires only a description of what they’re looking for. And everything they find during that inspection – every patient file, every prescription record, every note in every chart – can be used against you in federal criminal court. Not administrative proceedings. Criminal court. The kind where you go to prison.

The Investigation Probably Started Before You Knew

OK so heres the thing that most physicians dont understand. Most doctors think DEA investigations begin when agents walk through the door. Thats not how it works. The investigation started months or even years earlier through one of three pathways, and understanding these pathways is the first step in protection.

Let that sink in for a moment. While your seeing patients, writing prescriptions, running your practice – the DEA may already be collecting data about you. They may have already sent fake patients to test your prescribing habits. Your staff may already be providing information. The investigation is running, the evidence is accumulating, and you have absolutly no idea.

First, the DEA maintains databases that track every controlled substance prescription written in America. They run algorithms comparing your prescribing patterns to other physicians in your specialty and geographic area. If your numbers deviate significantly – higher doses, more frequent refills, larger patient volumes – your name gets flagged for review. No complaint required. No tip from anyone. Just data analysis that says your probly worth looking at.

Second, they send undercover agents. This sounds like something from a television show, but its standard procedure. The DEA dispatches investigators posing as patients to test your prescribing practices. They present with complaints designed to see if you’ll prescribe controlled substances with minimal examination. These visits get documented. If you failed these tests without knowing they were tests, that documentation is already in your file.

Third, tips from pharmacies and employees. Pharmacists have a legal obligation to flag suspicious prescriptions. And your own staff – the office manager, medical assistant, front desk person youve worked with for years – may already be serving as confidential informants. The DEA approaches employees, convinces them to cooperate, and suddenly theres someone in your practice providing documents, observations, photographs, and recorded conversations. You wont know this is happening untill its to late.

What Diversion Investigators Actually Do

Think about this for a second. Heres the irony that destroys physicians. The Diversion Investigators who show up at your office cannot carry firearms. They cannot make arrests. They look like bureaucrats conducting a routine compliance check. And they are gathering the evidence that sends doctors to federal prison for decades.

Look, these investigators are trained to seem non-threatening. Theyre polite. Professional. They ask questions in a way that makes you want to explain yourself. They know that physicians are trained to communicate, to be helpful, to provide information. They use your professional instincts against you.

The investigators request access to your prescription records. They want patient files. They want to interview you and your staff about your prescribing practices. Everything feels administrative because technically it is administrative – at that moment. But the information they collect feeds directly into the decision about wheather your case goes administrative or criminal.

The DEA brings in medical experts to review your patient charts. They calculate what they call the “error rate” – the percentage of prescriptions they beleive lacked legitimate medical purpose. A medical expert who has never met your patients, never examined them, never heard their complaints, reviews your documentation and decides which prescriptions were appropriate and which weren’t. Your entire career, your freedom, your familys future depends on that calculation.

The Administrative vs Criminal Track Decision

This is were everything changes. OK so the DEA operates two completely seperate tracks, and understanding the difference is probly the most important thing you can learn about protecting your practice. Most physicians have never even heard that these tracks exist. They assume investigation means investigation. It dosent.

The administrative track focuses on regulatory violations. Outcomes include corrective action plans, memoranda of agreement, civil penalties, and DEA registration revocation. This track is survivable. Your not going to prison. You might keep your medical license. Settlement is possible.

The criminal track focuses on intentional violations and drug distribution. It involves Department of Justice prosecutors, grand juries, potential imprisonment, and complete career destruction. This is the track were physicians receive sentences measured in decades.

The error rate determines which track you land on. Under 20% error rate, the administrative track is likely. Between 20% and 50%, criminal prosecution becomes possible. Above 50%, criminal prosecution is basicly presumed.

Heres the part that should terrify every physician. The decision about which track your case takes happens during what experts call the “critical decision window” – roughly weeks 8 through 24 of the active investigation. Thats about 30 to 60 days after they start reviewing your patient charts. Your fate is being sealed while your still seeing patients, still writing prescriptions, still completly unaware that anyones looking at you.

The Cooperation Trap That Destroys Doctors

Todd Spodek has seen this pattern destory careers over and over. Doctors are trained to be helpful. To answer questions. To explain themselves. To be transparent. These instincts, which make you a good physician, will absolutly destory you in a DEA investigation.

Dr. Ajeeb John Titus was a Pennsylvania family physician. When a narcotics investigator showed up at his office, the agent told him: “You are not in trouble, Doctor.” Dr. Titus beleived him. He agreed to a 45-minute interview. He answered every question openly and honestly, trying to explain his prescribing decisions.

Two years later, Dr. Titus was arrested. The indictment directly quoted his own words from that interview. The cooperation didnt make the investigation go away – it built the prosecutions case. He lost his medical license. He lost his practice. Everything he said trying to prove his innocence became the evidence used against him.

This happens constantly. Physicians feel pressured by DEA agents to cooperate, to surrender there DEA license voluntarily, to answer questions without an attorney present. The agents suggest that cooperation will resolve the matter quickly. That suggestion is not true.

The recommended response when DEA appears at your practice is: “I appreciate you reaching out. On the advice of counsel, I need to consult with my attorney before discussing this matter. Please provide your contact information, and my attorney will be in touch.” Then stop talking. Immediatly.

The Form 82 Constitutional Waiver

When DEA investigators arrive, they present Form 82 – the “Notice of Inspection of Controlled Premises.” Most physicians sign this form becuase it seems like standard procedure. Heres what signing actualy means.

Form 82 is informed consent to a search. When you sign it, your waiving your Fourth Amendment rights. Everything they find during that inspection can be used against you in federal criminal court. Not just administrative proceedings. Federal criminal court. The kind were physicians receive 21-year sentences.

The alternative is refusing to sign, which forces them to obtain an administrative inspection warrant. That warrant dosent require probable cause – they can get it – but it creates a paper trail and gives you time to contact an attorney before the search begins.

At Spodek Law Group, we’ve seen physicians sign Form 82 thinking they had nothing to hide, not understanding that they were surrendering constitutional protections. The evidence collected under that voluntary waiver then forms the foundation of criminal prosecutions. You basicly helped build the case against yourself becuase nobody explained what you were signing.

Your Staff May Already Be Informants

Read that again. This is the insight that physicians find hardest to accept. The person who schedules your patients, who handles your prescription pads, who has access to your files – they may already be working with the DEA. The person you trust completly may be the reason investigators know exactly what to look for.

Heres how it happens. The DEA identifies your practice as a target through database analysis or pharmacy tips. Before they ever contact you directly, they approach employees. They explain the legal exposure your staff faces for participating in a practice the DEA is investigating. They offer immunity or favorable treatment in exchange for cooperation.

Suddenly your office manager is photographing documents after hours. Your medical assistant is noting which patients receive which prescriptions. Your front desk staff is recording there impressions of how the practice operates. All of this information flows to investigators who are building a case you dont even know exists.

Many opioid-related indictments and search warrant affidavits specificaly reference contributions from physician employees who served as confidential informants. By the time you learn your under investigation, your own staff may have provided months of documentation, observations, and recorded conversations.

The uncomfortable truth is that you cant know whos been approached. What you can control is ensuring your practice operates in ways that would survive scrutiny regardless of who might be watching.

What Protection Actually Looks Like

Protection isnt about responding to investigation. Its about what you build before investigation becomes possible.

Documentation is your defense. Every prescription for a controlled substance should have a documented medical justification that would survive review by an outside expert who has never met the patient. Not just “chronic pain” – the specific diagnosis, the examination findings, the rationale for this medication at this dose at this frequency.

Prescription policies matter. Written policies governing controlled substance prescriptions create evidence that you operated with legitimate medical purpose. These policies should cover:

• Patient screening requirements
• Drug testing protocols
• Prescription monitoring program (PDMP) checks
• Circumstances that trigger prescription review

Compliance programs demonstrate good faith. The Ruan v. United States Supreme Court decision in 2022 changed prosecution requirements significantly. Prosecutors now must prove you knowingly or intentionally acted in an unauthorized manner – not just that you should have known. A documented compliance program is evidence that you were trying to prescribe appropriatly, which directly addresses the knowledge element prosecutors must prove.

Spodek Law Group recommends that every practice prescribing controlled substances conduct an internal audit before any investigation exists. Calculate your own prescribing patterns. Compare them to specialty benchmarks. Identify patients whose treatment might look questionable to outside review. Document your medical reasoning. Fix documentation gaps. This work is dramatically easier when no one is looking at you.

The Ruan Decision Changed Everything

Heres something that most physicians facing DEA scrutiny have never heard of. In 2022, the United States Supreme Court issued a unanimous decision in Ruan v. United States that fundamentaly changed how physician prosecution cases must be tried. And when we say fundamentaly changed, we mean the entire legal landscape shifted – but most doctors dont know it happened.

Dr. Xiulu Ruan was sentenced to 21 years in federal prison. His case went to the Supreme Court on the question of what prosecutors must prove to convict a physician of illegal distribution. The Court ruled 9-0 that prosecutors must prove beyond a reasonable doubt that the physician knowingly or intentionally acted in an unauthorized manner.

Before Ruan, prosecutors could convict physicians by proving their prescriptions fell outside objective medical standards – even if the physician genuinly beleived they were practicing medicine appropriately. After Ruan, the prosecutors burden is higher. They must prove the physician knew the prescriptions were unauthorized.

This matters enormously for protection. Documentation of your medical reasoning, compliance programs, continuing education, consultation with colleagues – all of this is evidence that you beleived you were prescribing legitimately. If prosecutors cant prove you knew you were acting illegally, they cant convict you under the current legal standard.

Since Ruan was decided, the ruling has been invoked in at least 15 ongoing prosecutions across 10 states. Doctors have used it for appeals, motions for acquittal, new trial requests, and plea reversals. The legal landscape has genuinly shifted – but most physicians facing investigation have never heard of this case.

The Timeline Reality

Understanding investigation timelines helps you understand why protection must happen now.

The average DEA investigation takes 24 to 32 months from initial data gathering to indictment. One defense attorney calculated 547 days – roughly 18 months – from raid to indictment across his cases. During this entire period, the investigation is active, evidence is being collected, and decisions are being made about your fate.

Of 378 physicians studied in one analysis, 272 who pled or were found guilty were incarcerated. The average incarceration was aproximately 63.43 months – more then five years. 76 physicians received probation only. Four physicians received life sentences.

These arnt theoretical numbers. These are physicians who practiced medicine, who believed they were helping patients, who found themselves facing federal prosecution. Dr. Frank Parasmo of Long Island received 36 months for prescribing 1.5 million oxycodone and hydrocodone pills. Dr. Jeanne Germeil of South Florida received 188 months – more then 15 years.

The question isnt wheather this could happen to you. The question is wheather your practice would survive scrutiny if it did. Because heres what nobody in medical school ever told you: the federal government prosecutes physicians. They send doctors to prison. They destory careers that took decades to build. And once that process starts, its almost impossible to stop.

What To Do Right Now

Heres the good news. If your reading this and no investigation has started, you have time. Use it. The window for protection is open right now. Every day you wait is a day your practice remains vulnerable to scrutiny it might not survive.

Review your prescribing data. The same databases the DEA uses are available through prescription drug monitoring programs. Look at your numbers. Compare them to colleagues in your specialty. Identify statistical outliers that might trigger algorithmic flags.

Audit your documentation. Pull random patient files for controlled substance prescriptions. Read them as if you were an outside medical expert hired to find problems. Would your documentation justify each prescription to someone who has never met the patient? If not, improve it going forward and consider supplementing existing records were appropriate.

Establish written policies. Prescription contracts. Drug testing protocols. PDMP check requirements. Red flag procedures. Document that these policies exist and that your practice follows them.

Train your staff. Everyone in your practice should understand documentation requirements, privacy obligations, and appropriate responses if federal agents appear. The training itself becomes evidence of legitimate medical purpose.

Identify legal counsel now. Not when agents appear – now. Have a relationship with an attorney who understands DEA investigations so that when you need help, you already have someone to call. The worst time to search for a lawyer is when your already panicking becuase agents just walked through your door.

Train your response. Know exactly what you will say if DEA investigators appear. Practice the words: “I need to consult with my attorney.” Know whos phone number to call. Have that number programmed in your phone right now.

Call Spodek Law Group at 212-300-5196. The consultation is free. The cost of waiting untill investigation starts is not. We can review your current compliance posture, identify vulnerabilities, and help you build the documentation and policies that could save your career.

The physicians who survive DEA scrutiny are the ones who prepared before they knew they needed to. The ones who assumed it wouldnt happen to them are serving federal sentences. Which category do you want to be in? The choice is yours. But the window wont stay open forever.