New York DEA Investigation Lawyer

New York DEA Investigation Lawyer: Murder Charges for Prescribing and the Nation’s Oldest PMP

Dr. George Blatti was charged with five counts of murder. Not manslaughter. Not reckless endangerment. Murder in the second degree under the theory of depraved indifference to human life. Five patients died. Prosecutors believe this is the first time a doctor has been charged under New York State law with murder for prescribing practices. The investigation showed that between 2016 and 2018, patients addicted to opioids went to Blatti with requests for controlled medications, and he prescribed thousands of pills – oxycodone, morphine, clonazepam, alprazolam, oxycontin – with no medical history and no examination.

New York established the nation’s first prescription monitoring program in 1973. For over fifty years, the state has tracked controlled substance prescribing. And now New York is pioneering something else: prosecuting doctors for murder when their prescribing kills patients. The enforcement trajectory has shifted from treating fatal overprescribing as malpractice, or even as drug distribution, to treating it as homicide.

If you’re prescribing controlled substances in New York, this is the legal landscape. The nation’s oldest PMP monitors every Schedule II through V prescription. The I-STOP system requires consultation before prescribing. And prosecutors are willing to charge prescribers with murder when patients die – applying the “depraved indifference to human life” standard that typically accompanies violent crime to the act of writing prescriptions.

Five Counts of Murder for Prescribing

Heres what the murder theory looks like when applied to prescribing. Dr. Blatti was arrested by the Nassau County Police Asset Forfeiture and Intelligence Unit and the DEA Long Island Tactical Diversion Squad. The investigation documented that patients came to him already addicted to opioids, requested controlled medications, and recieved prescriptions without medical history or examination.

Five of those patients died. The deaths triggered the murder analysis. Prosecutors argued that prescribing thousands of pills to addicted patients without examination demonstrated “depraved indifference to human life” – conscious disregard of a known, unjustifiable risk that was so great as to amount to a willingness that death occur.

The charging theory transforms prescribing from a regulatory matter into a homicide. Its not about wheather Blatti deviated from standard of care. Its not about wheather he violated DEA regulations. Its about wheather his prescribing showed such disregard for human life that it constitutes murder.

Blatti faces up to 15 years in state prison. But the precedent matters more then any individual sentence. If New York prosecutors successfully establish that fatal overprescribing can be charged as murder, every practitioner in the state faces homicide exposure when patients die from medications they prescribed.

More Prescriptions Than Every Hospital Combined

Dr. Eugene Gosy operated the Gosy Center in Western New York. His practice issued more prescriptions for controlled substances annually then any other prescriber or prescribing entity in New York State. Including hospitals. A single pain management practice outprescribed every hospital in the state.

Think about what that volume means. Hospitals have emergency departments seeing trauma patients around the clock. They have surgical departments managing post-operative pain. They have oncology units treating cancer patients. They have palliative care teams managing end-of-life comfort. And one pain management practice in Western New York wrote more controlled substance prescriptions then all of those hospital operations combined.

Gosy was sentenced to 70 months in federal prison. The sentencing emphasized “law enforcement’s commitment to saving lives by investigating, arresting, and prosecuting those responsible for fueling opioid addiction and overdoses.” His prescribing wasnt characterized as aggressive but legitimate medicine – it was characterized as fueling the epidemic.

The volume alone raised the prosecution flag. When your prescribing exceeds every hospital in your state, the arithmetic itself suggests that something other then standard medical practice is occurring.

Prescribing to Overdose Survivors

Dr. Frank Parasmo practiced on Long Island. He was sentenced to 36 months for illegal distribution of oxycodone. The detail that defined his case: between January 2014 and February 2015, Parasmo provided prescriptions for oxycodone and hydrocodone to 18 patients without legitimate medical purpose. Some of those patients had just left detox treatment in rehabilitation facilities. Others had just been discharged from a hospital following an overdose.

Prescribing opioids to someone who just overdosed on opioids. Prescribing opioids to someone who just completed detox for opioid addiction.

The U.S. Attorney stated: “Today’s sentence demonstrates that there are significant consequences for doctors who act as drug dealers.” The characterization of physicians as “drug dealers” has become routine in these prosecutions.

Parasmo’s case demonstrates how patient history becomes prosecution evidence. The patients who came to him after overdosing or completing detox were documented. There hospital discharges and treatment records established what he should have known about there opioid history. Prescribing controlled substances to those specific patients – patients whose recent history screamed opioid problem – became evidence of conscious distribution rather then medical treatment.

The Nation’s Oldest PMP

New York established its prescription monitoring program in 1973 – the first in the nation. The Bureau of Narcotic Enforcement initially tracked only Schedule II controlled substances, but expanded to include benzodiazepines in 1989 and all controlled substance prescriptions in 2007.

The program’s constitutionality was challenged almost immediately. In Whalen v. Roe (1977), the case reached the United States Supreme Court. Opponents argued that a centralized database tracking prescription medications violated privacy rights. The Supreme Court disagreed, holding that the right to privacy was not absolute and that states could legitimately restrict citizen privacy as part of there broad police power to prevent drug diversion.

That 1977 decision established the constitutional foundation for every PMP in the country. New York fought that legal battle fifty years ago. The monitoring infrastructure they pioneered has now spread nationwide.

Since August 2013, I-STOP – the Internet System for Tracking Over-Prescribing – has required most prescribers to consult the PMP Registry when writing prescriptions for Schedule II, III, and IV controlled substances. The consultation requirement means prescribers must check patient history before prescribing. It also means the system documents wheather you checked.

6 Million Pills From One Clinic

A Queens medical clinic operated by Dante Cubangbang, John Gargan, and others allegedly prescribed over 6 million oxycodone pills to individuals they knew did not need the medication for any legitimate medical reason. Six million pills. From one clinic.

To put that in context: 6 million pills prescribed over several years equals thousands of pills per day. The volume exceeds what most street drug trafficking operations move. But it flowed through a medical clinic, with a physician’s DEA registration, documented in prescriptions that pharmacies filled.

A Brooklyn operation resulted in charges against eight defendants including a medical doctor and three pharmacists. The case allegedly involved more then 1.2 million oxycodone pills with a street value of $24 million. Prosecutors described it as “a structured drug trafficking ring” whose “operations started in a doctor’s office and ended with $24 million worth of diverted oxycodone on the streets.”

The description – starting in a doctors office, ending on the streets – captures how prosecutors view these operations. The medical office is the source point for street drug supply. The prescription is the mechanism that transforms controlled substances from pharmaceutical product to street commodity.

How I-STOP Changes Investigation

New York law enforcement needs a subpoena to access PMP data directly – more restrictive then some states were investigators can access data with just an active investigation. But the Bureau of Narcotic Enforcement works with local and federal law enforcement to investigate unauthorized use of prescription controlled substance medications. The formal subpoena requirement doesnt prevent prosecution – it shapes how evidence is gathered.

Pharmacy providers must submit controlled substance dispensing data to BNE no later then 24 hours after the substance was delivered. Every prescription you write is documented within a day of being filled. The near-real-time reporting means investigators can see prescribing patterns as they develop, not just in historical analysis.

The BNE shares information with professional boards – pharmacy and medicine – and with the Office of the Medicaid Inspector General. The same data feeds multiple investigation tracks. Board discipline can proceed alongside federal prosecution can proceed alongside Medicaid fraud investigation. Your prescribing history fuels all of these simultaneously.

The I-STOP consultation requirement since 2013 adds another layer. You must check patient history before prescribing. The system documents that you checked – or that you didnt. Failing to check becomes evidence that you werent exercising appropriate diligence. Checking and prescribing anyway – when the patient history shows problems – becomes evidence that you knew and prescribed regardless.

Drug Dealers in White Coats

The rhetorical shift in how prosecutors characterize physician prescribers has become standard in New York cases. “Drug dealers in white coats.” “Started in a doctors office and ended on the streets.” “Act as drug dealers.” The language deliberately collapses the distinction between medical practice and street trafficking.

The characterization isnt just rhetoric – it reflects how these cases are structured legally. The charges are distribution and conspiracy charges, the same charges brought against street dealers. The evidence focuses on volume and pattern, not medical judgment. The sentencing treats pill quantities like drug trafficking quantities.

Dr. Noel Smith of Manhattan and Staten Island was charged for “conspiring to distribute tens of thousands of prescription pills.” The language is identical to how street conspiracy cases are described. The medical license provides no insulation from being characterized as a drug distributor when prosecutors decide the prescribing lacked legitimate purpose.

What Actually Protects New York Practitioners

If your prescribing controlled substances in New York, your operating under the nations oldest PMP, a mandatory consultation requirement, 24-hour pharmacy reporting, and prosecutors willing to charge murder when patients die. What actualy protects you?

First: Understanding that patient deaths can trigger murder prosecution. Blatti’s five deaths led to five murder counts. The “depraved indifference” theory requires proving conscious disregard of risk – prescribing without history or examination to addicted patients provides that evidence. Your documentation must establish legitimate medical purpose for every prescription, particularly to patients with substance abuse history.

Second: Recognizing that volume creates its own prosecution flag. Gosy prescribed more then every hospital in the state. That statistical fact alone established that something beyond normal medicine was occurring. If your prescribing volume approaches outlier territory, you should know it before investigators do.

Third: Extreme caution with high-risk patients. Parasmo prescribed to patients immediately after overdose and detox. That patient history documented what he knew – and prescribing anyway became evidence of distribution rather then treatment. Patients with recent overdoses, recent detox, documented substance abuse – prescribing to them requires extraordinary justification.

Fourth: I-STOP consultation compliance. The system tracks wheather you checked patient history. Failing to check is documented. Checking and ignoring concerning history is documented. The consultation requirement creates evidence of what you knew and when you knew it.

Fifth: Immediate counsel upon any investigation contact. The murder prosecution against Blatti involved DEA’s Long Island Tactical Diversion Squad and local police working together. When federal and state authorities coordinate, the potential charges span both systems. Legal strategy has to address both prosecution tracks from the beginning.

Thats the reality of prescribing controlled substances in New York in 2025. Murder charges for prescribing are no longer hypothetical – they’ve been filed. The nations oldest PMP documents everything. And prosecutors describe physicians as “drug dealers in white coats” when bringing charges. The medical license doesnt protect against homicide prosecution when patients die from medications you prescribed.