A question of criminal liability under the Controlled Substances Act is before the U.S. Supreme Court.

In their Journal of Opioid Management op-ed, Center for U.S. Policy Senior Fellow Lynn Webster, M.D.; Ronald W. Chapman II, JD, LLM; and Stephen J. Ziegler, PhD, JD; discuss the implications of the U.S. Supreme Court’s forthcoming decision in Ruan v. United States.

Dr. Xiulu Ruan was a pain specialist in Alabama and, following his conviction in 2017, was sentenced to serve over 20 years in federal prison for violating the federal Controlled Substances Act (CSA) when prescribing controlled medications. Dr. Ruan appealed his conviction and, in March 2022, argued before the U.S. Supreme Court that he had been wrongfully convicted because the trial court had denied his ability to assert a good-faith defense concerning the prescriptions he issued.

The central question before the Court is whether the government must merely prove that the prescription was issued outside of an acceptable standard of practice (limiting the focus to the intent to write the prescription), or whether the prescriber knew that the prescription was unlawful at the time it was written (focusing on whether the prescriber believed in good faith that the prescription was within the standard of care).

Dr. Webster and his co-authors explain that state licensing boards and civil lawsuits, along with the federal government’s  administrative framework, are more appropriate forums than federal criminal courts when dealing with questions surrounding medical care.

The Supreme Court’s decision in Ruan v. United States will establish the standard the government can use to prosecute prescribers and will affect the practice of medicine for years to come.

Read the full op-ed.

Related: CUSP Files Amicus Brief in Ruan Supreme Court Case.