Federal Law Enforcement Efforts to Combat the Opioid Crisis

PHILADELPHIA, PA – On February 6, 2019, United States Attorney William M. McSwain convened a press conference to highlight the Eastern District of Pennsylvania’s recent efforts to combat the opioid crisis.  U.S. Attorney McSwain announced two separate criminal indictments charging 14 individuals with a multitude of crimes, including conspiracy to dispense and distribute controlled substances outside the course of professional practice and without a legitimate medical purpose; distribution of oxycodone; health care fraud; and maintaining a drug-involved premises.  U.S. Attorney McSwain also announced details about a civil lawsuit his Office has filed to prevent the establishment of a facility in Philadelphia where drug users would go to inject themselves with illegal narcotics.  The suit, filed against the nonprofit corporation Safehouse and its Executive Director, Jeanette Bowles, seeks a judicial decree that Safehouse’s planned opening of one or more so-called “consumption rooms” would violate federal law.  This lawsuit is the first of its kind in the United States.

Remarks as Prepared for Delivery

Good morning.  I’m Bill McSwain, the U.S. Attorney, and I am here today to update the public on our ongoing efforts to combat the opioid epidemic in the Eastern District of Pennsylvania, and to make some specific announcements about several important cases in our District.

First, I want to recognize and thank the representatives from multiple federal, state, and local law enforcement partners that are here today as part of our announcement of two recent criminal indictments.  Thank you to the Federal Bureau of Investigation; the Drug Enforcement Administration; the Department of Health and Human Services, Office of Inspector General; the Department of Labor, Office of Inspector General; the Office of Personnel Management; Pennsylvania Department of State; the Pennsylvania Office of the Attorney General; the Abington Police Department; the Easttown Township Police Department, and the Philadelphia Police Department.

I also want to thank Greg David, the Chief of our Civil Division at the U.S. Attorney’s Office, who is here with me to announce developments on the civil enforcement front. 

Our collaborative approach to attacking the opioid epidemic includes aggressive criminal prosecutions and other initiatives to promote awareness, prevention, and addiction recovery.  On both the criminal and civil side, we continue to focus on stopping the illicit production, distribution, and use of opioids.  It is our duty to hold accountable those who have flooded our streets with heroin, synthetic opioids, and prescription opioids, and we will continue to indict and aggressively prosecute, including through civil penalty, everyone in that supply chain: manufacturers, importers, distributors, doctors, pharmacies, organized crime, and street dealers.  Those who make money by illegally exploiting addiction will be caught and prosecuted to the fullest extent of the law. 

Prosecuting doctors who run “pill mills” and commit Medicare fraud is a priority for the Department of Justice and this Office, and two recent cases in the Eastern District are excellent examples of our work in this area.  In one case, we charged physicians Murray Soss and Frederick Reichle with operating a pill mill medical practice out of Dr. Soss’s medical office in Philadelphia, and charged Dr. Soss with healthcare fraud for billing medically unnecessary charges to Medicare.  The indictment describes an elaborate scheme in which Dr. Soss paid others to recruit so-called “patients” seeking oxycodone and then paid Dr. Reichle to write prescriptions for those patients in Dr. Soss’s office, even though they had no medical need for the prescriptions.  According to the indictment, Dr. Soss recruited Dr. Reichle after his own medical license was suspended by the Drug Enforcement Administration (DEA).  And in one particularly heinous example, Dr. Soss even directed Dr. Reichle to write oxycodone prescriptions for a long-time patient with whom Dr. Soss had a sexual relationship, knowingly feeding this victim’s addiction in order to obtain sexual favors. 

In a second recent case, we have charged eight physicians, four physicians’ assistants, and an office manager in connection with the operation of a pill mill at Advanced Urgent Care (or AUC).  AUC is a provider of medical services, including pain management, with four locations throughout the Eastern District of Pennsylvania.  The superseding indictment charges Dr. Frederick Reichle (again) along with Dr. Mehdi Nikparvar-Fard, Dr. Vincent Thompson, Dr. Loretta Brown, Dr. Avrom Brown, Dr. Marcus Rey Williams, Dr. William Demedio, and Dr. Neil Cutler; Physician’s Assistants Mitchell White, Jason Dillinger, Debra Cortez, and Samantha Hollis; and Office Manager Joanne Rivera, with multiple drug crimes. 

Through a long-term, coordinated, multi-agency investigation, it became clear that AUC was functioning as a “pill mill” in its treatment of pain management patients.  Our law enforcement partners worked with our Office to uncover a whopping number of illegal prescriptions – at least 3,678 alleged illegal prescriptions that were medically unnecessary.  We uncovered a pattern of abuse where these doctors and physician’s assistants provided patient after patient with oxycodone – often despite clear evidence of overt illicit drug use and despite no diagnostic reason supporting the prescriptions. 

As we work to stem the tide of illegal, medically unnecessary prescriptions, we remain committed to taking out violent drug-traffickers who operate on the streets and suppliers who cause overdose deaths.  Recently, working again with the DEA, we secured a guilty verdict against Angel Luis Concepcion-Rosario, of Reading, Pennsylvania, for trafficking in fentanyl.  Fentanyl, of course, is the deadliest and most unpredictable opioid we see on the streets, and fentanyl is a major source of the spike in overdose deaths in Philadelphia.  

A federal jury also recently convicted Emma Semler of Collegeville, Pennsylvania, for distributing heroin and thereby killing her friend.  The jury at the Semler trial heard about how the defendant supplied the victim with heroin, watched as she injected it, and then fled the scene when she realized the victim was overdosing on the bathroom floor of a fast-food restaurant in West Philadelphia, leaving her to die.  Both defendants - Concepcion-Rosario and Semler - await sentencing, and we will do everything in our power to ensure they receive the punishment that they both deserve.

I’m grateful for the hard work of our agency partners and of those in my Office who prosecuted these cases, especially Assistant United States Attorneys Karen Marston, Jason Bologna, Seth Schlessinger, Kishan Nair, Randy Hsia, and Nicole Phillips.  By enforcing our drug laws in these cases and others, we prevent addiction and violence from spreading. 

Beyond our criminal prosecutions and civil enforcement work, our Office participates in many types of outreach programs that focus on prevention and addiction recovery.  One such program of particular note is Relapse Prevention Court, a program just launched in October 2018 in coordination with the U.S. District Court, the Federal Defenders’ Office, and U.S. Pretrial Services.  Relapse Prevention Court helps non-violent drug users who have entered the criminal justice system to maximize opportunities for long-term recovery from substance abuse while they complete their terms of supervised release.  The key attribute of this program is that it provides participants with a path forward to long-term addiction recovery while abiding by federal, state, and local laws.   

The work that we do in all these areas helps to keep drugs out of our communities and sends a powerful deterrent message.  And this work helps to save lives.

Today also marks a new chapter in the federal government’s fight against the opioid epidemic.  Philadelphia is, in many ways, ground zero in this crisis.  That is why my Office, and our dedicated federal, state, and local law enforcement partners, stand together today to reassure the community that we are aggressively fighting this epidemic by deploying all of the tools and resources at our disposal.

I am here to announce that the United States Attorney’s Office for the Eastern District of Pennsylvania has filed a federal civil lawsuit – the first of its kind in the United States – to ask the U.S. District Court to declare that so-called “supervised injection sites” violate federal law.  Because these deadly drug injection sites undoubtedly do violate the law.  And because it is the Department’s job to promote and enforce the rule of law, not to look the other way.  Normalizing the use of deadly drugs like heroin and fentanyl is not the answer to solving the opioid epidemic.

The civil lawsuit that we have filed names Safehouse, a private, non-profit corporation formed for the specific purpose of opening a deadly drug injection site in the Kensington neighborhood of Philadelphia.  Safehouse was incorporated in August 2018, after the Philadelphia Mayor’s Office publicly endorsed the idea of opening an injection site and Philadelphia District Attorney Larry Krasner pledged not to bring charges against those who fund, operate, or use such sites. 

Emboldened by the Mayor’s support and the District Attorney’s blessing, Safehouse ramped up its operations in the months that followed.  Its website described how the site would be operated: as drug users arrived at Safehouse, staff would direct them to a “consumption room,” provide them with drug paraphernalia, and observe the users as they prepare and inject themselves with illegal narcotics.  Safehouse’s staff would monitor the users for signs of overdose and, if necessary, step in and try to provide overdose reversal services.

Let’s step back for a moment, consider the big picture, and discuss what we really know about injections sites.  Safehouse claims that an injection site in Philadelphia would “save lives.”  But are we sure about that?  Consider the study the City of Philadelphia commissioned to evaluate this very issue.  The way the study qualified its recommendations is telling:

The vast majority of the available evidence in recent years comes from only one Supervised Consumption Facility, the [facility] in Vancouver, Canada.  The current models for harm-reduction estimates are sensitive to population-specific factors.  In turn, hyper-local population-level characteristics . . . and social and economic factors determine the need and potential utilization by [drug users] of Supervised Consumption Facilities.  The majority of the available literature with useful statistical methodology and analysis relies more commonly on the Vancouver Supervised Consumption Facility than on any other site.  It is uncertain how relevant or applicable the assumptions are to communities in other geographies. 

The study, by Main Line Health Center at Lankenau Institute for Medical Research, went on to caution that “[b]ecause it appears that existing Supervised Consumption Sites have not incorporated rigorous evaluation into their design and implementation, it has been difficult to disentangle the full impact of Supervised Consumption Sites on relevant harm-reduction outcomes.” 

Translation:  the study has no idea whether an injection site in Philadelphia would actually save lives.  So when Safehouse declares that an injection site would save lives, all they’re doing is speculating and trying to pass it off as fact.  They have no proof and no reliable data.  There is no expert consensus that this plan would do any good for anybody.       

But here is what we do know: setting up a drug house is illegal.  And on the legal issues in this case, our position has remained firm and our communications to Safehouse clear.  Safehouse’s operation would violate federal law, namely, section 856(a)(2) of the Controlled Substances Act.  That section makes it unlawful to “manage or control any place” that is “knowingly and intentionally . . . ma[d]e available for use . . . for the purpose of unlawfully  . . . using a controlled substance.”  On November 9, 2018, I sent a letter to Safehouse, advising that if it went forward with its plans as described, my Office would pursue appropriate remedies unless Safehouse provided me with assurances that it would comply with the law.  In response, Safehouse provided no such assurances, and its actions (most recently, its hiring of an Executive Director last month) point to the opposite conclusion.                  

The law is clear – and my job is to respect and enforce the rule of law.  If Safehouse wants to operate an injection site, it should work through the democratic process to try to change the law.  It should not expect prosecutors to turn a blind eye to wholesale illegal behavior and play politics by allowing political ideologies to determine their prosecutorial decisions.  That would be an abandonment of my oath to enforce the law.  While that may be a way of life for the Philadelphia District Attorney, it is something that I will never do.

And how much political support do injection sites really have among our law making bodies, anyway?  The answer is none.  Congress does not support the idea, the Pennsylvania legislature does not support it, nor does the Philadelphia City Council.  Councilwoman Maria Quinones Sanchez, whose district includes Kensington, does not support injection sites.  Governor Wolf does not support them, nor does Pennsylvania Attorney General Shapiro.

What is Safehouse’s response to this lack of support and to the fact that it is illegal under federal law to set up a drug house?  Their response is defiance.  Their response is that they are beholden to a supposedly higher power than our laws; they are beholden to saving lives.  While I do not doubt Safehouse’s good intentions, substituting its judgment in place of the law is not the way that democracy works.  It is not the way that a republic works.  If Safehouse doesn’t like the law, it should channel its efforts into changing it.  The bottom line is that when it comes to our justice system, there is no higher purpose than respecting the rule of law when our laws are consistent with our Constitution and enacted by our democratically elected representatives.  If you think that you’re above the law, you’ll soon find yourself in court to account for your actions.  That is exactly the situation here.

In closing, the lawsuit that we have filed is a necessary and important step in the Justice Department’s enforcement of our federal drug laws.  But it is just one part of my Office’s comprehensive approach to addressing the opioid crisis.  Again, I want to thank all of the law enforcement partners here today; we are proud to stand with you as we fight this crisis together.

Thank you, and at this time, I am happy to take your questions relating to these announcements.