The DEA investigation into your medical practice started somewhere between twenty-four and thirty-two months ago. You found out yesterday. Maybe it was agents at your door. Maybe a colleague mentioned theyve been talking to prosecutors. Maybe your practice manager noticed subpoenas for patient records that predate last quarters audits by two years.
Heres what nobody explains about this moment: you think you're at the beginning of something. You're not. You're near the end. The investigation isnt starting - its wrapping up. The case has been built methodically, patiently, invisibly, while you continued treating patients and writing prescriptions and assuming everything was fine. The asymmetry is staggering. They've had years to prepare. You have days to respond.
Welcome to Spodek Law Group. We represent doctors, pharmacists, and healthcare providers facing DEA investigations across Manhattan and Brooklyn. We understand the panic thats setting in right now - and we understand something else too. The next forty-eight hours matter more than you realize. Not because we're trying to scare you into a phone call, but because federal investigations operate on timelines that reward early intervention and punish delay.
The Investigation That Started Before You Knew
The DEA doesnt investigate doctors based on complaints anymore. Not primarily. They investigate based on algorithms. Theres over 150 risk factors coded into their analytics system - the PDMPAS - and your prescribing patterns have been running through that algorithm for years before any human investigator ever opened a file with your name on it.
How the flagging actually works: every prescription you write goes into the Prescription Drug Monitoring Program. The DEAs algorithm compares your patterns against every other doctor in your specialty. Schedule II prescriptions higher than your peers? Flag. Patients traveling farther than typical to see you? Flag. High percentage of cash payments? Flag. The algorithm doesnt need a complaint. It generates its own suspicion from statistical deviation. And the thing is, it cant tell the difference between a pill mill and a pain management specialist who's actually helping people. The data just shows deviation from the norm.
In July 2025, Operation Profit Over Patients resulted in 51 arrests across the country. Every single one of those doctors was flagged by algorithms analyzing their prescription patterns before any agent conducted any traditional investigation. The prescribing data identified statistical outliers. Files were opened. Surveillance began. And those 51 doctors continued treating patients, completely unaware that a federal investigation had been building for months or years.
The consequence of this timeline is profound. You're not responding to fresh allegations. You're responding to a case that's essentially complete. The evidence has been gathered, organized, and assessed. Wiretaps have been authorized - they run in 30-day periods, renewable as many times as prosecutors want. Cooperating witnesses have been cultivated. Financial records have been traced. By month twenty-four, the investigation isnt starting. Its deciding when to act.
And right now, as you're reading this, your prescribing history exists in a database with a risk assessment attached to it. If that score crossed certain thresholds, a file has been open longer than you realize. We've represented doctors whose investigations ran thirty-six months before contact. The average is twenty-four to thirty-two. You're not at the starting line of your defense. You're catching up to a prosecution that's had a two-year head start.
So now you understand: the algorithm flagged you years ago, the investigation has been running for two years, and you found out yesterday. That would be terrifying enough if you only had one battle to fight. You dont.
Two Battles, Two Standards
When the DEA targets a physician, two investigations launch simultaneously. Most attorneys talk about this like its a footnote. Its not. Its the entire problem.
The criminal investigation follows normal prosecution rules. Beyond reasonable doubt. Constitutional protections. The right to remain silent. Jury trial. All the safeguards you assume exist when the federal government accuses someone of a crime. The standard is demanding because the consequences - prison, felony conviction, destroyed career - are severe.
But theres another track running parallel, and it operates on completely different rules. The DEA administrative proceeding uses preponderance of evidence as its standard. That means fifty-one percent likelihood. More likely than not. Barely better than a coin flip. The administrative law judge can revoke your DEA registration, destroy your ability to prescribe controlled substances, effectively end your medical career - all on a standard that's dramatically lower than what a criminal jury would require.
Those 51 doctors arrested in Operation Profit Over Patients? They also faced 93 administrative cases. Same conduct, two proceedings, different rules. The administrative track moved faster. While the criminal cases were still in pretrial, the administrative actions were stripping licenses and ending practices.
And heres the part that catches people: these two tracks dont communicate the way you'd expect. Surrendering your DEA license does not stop the criminal investigation. The DEA registration is issued and revoked by one office. The decision to pursue criminal charges lies with the US Attorneys Office and the Justice Department. They're separate. Giving up your ability to practice medicine does not make the prosecutors go away. We've seen doctors surrender their registrations thinking it would end everything, only to face indictment six months later.
The conviction rate in federal drug cases runs between ninety-two and ninety-seven percent. Once the government files charges, they almost always win. Not because theyre always right. Because they dont file unless theyre confident they'll win. That ninety-plus percent conviction rate isnt a measure of guilt. Its a measure of how thoroughly they prepare before they ever reveal themselves. Which brings us to the instinct thats about to make everything worse.
Two simultaneous investigations. Two different standards. Two paths to losing everything. And heres where most doctors make the critical mistake:
Why Every Instinct Fails You
Your instinct right now is to explain. To cooperate. To help them understand that you're not a drug dealer - you're a doctor who was treating patients in pain. Every one of those instincts is wrong.
When federal agents ask if you'd like to tell your side, what they're actually asking is: would you like to provide statements that become evidence? Every word you say will be transcribed, analyzed, and used. Not to exonerate you. To convict you. The agents conducting the interview have been building this case for two years. They know the answers before they ask the questions. They're not gathering information. They're documenting your responses for trial.
The documentation you kept carefully because you were practicing good medicine? Thats now the governments evidence. Every patient assessment, every prescription rationale, every follow-up note in the chart - you created that record to protect yourself. Now prosecutors are reading those same notes to count prescriptions, flag refill patterns, build a spreadsheet of Schedule II medications that becomes Count 1, Count 2, Count 3 of the indictment.
And while you were treating patients, unaware of any investigation, your business partner was meeting with prosecutors. The pharmacist down the street was providing testimony. The colleague you shared call coverage with was negotiating their own cooperation agreement. The testimony thats going to be used against you has been shaped and refined over months of meetings that happened while you had no idea you were even a target.
But cooperation works, you're thinking. Substantial assistance reduces sentences. The safety valve exists.
Yes. Sometimes. Cooperation can work - but only when strategically deployed after your attorney has assessed what the government actually has, what they still need, and whether you have anything to offer. Cooperation as a first instinct, without that assessment, destroys cases that could have been won. Cooperation in federal court means becoming a witness. It means testifying against your colleagues, your partners, the pharmacies you worked with. If you're a solo practitioner with nothing to offer, your cooperation is worthless to them. If the government has been building this case for twenty-four months, they probably already have what they need - with or without you. Your "explanation" just becomes another piece of their evidence.
Some of those 51 doctors in Operation Profit Over Patients tried to cooperate. Surrendered their licenses. Provided information they thought would help. They're serving time anyway.
So explaining backfires. Cooperating destroys you. Surrendering your license doesnt stop the criminal case. Every natural response makes the situation worse. What actually works?
The Defense That Actually Works
Ruan v. United States changed everything in 2022, and most attorneys still dont know how to deploy it.
Before Ruan, federal prosecutors only had to prove your prescribing deviated from objective medical standards. They compared your practices to what a hypothetical reasonable doctor would do, found the deviation, and called it criminal. The jury instruction was essentially: if it looked wrong from the outside, it was wrong.
The Supreme Court unanimously disagreed. Now prosecutors must prove you knew you were acting outside the bounds of professional practice. That you subjectively understood you weren't treating legitimate patients. That you were aware you were acting for purposes foreign to medicine. This shifts the burden fundamentally. Its not about what a reasonable doctor would do. Its about what you actually believed.
If you genuinely believed your prescriptions were for legitimate medical purposes - even if that belief was wrong, even if other doctors would have prescribed differently, even if your judgment was imperfect - you are not guilty under the Controlled Substances Act as interpreted after Ruan. Your internal belief matters now. Not just the external appearance of your practice.
In the three months after the decision, Ruan was invoked in at least fifteen ongoing prosecutions across ten states. Doctors used it for post-conviction appeals, motions for acquittal, new trial requests, plea reversals. The legal landscape shifted. The government's playbook - prove it looked bad, call it criminal - no longer works the same way.
But Ruan only works if raised correctly and early. If your attorney doesnt understand how to build the subjective good-faith defense from the beginning, if they treat this like a standard drug case without appreciating what the Supreme Court changed, the opportunity slips away. Ruan is not a magic word. Its a framework that requires specific evidence, specific arguments, specific trial strategy. We've studied every case that's applied it since 2022. We know what works and what doesn't.
The investigation has been running for two years. You just found out. The administrative track is moving on a fifty-one percent standard while the criminal case prepares. Your colleagues may already be cooperating. The algorithm flagged you before any human opened your file. Every instinct you have about how to handle this is wrong.
And yet theres a path forward. Ruan changed the legal landscape for prescriber prosecutions. Early intervention can shift the trajectory before charges are filed. Dual-track strategy can protect your license while fighting the criminal case. The situation is serious. The situation is not hopeless.
Spodek Law Group represents healthcare providers facing DEA investigations throughout New York. We understand federal defense. We understand administrative law. We understand that the next forty-eight hours matter because every day of delay narrows your options.
Call us at 212-300-5196. Not because this paragraph told you to. Because you now understand what you're actually facing - and you understand that responding correctly requires expertise that matches the governments two-year head start.
The clock has been running since before you knew. Its time to catch up.
