The DEA investigation into your medical practice started two years before you knew about it. Welcome to Spodek Law Group. Before we talk about what this means for your career, you need to understand something that most doctors and pharmacists learn too late: by the time the DEA contacts you, they've already built their case. They've been analyzing your prescription patterns for 24 to 32 months. They've pulled your PDMP data. They've probably conducted surveillance. You're not at the beginning of this process - you're near the end.
Your prescription records aren't medical files anymore. They're evidence in a case that's been building while you were seeing patients. Every prescription you wrote is being compared to every other doctor in your specialty. The algorithm flagged you months ago. The humans are just catching up. At Spodek Law Group, our mission is to help you understand what's actually happening - not what you think is happening - so you can fight back effectively.
Todd Spodek and our team have defended doctors and pharmacists facing DEA investigations across New York City. We've seen how these cases unfold. We've seen the mistakes that destroy careers and the strategies that save them. The difference between losing everything and keeping your practice often comes down to understanding the system you're actually in - not the system you imagine.
How the Investigation Started Before You Knew
Heres what nobody explains about DEA investigations. The agency uses a data analytics process with over 150 risk factors to identify prescribers who stand out statistically. Who prescribes more Schedule II medications then peers in the same specialty? Who has patients traveling longer distances than typical? Whose cash payment ratio is higher than average? These questions get answered algorithmically before any investigator opens a file.
The Prescription Drug Monitoring Program was created to prevent drug abuse. Its become the primary tool for building criminal cases against doctors. DEA analysts use PDMP data to identify statistical outliers - and your among those outliers if your reading this. The database that was supposed to coordinate patient care has become a surveillance system, and you probably never consented to being watched this way.
A pharmacy inventory discrepancy three states away can trigger an investigation that leads back to your prescriptions. A patient overdose death in another jurisdiction can connect to your practice through PDMP data years later. Your not being investigated because of a complaint. Your being investigated because an algorithm decided your numbers looked wrong.
The red flags the DEA looks for include: Schedule II prescriptions higher than peers, patients traveling farther than typical, cash payments for opioid prescriptions, inventory irregularities at pharmacies you work with, out-of-state patients, unusual office hours. You might check several of these boxes without even knowing - because their not medical problems, their statistical patterns that trigger investigations.
The Two Tracks Running Against You Simultaneously
The DEA dosent just run one case against you. They run two. Administrative action and criminal investigation frequently run in parallel, using the same evidence. The ISO - Immediate Suspension Order - can destroy your practice on an administrative track while the criminal case is still building. What makes the administrative case also makes the criminal case. Your prescription records feed both.
Heres the part that should terrify you: the standards are completely different. Criminal conviction requires proof "beyond reasonable doubt." Administrative suspension only requires "preponderance of evidence" - thats 51%. You can lose your ability to prescribe controlled substances on a coin flip while your still presumed innocent of any crime. Your career can be destroyed at 51% certainty.
The Immediate Suspension Order is particulary devastating. The DEA can issue an ISO if they find "imminent danger to public health or safety." Theirs no automatic hearing after immediate suspension. You have to fight for one - while you cant prescribe. A registrant has only two procedural options to challenge the ISO, and both are often unsucessful. Meanwhile, your practice is closed.
Operation Profit Over Patients in July 2025 shows how this works in practice. 51 arrests. 122 criminal charges. 93 administrative cases. Same evidence, both tracks, running simultaneously. The DEA isnt choosing between destroying your license or sending you to prison. Their doing both at the same time.
The Mistakes That Destroy Careers
Your first instinct when the DEA contacts you will be to cooperate. To explain. To show them your documentation proves you were practicing legitimate medicine. This instinct is understandable. Its also dangerous. Every word you say without an attorney becomes evidence.
If the DEA notifies you that you are currently under investigation, the first thing you should do is not take any action unless you already have a DEA defense attorney. Cooperation without representation is confession. The help of a legal representitive will allow you to prevent audits from turning into criminal prosecution. But once you've talked, you cant untalk.
The second mistake is even worse: voluntary surrender of your DEA registration. When the pressure mounts, surrendering your registration seems like damage control. The DEA might even suggest it. But voluntary surrender makes future reapplication nearly impossible. It dosent help your criminal case. It dosent prevent prosecution. It just makes your administrative situation permanent.
Dr. Blatti in Nassau County voluntarily surrendered his license after arrest in 2019. It didnt reduce his 15-year sentence. He'd prescribed from a former Radio Shack, then from his car in parking lots - a Dunkin Donuts, a hotel where he lived. Five patients died. The voluntary surrender didnt demonstrate good faith. It demonstrated that even what feels like taking responsibility becomes a trap in this system.
You think explaining yourself will help. You think surrendering your registration will help. You think your documentation proves your innocence. None of these things are true. The records you kept to protect yourself are the records their using against you.
What Actually Works: The Defense Strategies That Matter
The Supreme Courts 2022 decision in Ruan v. United States changed DEA prosecution fundamentally. Prosecutors must now prove that physicians knew their prescribing was illegal - not just that the prescribing was objectively outside the standard of care. This is a significant defense shift. But it only helps if you survive the administrative track long enough to use it in criminal court.
Theres a critical distinction between medical "standard of care" and DEA's "legitimate medical purpose." They sound similar. Their not. You may have practiced good medicine by your standards. The DEA has different standards - and their the ones that matter. The gap between what's acceptable medicine and whats "legitimate medical purpose" under DEA rules is where careers end.
Understanding Ruan means understanding that your mental state matters. Did you know your prescribing was illegal? Or did you genuinely believe you were treating patients appropriatly? This knowledge requirement creates viable defenses - but only if your attorney understands how to use it, and only if the administrative track hasnt already destroyed your practice before the criminal case even begins.
The Federal courts are split on whether the DEA needs a warrant to access PDMP data. Oregon ruled warrant required. The First Circuit ruled no warrant needed under the "closely regulated industry" exception. In most jurisdictions, your prescription records are accessible without judicial oversight. This matters for your defense strategy - but it matters more that you understand the system your actually in.
The Time to Act Is Now
Lets be direct about were you stand. The DEA has had 24 to 32 months to build their case against you. You have days to respond. You've been investigated for months or years. The time to act is now - before the administrative track destroys what the criminal track hasnt touched yet.
Spodek Law Group defends doctors, pharmacists, and healthcare providers facing DEA investigations in New York City. We understand both tracks. We understand the Ruan defense. We understand why voluntary surrender is a trap and why cooperation without representation is disaster. We've seen the mistakes that destroy careers - and we've seen the strategies that save them.
Your medical records aren't private the way you thought. The investigation has been running longer than you knew. The standards are lower than you expected. But the situation isnt hopeless. Its just urgent. Call 212-300-5196. The case against you has been building for years. Your defense starts now.
