An Oklahoma doctor accused of prescribing a “horrifyingly excessive” amount of painkillers was charged with murder Friday, a pioneering prosecution that reflects nationwide efforts to stamp out the opioid crisis.
Oklahoma Attorney General Mike Hunter said Regan Nichols, an osteopathic physician, showed extreme disregard for human life in prescribing a total of 1,800 pain pills to five patients who died from drug toxicity after they saw Dr. Nichols at a Midwest City clinic from 2010 to 2013.
Investigators who reviewed her patients’ files said the prescriptions were far over the line or had no medical basis, according to court papers.
“The dangers associated with opioid drugs have been well-documented, and most doctors follow strict guidelines when prescribing opioids to their patients,” Mr. Hunter said. “Nichols prescribed patients, who entrusted their well-being to her, a horrifyingly excessive amount of opioid medications. Nichols’ blatant disregard for the lives of her patients is unconscionable.”
The murder charges are filed as President Trump, Congress, and state and local officials try to get control of an opioid epidemic that kills tens of thousands of Americans each year. Many people who overdose on heroin or powerful synthetic opioids become hooked on prescription painkillers first.
Public attorneys increasingly are taking people involved in the supply chain to court, though typically through civil lawsuits, so Mr. Hunter’s push on the criminal side stands out.
Richard C. Ausness, a law professor at the University of Kentucky who tracks the issue, said this is the first time he has heard of a doctor being charged with murder for overprescribing.
“With the opioid addiction situation now highly publicized, it is not surprising to see some public officials looking to charge doctors and pharmacists with serious crimes like murder and manslaughter,” Mr. Ausness said. “I would expect to see more of this in the future.”
Federal authorities have pushed criminal cases against physicians and pharmacists whose prescribing practices flout the Controlled Substances Act, which requires registered doctors to prescribe drugs for a “legitimate medical purpose” and “in the usual course of their medical practice.”
Mr. Ausness said the language used to describe Dr. Nichols’ conduct mirrored terms that are used to describe a violation of the federal act.
“That being said, the state criminal statute may define second-degree murder broadly enough to cover this kind of conduct,” he said. “Prescribing excessive amounts of dangerous drugs is similar to drunk driving which causes the death of another.”
The five patients who died were women ages 21, 46, 47, 52 and 55, according to an arrest affidavit.
Three of the five were prescribed a deadly combination of specific narcotic opioid pain relievers, anti-anxiety drugs and muscle relaxers — a mix known as the “holy trinity” or “cocktail” among addicts.
The son of one of the deceased women was also a patient of Dr. Nichols’ and received the same trio of drugs, the affidavit says. The mother and son lived in the same house.
A concerned former patient reported the doctor to authorities in May 2014, the affidavit says.
The Drug Enforcement Administration and Oklahoma authorities concluded that Dr. Nichols prescribed 3 million pills from Jan. 1, 2010, to Oct. 7, 2014.
A state board stripped her of her prescribing authority in September 2015.
Asked if she overprescribed, Dr. Nichols told the state board that she believed patients developed a tolerance and that they wanted more narcotics instead of waiting several months to see a pain specialist, according to the affidavit.