Three face charges in illegal pill mill operation — 10 insights

Pennsylvania Attorney General Josh Shapiro charged a Philadelphia-based psychiatrist, a Blair County, Pa.-based pediatrician and a Philadelphia resident in relation to alleged illicit prescription writing schemes, Penn Live reports.

Here's what you should know.

1. Psychiatrist Bruce Lief, MD, allegedly prescribed nearly 25,000 oxycodone, OxyContin, methadone and other pills to at least four patients. Pediatrician Rebecca Delbaggio, MD, allegedly prescribed 780 oxycodone and Xanax pills to Andrew Smithmyer, who was also charged in connection with Dr. Delbaggio's alleged crimes.

2. Dr. Lief was allegedly prescribing opioids to a nursing home-bound person, whose care was administered by nursing home staff. The patient's relative regularly filled the prescription, which caused a pharmacist to look into the matter.

3. The pharmacist called Dr. Lief, who allegedly wouldn't discuss the matter. The pharmacist then refused to fill prescriptions for the patient.

4. Investigators questioned Dr. Lief. He claimed to run a pain management practice in addition to his psychiatric practice. Dr. Lief said he was prescribing opioids to the son of the nursing home patient. Nursing home staff asked the patient about the excess prescriptions and the patient allegedly moved out of the nursing home.

5. Dr. Lief is not certified to practice pain management but claimed "he was competent enough to prescribe pain medications." A patient allegedly visited Dr. Lief and paid him $240 in cash for an "appointment". Dr. Lief admitted to prescribing an excessive amount of opioids at the appointment "because he needed the money to pay bills."

6. Dr. Lief allegedly neither examined patients nor required patients to be present while writing prescriptions.

7. Dr. Delbaggio also allegedly did not review medical records, perform medical examinations or check the state's drug monitoring program before prescribing Mr. Smithmyer prescriptions for 780 pills.

8. Dr. Delbaggio and Mr. Smithmyer were allegedly romantically involved. Dr. Delbaggio allegedly knew Mr. Smithmyer was a heroin addict. She also purchased a car for him and gave him approximately $50,000 during their relationship.

9. Dr. Delbaggio allegedly wrote prescriptions for Mr. Smithmyer to sell to pay her back.

10. Dr. Lief faces 12 felony counts for illegally prescribing opioids, while Dr. Delbaggio faces 15 felonies and 18 misdemeanors and Mr. Smithmyer faces 15 felonies in relation to the illegal prescriptions.

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