How Authorities Are Shutting Down Texas Pain Clinics Enormous Pill Prescriptions

Investigation Reports. Criminal organizations involved in the illegal distribution of pain killer pills contribute to the opioid crisis leading to drug addictions and overdose deaths.

Physicians are increasingly operating pain pill mills disguised as pain relief or pain management clinics, wellness centers, functional medicine clinics, and urgent care centers. These owners and operators continually devise methods to subvert regulations and investigations while attracting patients.

Physician Sentenced for $1.2 Million Pill Mill Scheme (U.S. Drug Enforcement Administration, December 2023)

HOUSTON – A Texas doctor was sentenced to seven years in prison for operating a pill mill clinic that unlawfully prescribed over 600,000 opioid pills in exchange for cash.

A federal jury convicted Dr. Oscar Lightner, 73, Laredo, of unlawfully distributing and dispensing controlled substances and conspiracy.

According to court documents and evidence presented at trial, Dr. Lightner and his stepson Andres Martinez Jr., 29, Laredo, operated Jomori Health and Wellness, a purported Houston pain management clinic, as a pill mill. Lightner, who was the owner of and physician at Jomori, unlawfully prescribed dangerous combinations of controlled substances—including hydrocodone, carisoprodol, and alprazolam—to his patients without a legitimate medical purpose in exchange for cash payments ranging from $250 to $500.

Martinez, who was Jomori’s office manager and Lightner’s stepson, coordinated with crew leaders to bring multiple people, including individuals living in homeless shelters, into Jomori to pose as patients to obtain prescriptions for opioids and other controlled substances. Jomori received over $1.2 million in cash over 14 months through its scheme, which resulted in the unlawful distribution and dispensing of more than 600,000 opioids and other controlled substances.

The DEA Houston Division conducted the investigation. It serves Austin, Beaumont, Brownsville, Corpus Christi, Del Rio, Eagle Pass, Galveston, Laredo, McAllen, San Antonio, and Waco.

According to the National Drug Intelligence Center, an estimated 7,500 pill mills operate in the United States. A pill mill is a type of business that prescribes narcotic medications in more significant numbers than would be prescribed in regular physician offices. State and local investigators came up with the name “pill mills.”

If you are aware of controlled substance violations in your community, you can submit your anonymous tip through the DEA online Tip Line

The Dangers of Pill Mills

Pill mills are extremely dangerous because they make it easy for people to abuse opioids. Opioids are a type of drug that is highly addictive and can be very harmful, even deadly, when misused. People who get opioids from a pill mill are more likely to misuse them because they don’t have to go through the proper channels to get the drugs. This means that more people are at risk of developing an addiction to opioids, and more people are likely to overdose on these drugs.

Houston-Based Pill Mills Moved 23 Million Opioid Pills, Feds Say (KPRC, Houston, YouTube Video)

North Harris County. Deputies Shut Down Pill Mill in Home. Thirty-eight people were charged as part of an investigation of pill mills in the Houston area.

Houston Pharmacist, Clinic Owner Sentenced for Illegally Distributing Thousands of Opioid Pills in $6 Million Pill Mill Scheme (Erica Ponder, Click2Houston, October 2023)

Sokari “Momma” Bobmanuel, 63, was sentenced to 14 years in prison following her conviction at trial for conspiracy to distribute and dispense controlled substances unlawfully. Alantha Stewart, 42, was sentenced to 10 years in prison following her guilty plea to conspiracy.

According to court documents, from May 2018 to August 2019, Sokari Bobmanuel was the Owner and Pharmacist-in-Charge of Cornerstone Rx Pharmacy, which illegally distributed nearly 160,000 opioid pills, including oxycodone and hydrocodone, often based on prescriptions issued by Dr. Jonathan Rosenfield, M.D., and others from Sunnyside Medical, which consisted of two Houston-area pill-mill clinics.

Investigators said through Cornerstone, Bobmanuel distributed controlled substances “outside the scope of professional practice, and without a legitimate medical purpose,” to individuals who brought prescriptions in the names of other people. These people then sold the pills they bought from Cornerstone illegally. Bobmanuel charged exorbitant prices for the pills – often $1,200 for a single oxycodone prescription – generating over $1 million from the scheme, the DOJ stated.

Stewart, who authorities said co-owned and co-operated the Sunnyside Medical pill-mill clinics, doing business as Sunnyside #1 and Sunnyside #2, and her co-conspirators issued prescriptions for opioids, including about 752,000 pills of oxycodone and 419,000 pills of hydrocodone, under co-owner and co-conspirator Rosenfield’s name, outside the usual course of professional practice.

“The prescriptions often were issued to individuals paid by drug dealers to pose as patients, and the pills ultimately were diverted to the illegal market,” a news release from the DOJ said. “From May 2018 to August 2019, the Sunnyside Medical clinics made approximately $5.4 million from the sale of the prescriptions of these drugs.”

Co-defendants Rosenfield and Elmer Taylor pleaded guilty to conspiracy. The DEA Houston Division and FBI Houston Field Office investigated the case.

What is Oxycodone and How Is It Used (United States Drug Enforcement Administration)

Nine Arrested for Illegally Distributing 1.5 Million Opioid Pills (U.S. Department of Justice, February 2023)

According to court documents, Kent Lyons, 52, of Houston; Roquel Turner, 47, of Manvel; and Traunce Alfred, 43, of Baytown, were charged with illegally distributing controlled substances, including oxycodone and hydrocodone. From August 2017 until late 2022, Lyons and Turner allegedly operated pill-mill pharmacies as fronts to obtain opioids in their highest-strength and immediate-release pill form. They then allegedly sold the drugs on the black market – without the involvement of patients, prescriptions, or doctors – to drug traffickers. Lyons and Turner allegedly concealed the drug proceeds using numerous bank accounts and real estate transactions. Lyons also allegedly used some proceeds to purchase luxury items, including a Rolls Royce, a Ford F-250, and a Mercedes Maybach.

According to court documents, starting around December 2020, Dwain Ross, 52, and Delores Mackey-Ross, 43, both of Pearland, along with licensed pharmacist Ann Nguyen, 30, of Stafford, allegedly used pharmacies to illegally distribute and dispense nearly half a million pills of oxycodone and hydrocodone. Dwain Ross and Mackey-Ross, along with David Ross, 53, of Houston; Kevin Peterson, 56, of Pearland; and Eleanor Marsh, 56, of Fulshear, also allegedly illegally ordered the opioid potentiators alprazolam, carisoprodol, promethazine with codeine – which are reported to enhance the high from opioids – from a pharmaceutical wholesaler and a pharmaceutical sales representative then allegedly illegally distributed the opioid potentiators in bulk. Dwain Ross and Mackey-Ross allegedly used numerous bank accounts and real estate transactions to conceal their ill-gotten gains. Dwain Ross also allegedly used some of the drug proceeds to purchase a Lamborghini.

The pharmacies alleged in the indictments to have been controlled by the defendants’ drug trafficking organizations are K Med Pharmacy, Nex Gen Pharmacy, TX United Pharmacy, Power Center Pharmacy #2, DR Pharmacy, and Nu Care Pharmacy. Several other pharmacies, including P&A Pharmacy and Pearland Holistic Pharmacy, voluntarily surrendered their DEA Registration numbers, which a pharmacy needs to purchase pharmaceutical opioids and other controlled substances legally.

Lyons, Turner, Alfred, Dwain Ross, Mackey-Ross, and Nguyen were charged with illegal distribution of Schedule II opioids. Dwain Ross, Mackey-Ross, David Ross, Peterson, and Marsh were charged with the illegal distribution of Schedule IV drugs. Lyons, Turner, Dwain Ross, and Mackey-Ross were also charged with money laundering crimes.  If convicted, Lyons, Turner, Alfred, Dwain Ross, Mackey-Ross, and Nguyen face up to 20 years on the top counts. David Ross and Peterson each face up to five years. Marsh faces up to 10 years if convicted. Court documents allege that over 15 bank accounts, four real properties, and several luxury vehicles – including a Rolls Royce, a Bentley, and a Lamborghini – were involved in, or acquired with proceeds from, the scheme and are subject to forfeiture if the defendants are convicted. A federal district court judge will determine any sentence after considering the U.S. Sentencing Guidelines and other statutory factors.

A pill mill engages in the non‐therapeutic dispensing of drugs when there is no valid medical need to do so. This is often at the monetary benefit of the doctors, pharmacists, and pharmacy owners who are complicit. As a pharmacist, you may not be knowingly complicit in a pill mill scheme, but the DEA—and subsequently, the Texas State Board of Pharmacy—identifies Corresponding Responsibility as the pharmacist’s role in ensuring proper therapeutic dispensing.

WFAA Investigates: Undercover DEA Video Shows North Texas Pill Mill in Action (YouTube Video).

A North Texas Physician was sentenced to prison for trafficking painkillers out of his clinic. Investigators say the case is a roadmap on how to prosecute bad doctors.

Operators of Three Texas Pharmacies and Two Pain Clinics Arrested for Illegally Dispensing Nearly Four Million Opioid Pills (December 2021)

Three Houston-area Pharmacists, a Doctor, and a Pharmacy Technician were arrested for allegedly running three pharmacies and two clinics as “pill mills,” distributing hydrocodone, oxycodone, and other controlled drugs without a legitimate medical purpose.

Dr. Shivarajpur Ravi, M.D., 65, of Houston, was arrested on a criminal complaint filed in the U.S. District Court for the Southern District of Texas, alleging that he operated two pill-mill clinics in the Houston area, which he used to distribute and dispense hydrocodone and carisoprodol illegally. According to court documents, undercover officers obtained illegitimate prescriptions from Ravi once in 2020 at his clinic operating out of 12555 Ste. B Gulf Freeway in Houston, and again at a new clinic at 3333 Bayshore Dr., Ste. 250, Pasadena, which he opened in 2021.

The papers detail how crew leaders were observed paying for groups of patients, filling out their paperwork, and coaching them on what to say to the doctor as they waited to be seen. The 2020 purported consult with Ravi is alleged to have lasted less than two minutes, after which officers filled the prescription at Keystone. In both cases, the visit ended with Ravi prescribing large quantities of hydrocodone and carisoprodol.

A few weeks before the arrests of Obute, Emeakoroha, and Ravi, Christopher Obaze, 61, of Richmond, and Eric Tubbe, 36, of Rosenberg, were arrested on charges brought in the U.S. District Court for the Southern District of Texas related to their alleged illicit operation of Chrisco as a pill mill. The eight-count indictment alleged that in doing so, Obaze and Tubbe conspired to illegally distribute and dispense hydrocodone and oxycodone, maintained Chrisco as a drug-involved premise in proximity to a facility for children, and laundered their ill-gotten gains, using the proceeds to promote the enterprise, depositing cash in amounts below $10,000 to avoid bank reporting requirements, and transferring the proceeds through numerous accounts to obscure the funds’ origins. Obaze was also charged with tax crimes. According to court documents, from around January 2018 to around October 2021, Obaze was the Pharmacist-in-charge, and Tubbe was a Pharmacy Technician at Chrisco, which the two men used as a front to purchase and then illegally sell around 2.25 million of the highest-strength short-acting hydrocodone and oxycodone pills commercially available. The indictment alleges that Obaze and Tubbe sold the pills, in bulk, directly to drug traffickers without the involvement of doctors, prescriptions, or patients.

According to court documents, Chrisco Pharmacy, Keystone Pharmacy, and Peoples Pharmacy illegally dispensed nearly four million pills of the Schedule II opioids hydrocodone and oxycodone. Keystone owner and Pharmacist-in-Charge Anthony Obute, 46, of Houston, was indicted for illegally distributing and dispensing hydrocodone and the Schedule IV muscle relaxer carisoprodol. According to the filed criminal complaint leading to Obute’s arrest, Obute operated Keystone as a pill mill, illegally distributing hydrocodone and oxycodone. The complaint further alleged that from about September 2018 to about September 2020, Obute directed Keystone to purchase around 1.1 million of the highest-strength, short-acting hydrocodone, and oxycodone pills commercially available, which he then sold to so-called “crew leaders,” or drug traffickers who pay individuals to pose as patients to obtain pills to sell onto the black market.

Ophelia Emeakoroha, 50, of Pearland, was arrested on a criminal complaint filed in the U.S. District Court for the Southern District of Texas, alleging that Emeakoroha, the Pharmacist-in-Charge at Peoples, illegally distributed and dispensed hydrocodone and oxycodone. According to court documents, from about Jan. 1, 2019, to about Dec. 31, 2019, Emeakoroha caused Peoples to purchase around 250,000 of the highest-strength, short-acting hydrocodone and oxycodone pills commercially available, which she then sold to crew leaders in a scheme similar to Keystone’s.

Federal charges related to the illegal distribution of Schedule II opioids like hydrocodone and oxycodone, which all of the indicted defendants face, carry statutory maximums of 20 years in prison. Obaze and Tubbe were both charged with money laundering crimes that carry statutory maximums of 10 and 20 years in prison, while Obaze’s tax charges carry a statutory maximum of three years. Federal Bureau of Investigation and Houston Police Department.

Operation Wasted Daze: 46 Convicted in $18 Million Pill Mill Scheme (U.S. Attorney’s Office, Northern District of Texas, March 2021)

Forty-six defendants, including two Doctors, a Nurse Practitioner, and five Pharmacists, were convicted of operating an $18 million pill mill scheme. They were arrested by the DEA’s Fort Worth Tactical Diversion Squad in “Operation Wasted Daze.”

The lead defendant, 61-year-old Oncologist Caesar Mark Capistrano, was charged with multiple counts of conspiracy to dispense hydrocodone and possession with intent to distribute hydrocodone or carisoprodol.  He and five co-conspirators – Pharmacists Ethel Oyekunle-Bubu, Wilkinson Oloyede Thomas, and Christopher Kalejaiye Ajayi, as well as recruiters Brian Kincade and Alphonse Fisher – were convicted at trial. The remaining 41 defendants pleaded guilty before trial.

According to evidence presented at three different trials conducted in early 2021, Dr. Capistrano and his associate, 36-year-old Dr. Tameka Lachelle Noel, wrote prescriptions for hydrocodone, oxycodone, alprazolam, carisoprodol, zolpidem, phentermine, and promethazine with codeine, knowing the drugs would be diverted to the streets for illicit use.

At the clinic, many of the “patients” were seen not by the doctors but by Clinic Manager Williams who possessed neither a medical license nor a DEA registration. After a perfunctory conversation with the “patient,” Ms. Williams allegedly coordinated with Dr. Capistrano and Dr. Noel to prescribe dangerous drugs without legitimate medical purpose.  In order to make the prescriptions appear legitimate, the doctors occasionally included prescriptions for non-controlled substances, such as antibiotics and mineral ice.

Dr. Capistrano and Dr. Noel, assisted by 48-year-old clinic manager Williams, used a network of recruiters to enlist individuals from the community and local homeless shelters to pose as “patients.”  Recruiters paid each “patient” a small fee, usually $50 to $200 cash, to obtain controlled substance prescriptions from Dr. Capistrano and Dr. Noel.  

The pharmacists charged the recruiters between $200 and $800 per prescription, filling hundreds and hundreds of prescriptions for a fee, according to evidence presented at trial. The recruiters – who paid the clinic based in part on the amount of drugs prescribed – then filled the prescriptions at various complicit pill mill pharmacies and diverted the drugs for resale on the streets.

Over a 9-year span, Dr. Capistrano issued prescriptions for more than 524,000 doses of hydrocodone, 430,000 doses of carisoprodol, 77,000 doses of alprazolam, and 2.07 million doses of promethazine with codeine. Over 7 years, Dr. Noel issued prescriptions for more than 200,000 doses of hydrocodone, 55,000 doses of carisoprodol, 14,000 doses of alprazolam, and 450,000 doses of promethazine with codeine.

Often, the doctors prescribed multiple medications simultaneously and at the highest dosages available.

“Pill mills funnel potentially deadly opiates onto our streets, wreaking havoc in communities beset by addiction,” said U.S. Attorney Prerak Shah. “The doctors, pharmacists, and clinic staff convicted in this case violated not only medical ethics but federal law as well. We are proud to bring them to justice, and we remain committed to fighting the opioid epidemic where it matters most – at the point of entry.”

“Mr. Capistrano and his criminal associates have violated the public’s trust and stained the image of such a vital and noble profession in our society, especially during a time where we need our front-line healthcare workers the most, said DEA Dallas Field Division Special Agent in Charge, Eduardo A. Chávez. “Profiting off the lives of those addicted to controlled prescription drugs stops now. DEA Fort Worth and all of our North Texas law enforcement partners will never waver and always ensure justice is the best medicine.” 

Medical Professionals Convicted in the Scheme include:

Dr. Caesar Mark Capistrano was convicted at trial of three counts of conspiracy to dispense a controlled substance and two counts of possession with intent to distribute a controlled substance. Dr. Capistrano faced up to 100 years in federal prison, 20 years per count. His co-conspirators also faced up to 20 years per count of conviction. 

Dr. Tameka Lachelle Noel pleaded guilty to conspiracy to dispense a controlled substance and was sentenced to eight years in federal prison.

Ngozika Tracey Njoku, Nurse Practitioner Pleaded Guilty to conspiracy to dispense a controlled substance.

Pharmacists Convicted in the Scheme include:

  • Wilkinson Oloyede Thomas, Calvary Pharmacy. Convicted at trial of three counts of conspiracy to dispense controlled substances and one count of possession with intent to distribute controlled substances. 
  • Christopher Kalejaiye Ajayi, Remcare Pharmacy. Convicted at trial of three counts of conspiracy to dispense controlled substances, and two counts of possession with intent to distribute controlled substances.
  • Bartholomew Anny Akubukwe, Beco Pharmac. Pleaded guilty to conspiracy to dispense a controlled substance and was sentenced to 11 years in federal prison.
  • Nedal Helmi Naser, Brandy Pharmacy. Pleaded guilty to conspiracy to dispense a controlled substance.

Ethel Oyekunle-Bubu, Ethel’s Pharmacy. Convicted at trial of three counts of conspiracy to dispense a controlled substance and two counts of possession with intent to distribute controlled substances.

The DEA Dallas Field Division’s Fort Worth Office conducted the investigation, with the assistance of Homeland Security Investigations, IRS – Criminal Investigation, the U.S. Marshals Service, the U.S. Postal Inspection Service, the Parker County Sheriff’s Office, and the Fort Worth Police Department.  

A Longtime Texas Family Doctor, Trusted for Three Decades by Many Families with their Health, Was Accused of Using His Prescription Pad as a License to Deal Drugs

MCKINNEY, Texas—The DEA and federal prosecutors said Dr. Wade was running a pill mill and prescribed massive amounts of powerful painkillers to patients who didn’t need them. The Drug Enforcement Administration linked Dr. Randall Wade to the deaths of at least six patients.

Federal prosecutors say Wade was repeatedly warned to change his prescribing practices: by the medical board, by the coroner’s office, by the DEA and by pharmacists, court records reveal.

“He won’t stop,” a Federal Prosecutor told a judge in a hearing. “He hasn’t stopped.”

By the time of his arrest in his office parking lot, Dr. Wade had been under investigation for nearly a year. During that time, the DEA posted a camera on a pole outside his clinic. Agents followed him to his mansion in his gated McKinney neighborhood.

At a detention hearing the day after his arrest, a DEA Agent testified that the DEA began receiving complaints about him as far back as 2012.

Wade was among the top prescribers of hydrocodone in a 10-county area for 10 months of last year.

Eighty-eight percent of the drugs – hydrocodone, alprazolam (Xanax) and carisoprodol (the muscle relaxer Soma) – he prescribed are three of the most abused drugs on the market, the agent said. They’re referred to as a “holy trinity” for the euphoric high they give users.

“This is highly unusual to see a family doctor prescribing these three drugs, three of the most abused controlled substances,” Herkert said.

The pharmacist reported that he called Dr. Wade about his concerns and that Dr. Wade told him that he did not think it was a problem and that Dr. Wade told him he was doing what his patients wanted.

CVS and Target also blocked prescriptions from Wade, the agent said.

Herkert said she interviewed a former employee, who said that Dr. Wade blamed the overdose deaths of his patients on “patients for abusing the drugs and not using it as directed.” 

A former employee reported that there were “mules” who brought in patients from the Gainesville area to get the drugs.

The Texas Medical Board cited him for running an unregistered pain clinic and over-prescribing to 17 patients “without stating a clear medical rationale.”

The medical board ordered him to send his current pain patients elsewhere within 180 days and to take no new ones. If he didn’t comply, his license would be suspended.

DEA agents raided Dr. Wade’s home and office. They confiscated about 1,000 patient files. Many of his patients were driving long distances, and there is little documentation for why he was prescribing the drugs, the agent said.

“We consistently see page after page of refill, refill, and refill,” Herkert said. An outside medical expert hired by the DEA reviewed a sampling of the files and determined Wade was prescribing without a legitimate medical purpose, the agent said.

The indictment specifically linked Dr. Wade to the death of Lowell Haynes, who went to Wade for a thorn in his hand. Wade prescribed pain medications for it.

Haynes filled prescriptions for hydrocodone and alprazolam (Xanax) at Dyer Pharmacy in Farmersville that same day. He was found dead by his brother the next day in Princeton. The autopsy results showed he died from the “toxic effects of hydrocodone and alprazolam.” The DEA reviewed Haynes’ file and concluded that he was given “high-risk medications” without documentation to back up why he prescribed it, according to court transcripts.

Herkert said when she asked him to voluntarily turn over his controlled substances privileges, Dr. Wade refused the request.

In the weeks it took obtain an indictment, Dr. Wade was still seeing patients. Another of Wade’s patients would die just days before his arrest, the agent testified.

Houston Physician and Pain Management Clinic Owner Sentenced to 35 Years in Prison for Running a Pill Mill (U.S. Department of Justice, September 2018)

HOUSTON, TEXAS—Gazelle Craig, D.O., 42, and Shane Faithful, 42, the Owner of a Pain Management Clinic, were each sentenced to 420 months in prison for their roles in running a pill mill that provided tens of thousands of unlawful prescriptions for millions of doses of opioids and other controlled substances.

According to evidence presented at trial, from March 2015 through July 2017, Craig and Faithful ran Gulfton Community Health Center, which operated as an illegal pill mill.  The evidence showed that Craig unlawfully wrote approximately 18,252 prescriptions for over 2.1 million dosage units of hydrocodone, a Schedule II controlled substance, and approximately 15,649 prescriptions for over 1.3 million dosage units of carisporodal, a Schedule IV controlled substance. The combination of hydrocodone and carisoprodol is a dangerous drug cocktail with no known medical benefit, the evidence showed.

Dr. Craig regularly issued unlawful prescriptions for controlled substances to more than 60 patients a day, the evidence showed.  “Crew leaders” ferried numerous patients to Gulfton so that Craig could provide them with unlawful prescriptions for controlled substances.  Faithful and Craig charged approximately $300 for each prescription and required payment in cash. The defendants divided each day’s cash proceeds, often in excess of $15,000, from the sale of the unlawful prescriptions.  

“Dr. Craig, along with clinic owner Shane Faithful, used their position of trust to illegally distribute over 2 million dosage units of hydrocodone into local communities across Houston,” said DEA Special Agent in Charge Glaspy.  “It is this kind of illegal distribution of prescription drugs that feed the opioid epidemic and destroys families.  The sentencing of Dr. Craig and Mr. Faithful is a victory for our communities while at the same time making a nationwide statement that the DEA and DOJ will not tolerate this type of illegal activity.”   

“Today’s sentences should serve as a stark warning to any medical professional considering exploiting the opioid crisis for profit: you will be caught, you will be prosecuted, and you will pay a steep price for abusing your prescription power for personal gain,” said Assistant Attorney General Benczkowski.  

41 Individuals Charged for their Alleged Involvement in a Network of Pill Mill Clinics and Pharmacies.

Those charged include medical providers, clinic owners and managers, pharmacists, pharmacy owners and managers as well as drug dealers and traffickers.  Their actions allegedly resulted in the diversion of approximately 23 million oxycodone, hydrocodone and carisoprodol pills

DR. BARBARA MARINO, a resident of Harris County, Texas, was a Medical Doctor, a purported addiction specialist, and was licensed to practice medicine in the State of Texas since August 1990. According to the Texas Medical Board, the primary location of practice was at 8118 Long Point Road, in Houston, Texas, which was also the location of Angels Clinica Familiar. Dr. Marino prescribed large volumes of controlled substances—primarily hydrocodone 10/325mg, oxycodone 30mg, and carisoprodol 3 50mg—from ANGELS CLINICA.

MARINO used her status as a licensed physician, her DEA Registration Number, and her medical practice ANGELS CLINICA, to knowingly and intentionally prescribe controlled substances, including oxycodone, hydrocodone, and carisoprodol, outside the usual course of professional practice and not for a legitimate medical purpose.

MARINO did not register ANGELS CLINICA with the Texas Medical Board as a pain management clinic, as required under Texas law, and thereby operated ANGELS CLINICA outside the usual course of professional practice.

MARINO often ignored obvious signs of addiction and drug-diversion, and nevertheless issued prescriptions for controlled substances to her purported patients.

From September 2018 through August 2019, MARINO issued prescriptions for approximately 1,060,000 controlled substance pills, including 518,000 pills of hydrocodone, approximately 65,000 pills of oxycodone, and approximately 416,000 pills of carisoprodol. During the time of the conspiracy, ANGELS CLINICA made approximately $1.7 million dollars by distributing prescriptions for hydrocodone, oxycodone, and carisoprodol that were outside the usual course of professional practice and without a legitimate medical purpose.

The charges allege participating Doctors, Medical Professionals and Pharmacies knew the prescriptions had no legitimate medical purpose and were outside the usual course of professional practice.  In some cases, “crew leaders” and “runners” allegedly filledor had the individuals who posed as patients fill the illegal prescriptions at Houston-area pharmacies. 

The owner and pharmacist in charge at one pill mill pharmacy allegedly dispensed the second highest amount of oxycodone 30mg pills of all pharmacies in the entire State of Texas in 2019, and the 9th highest amount in the nation. 100% of the oxycodone dispensed by this pharmacy – every single oxycodone pill that left the premises – was in the highest available dosage strength of that drug. 

To maintain the appearance of legitimacy, HEALTHFIT, through BILLINGS, COOPER, HOOPER, WINFIELD-GATES, and BRANCH, and their co-conspirators would sell pharmaceutical drugs with high street value to individuals posing as patients. These individuals came to HEALTHFIT from crew leaders—co-conspirators whose role was finding the patients, obtaining their prescriptions by whatever means necessary, and paying HEALTHFIT hundreds of dollars in cash for the drugs, including oxycodone, hydrocodone, alprazolam, carisoprodol, and promethazine with codeine syrup (or for combinations thereof), to sell on the black market for profit.

Pharmacists and their HEALTHFIT co-conspirators used their statuses as a licensed pharmacies, pharmacists, and technicians, and, where applicable, their DEA Registration Numbers, to dispense the controlled substances named. In return, they were rewarded with cash for the drugs in amounts well over the market value of legitimate prescriptions for the drugs.

Pharmacist-In-Charge JEREMY BRANCH, licensed by the Texas State Board of Pharmacy at HEALTHFIT from February 2017 to around September 2017.

Pharmacist ARTHUR NATHANIEL BILLINGS owned and operated HEALTHFIT.

FRANK COOPER was a Relief Pharmacist at HEALTHFIT.


DONNA ELAINE HOOPER was a Pharmacy Technician at HEALTHFIT.

“This type of criminal activity is, in part, what is fueling the 68,500 overdose deaths per year across the United States,” said Special Agent in Charge of the DEA’s Houston Division.  “The DEA and our numerous law enforcement partners will not sit silently while drug dealers wearing lab coats conspire with street dealers to flood our communities with over 23 million dangerous and highly addictive pills.”

“The doctors, nurses and pharmacists in this case allegedly misused their positions, violating the trust of the public they took an oath to serve. Together with their co-conspirators, these medical professionals released millions of highly addictive drugs onto the streets of our community.  FBI Houston remains committed to working alongside our federal, state, and local partners to combat this epidemic and protect our neighborhoods.”

On certain occasions, the indictments allege that drug dealers and traffickers then allegedly diverted and distributed the controlled substances to the streets, with some pills trafficked from Houston to Boston.

“By and large, these clinics are all about money and not the patient,” said U.S. Attorney Patrick. “If it was about the patient, no legitimate doctor would write, and no legitimate pharmacy would fill, these massive amounts and combinations of controlled substances. Pill mills are magnets for crime and should be eradicated. I am happy and willing to partner with any agency or police department in shutting down and prosecuting these places. I am also eager to expand our work into healthcare fraud in the Rio Grande Valley. These grifters are wasting taxpayer money and making healthcare more expensive for everyone else.”

Regulation of Pain Management Clinics

The legislature finds that deaths resulting from the use of opioids and other controlled substances constitute a public health crisis and that there is a compelling state interest in the board closely regulating the prescribing of opioids and other controlled substances by physicians and their delegates. Accordingly, the legislature finds that inspections and investigations conducted by the board, including the board’s use of subpoenas for immediate production, inspection, and copying of medical and billing records, are necessary to adequately regulate the prescribing of opioids and other controlled substances in order to protect the public health and welfare.

Abuse & Misuse of Prescription Drugs

These guidelines were prepared in cooperation with the following agencies: Texas Medical Board Texas State Board of Podiatric Medical ExaminersState Board of Dental ExaminersBoard of Nurse ExaminersTexas Optometry Board, and Texas State Board of Pharmacy.

Within the last decade, abuse and misuse of certain prescription drugs, especially pain medications, has become prevalent. Studies have indicated that educating health care providers about the growing problem and providing them with information will create a heightened awareness of the appropriate use of pain medication as well as the misuses and diversion of addictive pain medications.

Recognizing Non-Therapeutic Dispensing or Pill Mill Activity (State Board of Pharmacy)

A pharmacist’s professional responsibility includes looking  for certain patterns (i.e., “red flags”) that are relevant to preventing the non-therapeutic dispensing of controlled substances. If a pharmacist suspects that a patient is attempting to obtain controlled substances for non-therapeutic purposes (i.e., the pharmacist cannot resolve the “red flags” presented), the pharmacist must access Texas Prescription Monitoring Program for information on the patient.

Texas State Board of Pharmacy—“Red Flags” Checklist for Pharmacies: You Might Be a Pill Mill If…

Historically, Texas was among the four states in the nation with the highest concentration of pill mills (Drug Enforcement Administration, 2013). In 2009, Texas legislators addressed this problem by passing “pill mill” legislation, requiring all pain management clinics to be certified by the Texas Medical Board on a biennial basis and to be owned and operated by a licensed physician, effective September 1, 2010. Clinic owners must be present at the clinic for at least one-third of operating hours and must personally review at least one-third of all patient files. Additionally, clinic owners must annually verify the qualifications and licensure of all employees (Texas Legislature Online, 2010). 

America’s Pill Mills (American Addiction Centers, November 2023)

Of the survey respondents who said they were on prescription painkillers for minor surgery (such as a tooth extraction), 1.6% have been on medication for more than a year. About 48% have been on painkillers for between one week and one month. When it comes to chronic pain, though, 38% of respondents being treated have been on opioids for more than a year. For injuries, 10.7% have been on painkillers for more than a year, while 13% of respondents being treated for major surgery have been on medication for more than a year.

While addiction doesn’t always happen immediately, opioid tolerance does increase, resulting in a need for higher dosage. A patient being treated for a minor surgery may then find themselves needing more medicine because the original dosage is no longer adequately relieving pain.

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Pain Killer by Barry Meier

Between 1999 and 2017, an estimated 250,000 Americans died from overdoses involving prescription painkillers, a plague ignited by Purdue Pharma’s aggressive marketing of OxyContin. Families, working class and wealthy, have been torn apart, businesses destroyed, and public officials pushed to the brink. Meanwhile, the drugmaker’s owners, Raymond and Mortimer Sackler, whose names adorn museums worldwide, made enormous fortunes from the commercial success of OxyContin.
In Pain Killer, Barry Meier tells the story of how Purdue turned OxyContin into a billion-dollar blockbuster. Powerful narcotic painkillers, or opioids, were once used as drugs of last resort for pain sufferers. But Purdue launched an unprecedented marketing campaign claiming that the drug’s long-acting formulation made it safer to use than traditional painkillers for many types of pain. That illusion was quickly shattered as drug abusers learned that crushing an Oxy could release its narcotic payload all at once. Even in its prescribed form, Oxy proved fiercely addictive. As OxyContin’s use and abuse grew, Purdue concealed what it knew from regulators, doctors, and patients.

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Nationwide Investigations

How Pain Doctors Massive Opioid Prescriptions Lead to Pain Pill Overdose Deaths

How State and Federal Authorities are Dismantling Pill Mills in the United States

How to Recognize a Pain Pill Mill in Your Community

Authorities Crack Down on Pharmacists Fulfilling and Dispensing Massive Amounts of Pain Pills

How Pain Clinic Owners Turned Patients’ Pain into Enormous Profits

How Authorities Are Cracking Down on Rogue Pain Clinics in Florida

How Authorities Have Shuttered Georgia Pain Clinics Massive Pain Pill Distribution

How Federal Agencies are Shutting Down Maryland Pain Clinics Operating as Pill Mills

How Authorities are Dismantling Ohio Pain Management Clinics Prescribing Enormous Amounts of Opioid Painkiller Pills

How Authorities Have Shuttered Georgia Pain Clinics Massive Pain Pill Distribution

How Authorities are Dismantling Tennessee Pain Clinics Prescribing Massive Quantities of Opioid Pain Pills

How Authorities Are Cracking Down on Virginia Pain Clinics Massive Pain Killer Pill Operations

How State and Federal Agencies Are Shuttering California Pain Clinics Huge Distribution of Opioid Pain Pills

How Federal Agencies Are Dismantling Michigan Pain Clinic Doctors Scheme to Distribute Enormous Amounts of Opioid Pain Pills

How Federal Agencies Are Dismantling New York Pain Clinics Vast Pain Pill Operations

How Authorities Are Shutting Down Texas Pain Clinics Enormous Pill Prescriptions