Agents were already in the field making arrests this week as federal prosecutors announced the indictments of 32 medical professionals in Tennessee and 60 across the Appalachian region. They're each accused of opioid-related crimes. And this time, other government workers were also mobilized in response, looking for desperate patients.
The U.S. Justice Department has been increasingly focused on doctors deemed to be over-prescribing opioids. The potential health fallout is often a secondary consideration. But Assistant Attorney General Brian Benczkowski said Wednesday that this week's enforcement was coordinated with health agencies.
"That plan is designed to ensure that affected patients have continued access to care and are at the same time directed to legitimate medical professionals in the area," he said.
In Tennessee, the agency overseeing addiction usually gets just one day's advanced notice of a crackdown, says Marie Williams, commissioner of the Department of Mental Health and Substance Abuse Services. This time, she had nearly a month.
"This is the first time that we have had this type of heads-up," she says.
The department began plastering messages online just as the indictments were unsealed, giving patients a hotline to call. Overdose prevention specialists have been on high alert, trying to keep patients from turning to street drugs laced with fentanyl and potentially overdosing.
TDH, the TN Department of Mental Health & Substance Abuse Services and the Division of TennCare are activating community-based resources to assist Tennesseans impacted by recent enforcement actions against pain clinics. Learn more: https://t.co/kEP1IOW8Th https://t.co/npySbxuUAe
— TN Dept. of Health (@TNDeptofHealth) April 17, 2019
"They're out there distributing Narcan to individuals and giving information to get into treatment," Williams says. "This is an opportunity to really change your life and get to be the person that you want to be."
But among the thousands of patients getting their opioids through questionable providers, many say they have very legitimate needs.
"I've tried therapies; I've tried injections. I've tried several different things," says Gail Gray of Clay County. "We didn't just start off taking opiates."
Gray has chronic back problems that often prevent her from getting out of her home, nestled in the woods surrounding Dale Hollow Lake.
This week, her pharmacist, John Rolston, was charged with 21 counts of filling medically unnecessary narcotic prescriptions. Both of his locations were shut down a few weeks ago.
"We're being punished for people that do abuse drugs," she says. "The chronic pain patients are being punished for it."
Gray has found a new pharmacy, though it means driving out of town. Health officials say they're worried about those who can't find another option, will run out of their medication and begin to withdraw, making them more likely to take a risk on deadly street drugs.