Supreme Court Favors Doctors Seeking a Higher Burden of Proof in Opioid Prosecutions

On Monday, the Supreme Court of the United States rejected the objective standard used by the government to prosecute doctors prescribing controlled substances in its 9-0 opinion for Raun v. United States.

According to the opinion authored by Justice Stephen Breyer, the petitioners, Xiulu Raun and Shakeel Kahn, are medical doctors licensed to prescribe controlled substances and each were tried and ultimately convicted under the Controlled Substances Act. Further, the opinion states that federal regulations allow registered doctors to prescribe controlled substances, but only if the prescription is issued for a legitimate medical purpose in the usual course of their professional practice. 

At trial, both Ruan and Khan argued that they subjectively believed they were prescribing the controlled substances in good faith. However, the government contended that the “except as authorized” clause of the Controlled Substances Act does not account for the doctor’s intent or mental states and instead is an objective standard. Raun and Kahn contested the jury instructions regarding mens rea, but each were separately convicted and affirmed by the Court of Appeals.  

Subsequently, the petitioners filed a writ of certiorari asking the Court to determine the mens rea requirement for the Controlled Substances “except as authorized” clause. The Court held that a “knowingly or intentionally” standard applies to the clause, requiring the government to prove beyond a reasonable doubt that the defendant knowingly or intentionally acted in an unauthorized manner once a defendant meets the burden of producing evidence that his or her conduct was “authorized.” 

The opinion states that criminal law generally seeks to punish “conscious wrongdoing” and that there is a presumption of a knowledge or intent requirement to convict under a statute even if the statute does not include such a provision. Further, the Court stated that the law at issue is not the kind of regulatory or public welfare offense carrying only a minor penalty in which a culpable mental state is not required. 

Therefore, the Court vacated the Court of Appeals decisions affirming Ruan’s and Khan’s convictions and remanded the case for further proceedings. Justice Alito filed a concurring opinion in which Justice Thomas joined and Justice Coney Barrett joined in part. In his concurring opinion, Justice Alito stated that he would also vacate and remand the lower court decisions, but argued that the Controlled Substances Act should be read to apply a traditional preponderance-of-the-evidence standard.