Doctor Convicted of Illegal Opioid Prescribing Imprisoned Before Sentencing

By Pat Anson, PNN Editor

A Louisiana doctor who federal prosecutors labeled as a "drug dealer in a white coat" has been taken into custody, weeks before he was scheduled to be sentenced for improperly prescribing opioid pain medication.

A jury found Randy Lamartiniere guilty last month on 20 counts of illegally distributing controlled substances outside the usual course of a medical practice. The 64-year old doctor was out on bail and scheduled for sentencing on March 30, but prosecutors wanted him taken into custody immediately after his conviction. A judge denied their motion, pending another court hearing on Tuesday, January 17.

“Needless to say this hearing is about as scary as it gets as I may or may not be taken into custody then. Kind of impossible to prepare for being incarcerated for 5-10 years in this situation,” Lamartiniere posted on his Facebook account prior to the hearing.

“There is no justification for pre-sentencing incarceration of course. I have an excellent chance of an appeal and a new trial and am hoping to stay out of prison altogether. Could use some support and kind thoughts at this extremely trying time. I’m more anxious about this than prior to my trial.”

Lamartiniere’s fears were justified, as the judge reversed his previous decision and had him taken into custody. According to Lamartiniere’s sister, he is now in a crowded holding cell with 18 other men, awaiting transfer to another facility.

Lamartiniere faces up to 400 years in prison when he’s sentenced in March – 20 years for each count – but is likely to get less under federal sentencing guidelines. It’s also possible he could be freed on bail again, pending his appeal.

Lamartiniere’s legal troubles date back several years. The Louisiana State Board of Medical Examiners issued an emergency order in 2015 suspending his license to prescribe opioids and other controlled substances. Despite the suspension, Lamartiniere kept writing “medically unnecessary prescriptions,” according to prosecutors, charging patients $100 to $300 per visit and taking payments only in cash. Baton Rouge police arrested him in 2016, but legal delays prevented his trial until last year.

As he awaited trial, Lamartiniere became active in the pain community, giving advice and encouragement to patients unable to find good pain care. Beau Brindley, Lamartiniere’s defense attorney, told jurors during closing arguments that he prescribed drugs in “good faith” to people he believed were in real pain.

“Taking the patient at face value is not a crime,” Brindley said, according to The Advocate. “He was an old-school doctor trying to manage patients in a new age world. … He was trying, and trying makes him not guilty. There is no way to prove that he was not making an honest effort.”

That “honest effort” will form the basis of Lamartiniere’s appeal, which is based in part on a recent U.S. Supreme Court decision in favor of two doctors who were also convicted of overprescribing opioids. Writing for the majority in that case, Justice Stephen Breyer said it was up to prosecutors to prove that doctors “knowingly or intentionally acted in an unauthorized manner" under the Controlled Substance Act.

So far the high court’s decision has had a mixed impact on other doctors in similar situations. Earlier this month, Dr. Lesley Pompy was acquitted by a Michigan jury of charges that he illegally distributed opioids and committed health care fraud. The charges stemmed from an investigation of Pompy that began in 2016.

More recently, the DEA suspended the license of Dr. David Bockoff, a California physician who was treating patients with severe pain conditions who required high-dose opioids. At least three people have died as a result of that suspension. Bockoff is currently appealing the DEA’s suspension.