In pursuit of accountability for the ongoing opioid crisis, the Department of Justice has enhanced its scrutiny of individual physicians who prescribe highly addictive and potentially lethal drugs.

To that end, federal prosecutors are using the Controlled Substances Act (CSA), the so-called drug dealer statute, to prosecute physicians alleged to have prescribed narcotics outside the professional standards of care—often referred to as “dirty doctors” running “pill mills.” Born from these prosecutions was a uniquely criminal question: can a physician be convicted of a crime in the absence of criminal intent?