The opioid epidemic in this country has destroyed countless lives. One response has been an array of civil and criminal actions seeking to hold medical professionals accountable for sowing addiction (and, ultimately, deaths). Courts are divided, however, on the proper legal standard for imposing criminal penalties. In Ruan v. United States, the U.S. Supreme Court will decide whether a jury should consider a doctor’s subjective intent when assessing a potential violation of the Controlled Substances Act.

The CSA provides that, “except as authorized by this subchapter, it shall be unlawful for any person knowingly or intentionally” to distribute controlled substances. Physicians are exempt under the CSA if they prescribe controlled substances for a “legitimate medical purpose … in the usual course of their professional practice.”