Federal prosecutors say Dr. Paul Volkman was part of a scheme that illegally distributed millions of highly addictive pain pills that may have led to a dozen deaths. The doctor says he is innocent and was vigilant about conducting drug tests to make sure patients weren't abusing substances.
The trial, which begins Tuesday in Cincinnati, will focus on the allegations against Volkman, a 64-year-old Chicago doctor. But it's also drawing attention to the problem of prescription painkiller addiction in southern Ohio and across the state.
The Drug Enforcement Administration considers Scioto County, where Volkman allegedly distributed the pills, one of the worst places in the country for prescription painkiller abuse. Accidental drug overdoses, driven by an increase in painkiller addictions, have surpassed car accidents as the leading cause of accidental death in Ohio.
Volkman could face 20 years in prison if convicted.
A 2007 indictment alleges he went to work at the Tri-State Health Care and Pain Management clinic in Portsmouth in 2003. The clinic was operated by a mother and daughter who have since pleaded guilty to one count of operating Tri-State as a place whose primary purpose was the illegal distribution of prescription drugs.
Both Denise Huffman and her daughter, Alice Huffman Ball, could testify against Volkman at trial.
The government alleges that on June 23, 2003, Volkman prescribed oxycodone, hydrocodone and other drugs for a patient named Aaron Gillespie, who died four days later as a result of "multiple drug intoxication."
Prosecutors say that the following month, Huffman and Volkman opened a dispensary within the Tri-State clinic after local pharmacists refused to honor Volkman's prescriptions.
The government says at least 11 more people who received drugs prescribed by Volkman died as a result of those prescriptions over the next two years.
The indictment said patients came from hundreds of miles away and were charged $125 to $200 in cash for visits to see a doctor.
Prosecutors say Volkman rarely, if ever, counseled patients on alternative treatments for pain, such as physical therapy, surgery or addiction counseling.
"On multiple occasions, Volkman's dosages resulted in the addiction of said patients, overdoses and deaths," according to the indictment.
Volkman denies the allegations and says evidence will show he always acted in good faith.
He "has dismissed patients, refused patients, decreased medications, did not charge some patients, performed drug tests, saw a variety of patients, treated pain patients for a variety of ailments, and conducted physical exams when necessary," his attorney said in a court filing this month.
The government will have its work cut out for it, if another attempt at prosecuting prescription painkiller abuse is any indication.
Last year, federal prosecutors charged Columbus pharmacist Eugene Fletcher with nearly 200 counts of illegally disbursing prescription painkillers.
Prosecutors alleged Fletcher had conspired with Volkman, and DEA records show that Fletcher filled painkiller prescriptions in 2009 for two people who died of overdoses the next day.
Yet in the end, Fletcher pleaded guilty to just one count of illegally prescribing painkillers and faces a sentence of no more than two years.
Fletcher also pleaded guilty to filing a false tax return and hiding money by making cash deposits under a limit that triggers automatic bank review.
Ohio has tried to do more in recent years to address prescription painkiller abuse as the statistics have grown worse.
More than 1,300 people died from accidental drug overdoses in 2009 in Ohio, according to the most recent data from the Ohio Department of Health. The number of fatal overdoses has more than quadrupled from 1999, when the state recorded 327 accidental deaths, according to the department.
The numbers are particularly bad in Scioto County, where high unemployment rates and a profusion of so-called "pill mills" have led to growing addiction rates.
At least 117 people died of drug overdoses in the county between 2000 and 2008, according to county and state data. Rehab admissions in the region for prescription painkiller addictions were five times the national average in 2009.
Former Gov. Ted Strickland, who is from Scioto County, created a state task force that last fall recommended updating laws, increasing education and improving disposal of prescription drugs as ways to reduce painkiller abuse in Ohio.
Strickland's successor, Gov. John Kasich, has created his own task force and tapped a former state attorney general to lead its efforts. Kasich this month announced $100,000 in state money for a new halfway house and outpatient treatment facility at the private, nonprofit Counseling Center in Portsmouth.
Current Attorney General Mike DeWine has his own initiative led by a former prosecutor from Adams County, another southern Ohio area plagued by prescription painkiller abuse.