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PORTLAND – A Federal Bureau of Investigation affidavit written to support a search warrant for the business premises of Kennebunk physician Merideth Norris on Oct. 25 said a review of Medicare information shows Norris is in the 99th percentile among all prescribers in the country for total MMEs, which are values used to represent the potency of an opioid drug. In Maine, she has the highest MME prescribing rate per patient, according to the affidavit.

Norris, 52, is facing 10 federal drug charges alleging she illegally distributed opioids and other federally regulated substances. A federal Grand Jury handed up the indictments on Oct. 20. Norris, who operates Graceful Recovery on Portland Road, was the first to be arrested and charged by the New England Prescription Opioid Strike Force, an entity launched in the summer of 2022 to combat unlawful prescribing amid the continuing opioid epidemic.

Norris  is registered with the U.S. Drug Enforcement  Administration to prescribe controlled substances and is authorized under the U.S. Drug Addiction Treatment Act of 2020 to treat up to 275 patients for
addiction treatment according to the affidavit.

The federal indictment charges allege Norris routinely prescribed controlled substances “to her patients and other individuals, outside the usual course of professional practice, without a legitimate medical purpose.”

Written by FBI special agent Dale Wengler, the affidavit was unsealed on Feb 22.

Norris is represented by attorney Amy Fairfield, among others. Fairfield did not respond to a telephone request for comment or a follow-up message on Monday, Feb 27. Attempts to reach Tim Zerillo, another of Norris’ attorneys, were unsuccessful.

The affidavit noted that due to her overall prescribing practices, Walmart “centrally blocked’ Norris as of November 2021, ensuring that Walmart’s pharmacy locations were prohibited from filling prescriptions written by her.

According to Wengler, Walmart performed an analysis of Norris’ prescribing practices between October 2020 and October 2021. During those 12 months, her top-prescribed drugs were methadone, suboxone, and oxycodone. As part of that investigation, Walmart identified a number of “red flags” in her prescription practices, including evidence of “pharmacy shopping” by patients traveling to multiple pharmacies to fill prescriptions; the total number of percentage of controlled substances prescribed; patients insisting on paying for refills in cash; unusually large quantity or high starting doses for the prescription, and providing the same diagnosis for a majority of her patients.

According to guidance from the CDC, to minimize the risk of potential overdose, medical professionals prescribing opioids should use a threshold prescription rate of 90 MME for safely prescribing opioids. According to Walmart’s investigation, Norris prescribed the average patient approximately 174 MMEs per day, Wengler wrote in the affidavit.

In June, the Maine Board of Osteopathic Licensure reviewed five patient records from Norris’s office and determined that thee of the five patients were on high doses of methadone, with two on benzodiazepines, without any plan to taper those medications, as part of her treatment of their drug dependency.

As part of the investigation, the federal government consulted a professor of pharmacy practice and science at Ohio State University, Donald Sullivan, who alleged that Norris wrote “thousands of prescriptions for narcotic pain killers benzodiazepines, and stimulants that were not for a legitimate medical purpose.” In the affidavit Sullivan is said to have determined that Norris’s prescriptions exceed U.S Centers for Disease Control guidance of 90 MMEs per day and Maine’s 100 MME per day – with many patients prescribed more than 300 MMEs, “with a few over 1,000 MMEs.” One patient was prescribed both methadone and hydromorphone with a total MME of 1,200-1,360, placing the patient “at imminent risk for an overdose,” according to the affidavit. Another patient was prescribed three narcotic painkillers including what Sullivan described as “the highest ever dose of hydromorphone,” with a total MME of 1,664.

According to the affidavit, Sullivan noted most prescriptions are for about four weeks or a month of medication. He noted Norris frequently wrote prescriptions for between 7-15 days.

The affidavit detailed an investigation a consultant performed on behalf of the federal Center for Medicare and Medicaid Services contained several findings, including that Norris prescribed high-dose, short-acting opioids to patients with severe opioid-use disorders, which it said is contraindicated.

Another expert, Dr. Shonali Saha, was retained by the government to review patient files and noted that in one case, a patient was prescribed a three-drug combination of methadone, hydromorphone, and diazepam with a total MME of 1,280 per day. The patient was diagnosed with hepatitis C which affected her liver function and ability to clear the medication. The patient also tested positive for cocaine, which the affidavit noted was not addressed in the patient file, and the prescription continued.

The affidavit goes on to outline a number of other allegations.

The affidavit alleges that between January 2018 and June 2022, an estimated 22 of Morris’ Medicaid patients died and that nine of her Medicare patients died. “… the data revealed that Norris prescribed controlled substances to multiple patients who died of overdoses within 45 days of receiving a controlled substance prescription from Norris,” Wengler wrote in the affidavit.

Norris’s medical license to practice in Maine remains active, according to the state website on Tuesday, Feb. 28.

She remains free on $10,000 unsecured bond and is prohibited from prescribing certain controlled substances.

If convicted of illegal distribution, Norris faces a maximum penalty of 20 years in federal prison and a $1 million fine on the most serious counts. She faces up to five years in federal prison and a $250,000 fine if convicted on the other charges.

All defendants are presumed innocent until proven guilty beyond a reasonable doubt in a court of law.

The case is currently scheduled for the May trial list.