Psychiatrist and Addiction Specialist Pleads Guilty

United States District Court Judge David J. Hale sentenced Louisville physician Peter Steiner to 60 months’ imprisonment to be followed by three years of supervised release for knowingly and intentionally distributing and dispensing Schedule II, Schedule III and Schedule IV controlled substances without any legitimate medical purpose and outside the course of professional medical practice, announced Acting United States Attorney Michael A. Bennett.  There is no parole in the federal system.  Steiner was also ordered to forfeit $225,000.

Steiner admitted that he prescribed high dosages and large quantities of controlled substances, prescribed early refills for controlled substances, continued to prescribe controlled substances to patients even though he knew they were addicted, continued to prescribe controlled substances to patients even though he knew they tested negative for those substances, prescribed controlled substances in return for sexually graphic photos and videos, prescribed controlled substances that were contraindicated for patient medical concerns, prescribed controlled substances not typically associated with psychiatric complaints, and prescribed dangerous combinations of controlled substances.

Steiner, a psychiatrist and addiction specialist, isn’t charged in any of the deaths. However, he is charged with drug dealing, accused of recklessly keeping some vulnerable patients like Bozian on medicines that can be addictive and lethal.

A pharmacist who reviewed several patients’ files in 2014 found that “5 deaths were potentially related to negative outcomes of stimulants” that Steiner prescribed. That was two years before Bozian, who was prescribed Adderall, died of heart problems, according to a Courier Journal investigation.

Louisville Metro Police were investigating an unrelated 2013 crime when they learned troubling details about Steiner’s practice.

Uncovering what went on inside the doctor’s offices in Louisville and Lebanon, Kentucky, took investigators four years and included undercover agents, hidden recording devices, embedded criminal informants, police surveillance and extensive audits of medical and Medicaid records.

When federal agents surprised Steiner at his St. Matthews office in June 2017, they caught him tossing marijuana hidden in a McDonald’s bag into a trash can. The doctor also was clutching two thick envelopes filled with cash, checks and a list of patient names and amounts.

In February, a Jefferson County grand jury indicted Steiner on a charge of misdemeanor drug possession and felony tampering with physical evidence. A federal grand jury indicted the doctor in June on 26 counts, including conspiracy to distribute and unlawful distribution and dispensing of controlled substances beginning in 2014.

The latest indictments accuse Steiner of doling out potentially addictive opioids that weren’t needed. Investigators said he even prescribed fentanyl, a man-made drug commonly used by pain specialists or oncologists to ease severe pain for terminal cancer patients. Illicit fentanyl, much more deadly than heroin, is now Louisville and Kentucky’s No. 1 killer.

The Kentucky Board of Medical Licensure issued an emergency order in March barring Steiner from practicing medicine while the criminal case is pending, noting it had probable cause to believe Steiner “constitutes a danger to the health, welfare and safety of his patients or the general public.”

At least nine pharmacists in Louisville, Southern Indiana and Central Kentucky raised concerns about Steiner to investigators. The Courier Journal found pharmacists at additional stores who had stopped filling controlled-substance prescriptions from Steiner long before the federal charges and before the board suspended his medical license.
In a 44-page court document, an FBI agent detailed the death of Bozian and other patients, as well as those who felt at risk. The agent convinced a judge to issue a search warrant in June 2017 to inspect Steiner’s offices, computers and patient files.

Bozian and five more patients who died were over age 47 — some with serious health problems — and were prescribed stimulants. Those drugs are supposed to be used sparingly because they can elevate blood pressure, speed up the heart rate and contribute to strokes, heart attacks or lethal heart-related illnesses.

Eight other patients who died between March 2015 and January 2017 suffered accidental drug overdoses or poisonings.

Several patients or their loved ones disclosed their fears that Steiner’s care could be lethal, according to the federal document filed in June 2017.

One patient told investigators last spring that Steiner prescribed so much medication, he or she would be dead if not for illegally selling the surplus on the streets.

A mother of one of Steiner’s patients claimed her adult child overdosed three times on drugs prescribed by Steiner in February 2015, November 2016 and January 2017.

Investigators discovered Steiner prescribed that patient 510 pills — filled in two months at three pharmacies in three cities, including 300 pills the month of the patient’s third overdose.

The mother agreed to hide a recorder as she met with Steiner inside his office at 6500 Glenridge Park Place to complain that her child suffered a third overdose and was taking too many of the prescribed medications. Yet a few weeks later, agents said Steiner essentially doubled the patient’s daily dose of benzodiazepine or “benzos” with 120 alprazolam pills and 90 amphetamines, as three investigators secretly conducted surveillance.

Indiana pharmacists at Westmoreland Pharmacy in New Albany and Jeffersonville made it a company policy to stop filling Steiner’s controlled-substance prescriptions because of their concerns about the dosage and duration of drugs prescribed by Steiner, as well as the doctor’s unavailability.

Also, nine other pharmacists in Louisville, Southern Indiana and Central Kentucky detailed concerns about Steiner to investigators last year, including Kroger on Buechel Bypass, Rite Aid stores on Preston Highway and Bardstown Road, CVS Pharmacy on Antle Drive and Walgreens Pharmacy on Baxter Avenue.

“We’re kinda the gatekeepers,” said Burks, the pharmacist who refused to fill Bozian’s Adderall prescription.
Concerns about Steiner date back nearly a decade, the Courier Journal has learned.

In 2009, a state medical board inquiry panel opened an investigation of Steiner due to concerns about controlled-substance prescribing and deficient medical record keeping, according to a sworn statement from an FBI agent.

A physician consultant reviewed a random sample of Steiner’s patient charts, resulting in a recommendation that the doctor receive additional training.

Steiner agreed, completing training in Nashville, Tennessee, and Denver. The investigation was then terminated in December 2010 without any board action against him.

A few years later, the doctor hit Louisville Metro Police’s radar. Police sought help from pharmacist Carrie Gentry, who noticed several problems while reviewing a private state database listing Steiner’s prescriptions.

Gentry, a consultant with the state’s Office of Inspector General — which regulates health care facilities — noted several drug-related deaths of Steiner’s patients in her 2014 report. That’s two years before Bozian’s death.