What Happened
Thomas Strick, a family practice physician employed by Aspirus Health Care in Wausau, Wisconsin, pleaded guilty to obtaining fentanyl by misrepresentation and fraud after using his own patients to feed his opioid use.
Strick worked at Aspirus Wausau Hospital and the Aspirus Wausau Family Clinic. Rather than diverting from a dispensing cabinet, he prescribed fentanyl patches to patients without a legitimate medical need, then instructed those patients to fill the prescriptions and hand the patches back to him for his personal use. A DEA review of Strick's patient prescribing records, covering 2011 through 2018, identified more than 100 suspected fraudulent diversions of fentanyl patches.
On July 18, 2019, Strick pleaded guilty in the Western District of Wisconsin to five counts of obtaining a controlled substance by fraud, facing a maximum of four years in prison, with sentencing scheduled for that October.
What Went Wrong
- Prescribing patterns went unreviewed. A single physician generated more than 100 suspected fraudulent fentanyl-patch prescriptions over several years without an internal audit flagging the pattern.
- Patients were used as an unwitting diversion channel. Because the drugs were dispensed through a pharmacy on legitimate-looking prescriptions, standard hospital-based dispensing controls never applied.
- No cross-check existed between prescribing volume and any documented clinical indication for repeat fentanyl patch prescriptions from the same practice.
How It Could Have Been Prevented
- Run periodic peer-comparison audits of individual prescribers' controlled-substance prescribing volume against clinical documentation and specialty norms.
- Flag repeat high-potency opioid prescriptions, such as fentanyl patches, that lack a documented pain-management diagnosis or treatment plan.
- Cross-reference prescribing data with the state prescription drug monitoring program to identify patients who are filling but never appear to be using their own prescriptions.
- Encourage pharmacy staff and clinic colleagues to report prescribing patterns that don't match a patient's presentation or history.
Related Guidance
- 15 Red Flags of Drug Diversion — Prescribing-based diversion indicators for hospital and clinic staff.
- Hospital Diversion Prevention Checklist — Self-assessment for hospital-affiliated prescribing oversight.
- Regulatory Guide — Prescriber monitoring obligations under the Controlled Substances Act.
- Diversion Case Registry — Related cases of physician self-diversion through prescribing.