Support Dr. Merideth Norris in Her Fight for Justice

Subject: Urgent Appeal: Support Our Beloved Dr. Merideth Norris in Her Fight for Justice

Fundraiser team: Brian Kaufman (husband of Merideth Norris DO). These are my own words and only I am responsible for this posting. Merideth Norris had no part in creation, or posting.

Our Short Story:

Dear Friends, Colleagues, and Supporters,

I am reaching out to you today with an urgent appeal. Dr. Merideth Norris, my wife and a dedicated and compassionate physician who has served Maine’s medical community for over 20 years, was arrested by the Department of Justice (DOJ) in October 2022 for prescribing controlled medications. Their investigation was largely triggered by Walmart, which was then negotiating a $3.1 billion settlement over opioids and so had employed a data-mining algorithm to identify doctors prescribing opiods for pain management—a system that applied a ‘central block’ to Merideth’s patients' prescriptions (including diabetes medication) and sent a report to DEA reporting her as an outlier.

As one of the few local providers still willing to write controlled meds for chronic pain, Dr. Norris had accumulated many patients from local providers who had either stopped prescribing, retired, or simply wanted to off-load their more complex and challenging patients to another provider. In this she was indeed an outlier, as few in the state continue to provide medical care to this population.

The Walmart block led to an investigation by the State Licensing Board, composed of a panel of doctors and physician assistants who deemed Merideth's medical care to be without issues, and in fact, specifically thanked her for her service with this difficult population, whose access to medical care was limited by the pandemic and a general lack of resources. Two weeks later the DEA/FBI and DOJ raided her office and arrested her.

After the arrest on October 26, 2022, she continued to see patients at Graceful Recovery, her office in Kennebunk Maine. The state never revoked her license, insurance companies continued to maintain her on their panels, pharmacies (Walmart aside) continued to fill her prescriptions. (And in fact, CVS, Walgreens and all the other pharmacies fill meds for her patients to this day.)

Merideth did have to resign as medical director of a methadone treatment facility, as director of an Intensive Outpatient addiction treatment program (IOP), and stop practicing addiction medicine, pain management, and many other types of medicine in her private office due to agreeing to stop prescribing any controlled meds (everything from certain mental health meds, hormone prescriptions, etc).

For many months, I assumed that this was a mistake that would be rectified as the investigation continued and felt confident that the government would conclude that there was no harm and this as simply an issue of numbers-driven overreach once they understood the appropriate clinical context. Even U.S. District Judge Nancy Torresen agreed that that investigators acted “with a reckless disregard for the truth.”

Nonetheless, the government pursued its case and tried her this past June. And on June 21st, the jury found her guilty of 15 out of 16 counts of "prescribing controlled medications without a legitimate purpose." Each count represented a single prescription, even a refill. These serious criminal charges refer to 16 separate prescriptions out of the hundreds written in the course of normal medical practice.

I strongly believe this is a case of misguided governmental overreach and the criminalization of medical decision-making. While I assume the jury did their best, and the judge was extremely professional and fair, I firmly believe the jury got it wrong. Dr. Norris acted appropriately and responsibly, providing evidence-based treatment, in good faith for her patients' complex cases at all times.

Dr. Merideth Norris is not only a devoted physician but also a loving mother, spouse, sister, aunt, and friend and is active in her local church and engages in many social programs to help those in need. In short, Merideth always was, and remains a “do-gooder.” She has been a staunch advocate for addiction treatment, harm reduction (the evidence-based treatment for substance use disorder) and has always gone the extra mile for her patients, who include some of the most marginalized people in our community and state. These are the patients’ other doctors often dismiss, and the ones who most need our compassion and help. She considers it her mission to help those who could not help themselves.

I extend my deepest gratitude to our community of friends and colleagues who have spoken out, provided testimony, and advocated for Dr. Norris. Your support has been invaluable during this strenuous time.

Now, she and our family are in serious financial need. We have raised about $12,000 previously through a fundraiser set up by a friend but have spent well over 100,000 dollars of our own, and still owe over $100,000. I am reaching out to the world to seek help so I can continue to fight on her behalf.

The Bigger Picture

Few healthcare professionals are willing and able to treat patients with controlled medications these days, especially patients who have both chronic pain and substance-use disorder. Dr. Norris is one of the few who specializes in treating both conditions, along with the mental health issues that accompany them. This rare skillset made her a referral source of choice for many area physicians, as well as for pain clinics at the local hospital system. This, in turn, made her an outlier in the number of patients receiving prescriptions through her office, and, subsequently, a target for the DOJ.

Due in part to today's climate of fear around opioids themselves and of this population, her patients would occasionally experience pushback when filling prescriptions. Walmart, who recently agreed to a $3.1 billion settlement over its own opiate policy, decreased its risk tolerance and began data mining the numbers controlled med prescriptions, a largely automated process that placed the initial corporate block on prescriptions from Dr. Norris, attempted a discourse and appeal to explain the current conditions in Maine to no avail. This corporate decision in part led to the arrest.

After the arrest, I was sure that the DOJ would realize they made a mistake, and a correction would be made resulting in the case being dropped. I contacted legislators, my professional organizations, and spoke to many around the country, but were repeatedly told that these organizations would not get involved in an individual case.

I later found out, this has been a systematic approach of the DOJ to arrest doctors who utilize opioids to treat chronic pain and this has largely been successful in creating fear around prescribing and caring for this population. Patient advocacy groups have been vocal in working on behalf of chronic pain patients to increase access to care however few of the medical organizations have been vocal in working to protect physicians, with the exception of the AMA, who has been increasingly vocal regarding keeping medical decisions in the ‘house of medicine.’

The government’s case was based on Dr. Norris prescribing controlled medications for pain management to a complex patient group with chronic pain, mental health issues, and addiction. No harm was demonstrated, and no benefit to Dr. Norris was demonstrated, yet the government claimed the possibility of future harm. They argued that these medical decisions were illegal despite that all the evidence shows good faith in her actions.

If you still feel like you must be missing something here, you're not alone. Despite the medical communities’ statements opposing the criminalization of medical decision making, despite the CDC revising its guidelines to stress flexibility in treating chronic pain and substance-use disorder and moving away from a ‘data driven approach’ to treatment, and despite a Supreme Court ruling (in Ruan and Kahn vs. US) that overturned the convictions of doctors with similar charges— declaring that they should not be convicted for decisions made in good faith—the DOJ formed a new strike force in 2022 to pursue doctors and Merideth was its first and most public arrest.

Like most of our professional colleagues, I am aware that the genuinely nefarious and headline-grabbing activity in this arena—"pill mills" and other drug-profiteering medical providers—occurred in the past, prior to all of the safeguards that are now in place. As a physician, I sometimes disagree with decisions from other healthcare providers, but I mostly see this as different treatment styles, risk tolerances, etc. I can still believe they make their decisions in good faith and with their patients' best care in mind. Treating this population is challenging, requiring a high degree of specialization and expertise. Dr. Norris made her decisions with the best intentions, drawing on years of knowledge and experience and has 3 board certifications that help inform her treatment decisions.

The regulation of doctors should be managed by healthcare professionals who understand the complexities of medicine and healthcare. Earlier that same year, the Maine state osteopathic licensing board, composed of medical professionals who live and practice in Maine, performed a thorough investigation and sent a letter on October 12th 2022 that concluded her medical care was appropriate and in an unusual move, thanked her Dr. Norris's for caring for this population. Despite this, on October 26, 2022, her office was raided and she was led away in handcuffs and leg-irons. They spent 3 hours searching her office but there were no bundles of cash, no buckets of illicit meds and no contraband of any kind found. Just a simple and modest office for routine patient care.

This situation is not just a personal tragedy for our family but also a threat to the ability of doctors to provide necessary care without fear of persecution. Criminalizing medical decision-making undermines the trust between patients and doctors and jeopardizes the quality of healthcare, particularly for the disenfranchised population Dr. Norris has dedicated her career to helping.

Dr. Norris has always prioritized her patients' well-being, tirelessly providing the best medical care possible. She has worked with some of society’s most marginalized members, despite an increasingly hostile environment for physicians who are willing to provide chronic pain management and addiction recovery treatment at all. Now, with her career and liberty at stake, she needs your help to fight this unjust charge and continue her mission.

The overdose crisis is a complex issue, often misunderstood. While the number of fatal overdoses from prescription opioids is substantial, most involve illicit fentanyl rather than medications prescribed by doctors. Dr. Norris's approach, based on harm reduction strategies, aims to make the least risky decision from a range of risky options. This nuanced understanding was lost on those reviewing her decisions retrospectively.

The DOJ’s continued pursuit of doctors, even those practicing within state laws and established medical principles, harms the medical community and their patients. The focus should be on combating illegal drug trafficking rather than criminalizing medical professionals.

This continues to be a true ordeal for her friends and family. This tragedy has left a void in our lives, and an emotional toll we're only beginning to realize now. We're doing our best to maintain stability as we all go through this, and Merideth will always have our unwavering support. But the particular conviction we all share—family, friends, doctors, other medical professionals—is that she didn't actually do anything wrong. Seeing her go through this unjust legal battle is heart-wrenching.

I am committed to supporting her through this, but I need your help to cover the significant legal fees, which have already exceeded $100,000. So, have turned to the community for support. Every donation, no matter how small, brings us one step closer to ensuring we survive this ordeal.

Dr. Norris has always been there for her patients, providing compassionate care even in the most challenging circumstances. Now, she needs your support. By coming together, we can help Dr. Norris fight this battle and continue her essential work in our community.

Please join me in supporting Dr. Merideth Norris during this critical time. Your generosity and advocacy can make a profound difference in her fight for justice.

Thank you for your support.

With heartfelt gratitude,

Brian Kaufman (husband of Dr. Merideth Norris)