Former Physician Sentenced to 20 Years in Pill Mill Case

Alicia Ault

March 04, 2022

A former pain medicine physician received a sentence of 20 years in prison for selling opioids and writing prescriptions for patients who were abusing or diverting the medications.

Patrick Titus, 58, operated Lighthouse Internal Medicine in Milford, Delaware, from 2005 to 2014.

Federal prosecutors said Titus unlawfully distributed or dispensed opioids including fentanyl, morphine, methadone, OxyContin, and oxycodone outside the scope of practice and often prescribed them in combination with each other or in other dangerous combinations. Titus distributed over 1 million pills, said the government.

In a 2018 indictment, the government said that Titus would, "at the first and nearly every follow-up visit" prescribe opioids in high dosages, often without conducting an exam or reviewing any urine test results. He would also write prescriptions for opioids without getting patients' prior medical records or reviewing test results and rarely referred patients to alternative pain treatments such as physical therapy, psychotherapy, or massage.

According to the indictment, he ignored "red flags," including that patients would come from long distances, sometimes from out of state, and would pay cash, despite having Medicaid coverage.

"Today's sentencing makes clear that medical professionals who recklessly prescribe opioids and endanger the safety and health of patients will be held accountable," said Anne Milgram, a Drug Enforcement Administration (DEA) administrator, in a statement.

"This sentence is a reminder that the Department of Justice will hold accountable those doctors who are illegitimately prescribing opioids and fueling the country's opioid crisis," said Assistant Attorney General Kenneth A. Polite Jr, of the Justice Department's Criminal Division, in the same statement. "Doctors who commit these unlawful acts exploit their roles as stewards of their patients' care for their own profit," he added.

The sentence follows Titus' 2-week jury trial in 2021, when he was convicted of 13 counts of unlawful distribution and dispensing of controlled substances and one count of maintaining his practice primarily as a location to sell drugs. Titus faced a maximum of 20 years per count.

At the time of his conviction, Titus' attorney said he planned to appeal, according to Delaware Online.

Delaware suspended Titus' registration to prescribe controlled substances for 1 year in 2011. At the time, the state said it had determined that his continued prescribing "poses and [SIC] imminent danger to the public health or safety."

The state found that from January to November 2011, Titus issued 3941 prescriptions for almost 750,000 pills for 17 different controlled substances, all sent to a single pharmacy.

The state also alleged that he wrote prescriptions for controlled substances to patients with felony convictions for drug trafficking, and to at least one patient who his staff told him was selling the opioid that Titus had prescribed. It later determined that Titus continued prescribing even after it had suspended his DEA registration.

According to a 2014 consent agreement, the state subsequently ordered another 1-year suspension of his DEA registration, to be followed by a 3-year probation period.

Meanwhile, the same year, the state Board of Medical Licensure put Titus' medical license on probation for 2 years and ordered him to complete 15 continuing medical education credits in medical record keeping, ethics, how to detect diversion and abuse, and in some other areas, and to pay a $7500 fine.

In 2016, the medical board revoked Titus' license, after finding that he continued to prescribe pain medications to patients he did not screen or monitor and for a multitude of other infractions.

Alicia Ault is a Lutherville, Maryland-based freelance journalist whose work has appeared in publications including JAMA,, The New York Times, and The Washington Post. You can find her on Twitter: @aliciaault.

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