A Gulf Shores psychiatric physician is facing federal drug charges after agents executed a search warrant on his offices, according to court records unsealed this week. Dr. James Henry Edwards, who has practiced medicine in Montgomery, Fairhope, Gulf Shores and Opelika over the past decade, is accused of prescribing large quantities of anti-anxiety and stimulant medications to patients without properly evaluating or monitoring their conditions.
Edwards operates a practice called Analytic Options, which opened in Montgomery in 2010 before expanding in 2017 to a second location in Opelika and to an office at 229 E. 20th Ave. in Gulf Shores. Before establishing that practice, records show Edwards also saw patients at East Bay Psychiatry Practice in Fairhope as recently as February 2017.
Court documents show Edwards has been under scrutiny from state regulators for several years. In 2017, the Alabama Board of Medical Examiners opened an investigation into his prescribing practices and subpoenaed 12 patient files. An independent reviewer who examined those records for the board concluded that 11 of the 12 patients had been prescribed excessive doses of stimulant medications, and found that documentation across all 12 files was either inadequate or incomplete.
Investigators noted that in 10 of the 12 files reviewed, Edwards had prescribed two medications from the same drug class to treat a single condition. In eight of the 12 cases, patients were found to have received what reviewers described as hazardously high dosages.
The Board of Medical Examiners reached a settlement agreement with Edwards in January 2019. Under that agreement, Edwards was permitted to deny any history of excessive prescribing, but he agreed to abide by certain restrictions on his practice and to follow standard treatment protocols going forward.
According to the newly unsealed affidavit, the board received a fresh complaint about three months after that settlement, this time from the mother of a patient in the Auburn area. The woman told investigators her 29-year-old son died by suicide amid an addiction to Xanax that he had obtained through prescriptions written by Edwards. The affidavit states that other physicians who saw the young man had raised concerns about the high dosages he was receiving, but he kept returning to Edwards because of his dependency on the medication.
A Drug Enforcement Administration agent working the case also interviewed a couple who were dating and had both sought treatment from Edwards for anxiety and panic attacks. Both told investigators they had disclosed prior struggles with addiction, or reservations about taking Xanax, before Edwards prescribed it to them regardless. According to the affidavit, one of the two patients was prescribed 60 tablets of 2-milligram Xanax after a roughly 15-minute consultation, with instructions to take one tablet twice a day.
Investigators say the patient instead took 50 of the pills within three days, resulting in an overdose that required three days of hospitalization in an intensive care unit. After being released from the hospital, she called Edwards to inform him of the overdose and told him she would not continue as his patient. Shortly after that call, according to the affidavit, she received a text message from a Publix pharmacy notifying her that a prescription for Valium was ready for pickup. When she contacted the pharmacy to ask about it, a pharmacist reportedly told her that Edwards had called in the prescription himself.
The affidavit also describes interviews the DEA agent conducted with several pharmacists in the Auburn and Gulf Shores areas, who said they had voiced concerns internally about the volume and dosage of medications Edwards was prescribing. Investigators additionally cited a number of anonymous online reviews from people identifying themselves as patients who described similar experiences with his practice.
Court records show the search warrant on Edwards’ office was carried out July 11. Six days later, a federal grand jury in the Middle District of Alabama returned an indictment charging him with three counts of unlawful distribution of a controlled substance. The affidavit further suggests that if his prescriptions and office visits are ultimately found to have been illegitimate, Edwards could bear responsibility for more than $2.5 million in Medicare and Medicaid reimbursements paid to pharmacies, along with more than $500,000 in Medicare and Medicaid reimbursements for medical services.
Edwards is the latest in a series of physicians in the region to face federal scrutiny over so-called “pill mill” operations. The most prominent case to date involved former Mobile physicians John Patrick Couch and Xiulu Ruan, whose practice, Physicians Pain Specialists of Alabama, was accused of prescribing massive quantities of opioids, including fentanyl, oxymorphone, oxycodone, hydromorphone and morphine, well beyond any accepted medical standard. The pair was convicted in 2017 on 19 federal counts, including conspiracy to distribute controlled substances, health care fraud, violations of anti-kickback statutes and violations of the Racketeer Influenced and Corrupt Organizations Act. Couch was ultimately sentenced to 20 years in prison and Ruan to 21 years, and both were ordered to forfeit homes, vehicles and other property in addition to paying substantial restitution.
In a separate case in 2018, former neurologist Rassan M. Tarabein, who ran the Eastern Shore Neurology and Pain Center in Daphne, was sentenced to five years in prison after pleading guilty to health care fraud and unlawful distribution of a schedule II controlled substance. He was ordered to pay more than $15 million in restitution to six different health care benefit programs, including Medicare and the Alabama Medicaid Agency.
Not every local case involving prescribing practices has ended in conviction. Fairhope internist Dr. Richard Snellgrove was indicted on 13 criminal charges in October 2016, roughly two months after former Three Doors Down guitarist Matthew Roberts died of an overdose in a Wisconsin hotel room after allegedly taking opioids Snellgrove had prescribed. Following a trial in May 2018, a jury acquitted Snellgrove of all charges. His attorney argued at the time that the allegations against his client bore little resemblance to those in the Ruan case.
The case against Edwards remains active, and additional developments are expected as the prosecution moves forward.