CINCINNATI — Tiffany Meadows had been addicted to drugs for most of her life when Dr. Saad Sakkal tried to prescribe her Xanax for depression and anxiety, she said Tuesday in court. She turned him down. Other patients didn't — and, according to prosecutors, became casualties of Sakkal's long-running pattern of overprescribing dangerous drugs to vulnerable people.
Meadows testified during the second day of trial in U.S. District Court for the Hamilton doctor, who stands accused of overprescribing pain pills and deadly drug combinations. Prosecutors have argued these habits led directly to at least two patients' deaths.
“He told me he could tell I was depressed and he could prescribe me something for the anxiety and depression,” Meadows testified of her first visit. “He tried to give me Xanax … I just refused it.”
But she accepted a methadone prescription from Sakkal and went back several times for refills. She later brought a friend to see Sakkal so that the friend could stop using street-level drugs and get a prescription for methadone instead, she testified.
They both smoked crack before the visit, according to Meadows. Sakkal examined the friend, gave her a drug urine screening, and then wrote her prescriptions for Xanax and methadone.
“We stopped by a couple of places in Hamilton, and nobody would fill them at all,” Meadows said.
Three pharmacists testified that they refused to fill Sakkal’s prescriptions because they contained dangerous drug combinations and high dosages of controlled substances, and they were often prescribed to patients who were doctor-shopping.
“A lot of times they’d come in, and we’d have 10 prescriptions that were sent over,” testified Libby Swanson-Barr, a pharmacist at Kroger in Hamilton. “We’d ask them, 'What are you taking this for?', and they were confused.”
Meadows testified that her friend, who is identified only as Patient 3 in court documents, filled the Xanax prescription first and then found a pharmacist to fill her methadone prescription weeks later.
She sounded excited when Meadows spoke to her that day.
“She wasn’t suicidal?” Assistant U.S. Attorney Tim Mangan asked.
“No,” Meadows said with a chuckle.
But she would be dead within an hour.
Defense attorney Richard Goldberg told jurors during opening statements that Sakkal wasn’t to blame for his patients’ deaths. They committed suicide, and the doctor couldn’t have stopped them, he said.
“Once she left Dr. Sakkal, he had no control over what she did … you can overdose on anything,” Goldberg said of 31-year-old Ashley Adkins, who died of an overdose in 2016.
A grand jury charged Sakkal with illegally prescribing pain medication that led to the overdose deaths of two patients: Adkins, of Middletown, and 51-year-old Lisa Anne Hawkey, of Hamilton. Each charge carries a mandatory minimum penalty of 20 years to life in prison.
His indictment also mentions six other patients who died in 2016 from drug use complications, including Meadows's friend. He is not charged in those deaths.
“He cared about his patients,” Goldberg told jurors. “He went to the funerals of two of his patients who passed away.”
Sakkal also faces 30 counts of illegal distribution of controlled substances and seven counts of using a nurse practitioner’s prescription pad to write prescriptions for his patients. Goldberg described those actions as honest mistakes.
“He was doing the best he could in a bad situation,” Goldberg said, who admitted his client ran a sloppy practice. “He was not trained to deal with addicts in pain.”
Sakkal, who practiced medicine for 46 years, claimed that he did not prescribe pain medicine to new patients who weren’t already taking the drugs, according to court testimony. However, Drug Enforcement Administration agent Rachel Tompkins testified that Sakkal did write prescriptions for opioids such as methadone and oxycodone to patients who had never taken them before.
The agent read aloud from Adkins’ medical records, stating that she arrived at Sakkal’s office slurring her speech, off-balance and apparently under the influence of drugs or alcohol.
An anonymous caller warned Sakkal’s office that Adkins was abusing her medicine and trying to sell it. Yet Sakkal still wrote her new prescriptions, Tompkins testified.
The trial is expected to last into next week.