An Illinois doctor traded drugs for sex and cash. He just pleaded guilty.

By Washington Post

(WASHINGTON POST) – The first scheme that Constantino Perales ran involved some simple math. He’d provide a drug dealer with hundreds of oxycodone and Xanax pills and the man would pay the doctor $15 to $20 for every tablet he sold, according to federal prosecutors.

The second scheme was even simpler, if baser. Perales would write prescriptions for the drugs; in return, his drug-addicted patients would have sex with him, the prosecutors say.

Perales, of Peru, Ill., pleaded guilty Monday to conspiracy to possess a controlled substance with the intent to distribute, according to the U.S. Attorney’s Office in the Northern District of Illinois. The 66-year-old faces a maximum sentence of 20 years in prison and a $1 million fine when he is sentenced in March.

Perales flooded the Illinois Valley area with hundreds of opioid pills, authorities and addicts say. For the patients he had sex with and others, he prescribed drugs without so much as an examination.

“Today’s guilty plea ends a long and sad chapter in the Illinois Valley,” said Peru Police Chief Doug Bernabei, according to the La Salle News-Tribune. The department participated in a 2013 raid on Perales’s office.

“What is arguably one of the most egregious betrayals of trust conducted by this doctor, it certainly did not go unnoticed by local law enforcement and resulted in bringing justice on behalf of all the victims and their families,” Bernabei said.

Luke Tomsha, a recovering addict and the founder of the Perfectly Flawed Foundation, a nonprofit that seeks to help communities affected by substance abuse, told The Washington Post that Perales was well known among opioid addicts.

That section of central Illinois is not a major market for drug dealers, Tomsha said. To feed his addiction, he’d have to drive three hours to and from Chicago to get his fix.

Then Perales started making oxycodone pills — addicts called them “Blues” or “Blue 30s” — widely available. There was always a steady demand.

“There are a lot of people that were his patients,” Tomsha told The Post, saying that only a fraction of the amount was captured in the criminal case. Even Tomsha occasionally took “Blues” obtained via Perales’s prescriptions.

“The amount that he was giving was unreal,” Tomsha said. “If you didn’t have cash for the appointment, you’d go fill the prescription, then you’d come back and you’d give him half your prescription. He supplied a lot of drugs for a long time.”

Perales’s co-conspirator, Andrew Strandell, 36, of Sandwich, Ill., pleaded guilty to the same conspiracy charge. The court has not yet scheduled Strandell’s sentencing hearing.

According to the News-Tribune, Perales had intended to fight the charges but changed his mind when he saw the juror pool.

Shortly afterward, a reporter heard him telling his attorneys, “I want to take the plea.”

As The Washington Post’s Ariana Eunjung Cha wrote in 2016:

Opioid prescriptions alone have skyrocketed from 112 million in 1992 to nearly 249 million in 2015 … and America’s dependence on the drugs has reached crisis levels.

Millions are addicted to or abusing prescription painkillers such as OxyContin, Vicodin and Percocet. Statistics from the Centers for Disease Control and Prevention show that, from 1999 to 2014, more than 165,000 people died in the United States from prescription-opioid overdoses, which have contributed to a startling increase in early mortality among whites, particularly women — a devastating toll that has hit hardest in small towns and rural areas.

Courts have come down heavily on doctors who have used prescription pain pills to illegally enrich themselves or to manipulate addicted patients.

In March, Naga Thota was sentenced to two years in federal prison for what the San Diego Union-Tribune called a “quid pro quo situation in which he exchanged drugs, gifts and money for sex.”

Thota’s relationships followed a similar pattern, according to a news release from the U.S. Attorney’s Office in the Southern District of California. Thota and the women would exchange sexually explicit texts, then Thota would write prescriptions in exchange for sexual favors, the release said.

His victims told investigators that he switched them to more powerful painkillers, then increased the dosages — and their dependence on him as a supplier.

“Prescription drug abuse and overdoses have reached alarming levels,” U.S. Attorney Laura Duffy said in a news release announcing the charges against Thota last year. “We are going after doctors who abuse their power to prescribe and exploit the desperation of addicts for their own gratification.”

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