If Jamie Chiles Cordes sold on the street the opiates she put in the hands of addicts, she would have been staring down as many as nine years behind bars Friday.
But because she wore a medical coat and used prescriptions to deal drugs, she walked away instead with 54 months.
The disparity was not lost on U.S. District Judge Pamela Reeves at Friday's sentencing hearing in U.S. District Court for former nurse practitioner Cordes but neither, she said, was the reason behind it.
Cordes was a freshly-minted licensed nurse practitioner when she took a job at Breakthrough Pain Therapy Center in Maryville in November 2009. It was good money, and her attorney, David Eldridge, said this married mother needed it. She was paid between $500 and $800 per shift. The clinic was owned by drug-dealing addicts, and its clientele were people addicted to opiates. The sole purpose of the clinic was to put cash in the owner's hands, and drugs in the addicts' hands.
She wrote a lot of them in just a matter of months - more than 2,000 addicts and more than 6,800 prescriptions - without examining a single patient.
"There is no question in the court's mind this was a serious offense," Reeves said.
But Eldridge and attorney Loretta Cravens argued Cordes, like many medical professionals who were creating the opiate addiction epidemic two decades ago and then feeding it for years, didn't know how addictive and deadly prescription painkillers were and took her training cues from a more experienced doctor at the clinic - Dr. Deborah Gayle Thomas.
Assistant U.S. Attorney Frank Dale scoffed at the idea that Cordes did not know she was acting as nothing more than a drug dealer and insisted she should be treated as one. The penalty range for a garden-variety drug dealer with the same plea terms as those granted Cordes was 87 months to nine years.
"She knew about these drugs," Dale said. "She knew the horrors that were associated with addiction."
Reeves said the entirety of the circumstances in Cordes' case make her an anomaly among drug dealers unlikely to continue a life of crime. She's been stripped of her license but found and kept work since the clinic was raided and shut down in late 2010, the judge noted. The judge also said she believes the medical profession is finally on notice that if they keep acting like drug dealers, they will be treated as such.
"You were willfully blind to the fact medical protocols were not being followed," Reeves told Cordes. "It is still important for medical professionals to understand they cannot willfully ignore their ethical obligations."
Reeves essentially cut Cordes' sentence in half from the maximum term favored by the government.
She is the second medical professional tied to Breakthrough to be sentenced. Dr. James Brian Joyner was sentenced late last year to 70 months. Six other medical professionals, including Thomas, await sentencing.
The case marked the first time federal prosecutors took direct aim at the medical staff of pain clinics shut down as pill mills.
The case also has exposed a disparity in potential punishment for opiate dealers compared to those who peddle typical street drugs, such as cocaine and methamphetamine. Drug conspiracies involving street drugs carry minimum mandatory sentencing, ranging from a minimum of 10 years to life. Congress has refused so far to set similar minimum mandatory sentencing guidelines for opiate dealers.
A dealer caught in a conspiracy involving 1,000 kilograms of pot walks into court facing a 10-year sentence. A cocaine dealer who peddles five kilograms also faces a 10-year sentence.
Cordes put in the hands of opiate addicts the equivalent of 17,422 kilograms of marijuana, according to court records.
She is being allowed to report on her own to prison. She has been free under court conditions since she was indicted in 2014 with no problems, Reeves noted.