United States v. Moore, 423 U.S. 122 (1975). · Go Syfert
United States v. Moore, 423 U.S. 122 (1975). Cases Citing This Book View Copy Cite
1,335 citation events (761 in the last 25 years) across 67 distinct courts.
Strongest positive: United States v. Simon (ca1, 2021-08-25)
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discussed Cited as authority (verbatim quote) United States v. Simon
1st Cir. · 2021 · quote attribution · 1 verbatim quote · confidence high
he statute applies to a pharmacist's (or physician's) drug-dispensing activities so long as they fall outside the usual course of - 27 - professional practice.
discussed Cited as authority (verbatim quote) United States v. Khan
10th Cir. · 2021 · signal: see · quote attribution · 1 verbatim quote · confidence high
but the scheme of the , viewed against the background of the legislative history, reveals an intent to limit a registered physician's dispensing authority to the course of his 'professional practice.
discussed Cited as authority (verbatim quote) United States v. Chia Lee (2×) also: Cited as authority (rule)
5th Cir. · 2020 · signal: cf. · quote attribution · 1 verbatim quote · confidence high
did not regulate the dosage at all, prescribing as much and as frequently as the patient 4 case: 19-40435 document: 00515489391 page: 5 date filed: 07/14/2020 no. 19-40435 demanded.
examined Cited as authority (verbatim quote) United States v. Santiago-Mendez (4×) also: Cited as authority (rule), Cited "see"
1st Cir. · 2012 · signal: see · quote attribution · 1 verbatim quote · confidence high
the legislative history indicates that congress was concerned with the nature of the drug transaction . . . . with the diversion of drugs from legitimate channels to illegitimate channels.
discussed Cited as authority (verbatim quote) Commonwealth v. Brown
Mass. · 2010 · quote attribution · 1 verbatim quote · confidence high
in practical effect, acted as a large-scale 'pusher' - not as a physician
examined Cited as authority (verbatim quote) Gonzales v. Oregon (10×) also: Cited as authority (rule), Cited "see"
SCOTUS · 2006 · signal: see · quote attribution · 2 verbatim quotes · confidence high
on its face 829 addresses only the form that a prescription must take. . . . 829 by its terms does not limit the authority of a practitioner
discussed Cited as authority (verbatim quote) United States v. Nelson (2×) also: Cited as authority (rule)
10th Cir. · 2003 · quote attribution · 1 verbatim quote · confidence high
egistered physicians can be prosecuted under 841 when their activities fall outside the usual course of professional practice.
examined Cited as authority (verbatim quote) Whether Physician-Assisted Suicide Serves a \Legitimate Medical Purpose\" Under DEA Regulations" (4×) also: Cited as authority (rule), Cited "see"
OLC · 2001 · signal: see · quote attribution · 1 verbatim quote · confidence high
in the case of a physician th scheme contemplates that he is authorized by the state to practice medicine and to dispense drugs in connection with his professional practice. the federal registration . . . follows automatically.
discussed Cited as authority (verbatim quote) United States v. R. L. C.
SCOTUS · 1992 · signal: see · quote attribution · 1 verbatim quote · confidence high
by its terms 841 reaches 'any person' " and "does not exempt (as it could have) 'all registrants' or 'all persons registered under this act
discussed Cited as authority (verbatim quote) United States v. RLC
SCOTUS · 1992 · signal: see · quote attribution · 1 verbatim quote · confidence high
by its terms 841 reaches any person' " and "does not exempt (as it could have) all registrants' or all persons registered under this act
discussed Cited as authority (verbatim quote) United States v. R. L. C.
SCOTUS · 1992 · signal: see · quote attribution · 1 verbatim quote · confidence high
by its terms 841 reaches 'any person' " and "does not exempt (as it could have) 'all registrants' or 'all persons registered under this act
examined Cited as authority (quoted) United States v. Robinson (3×)
D.D.C. · 2017 · signal: see · quote attribution · 3 verbatim quotes · confidence high
registered physicians can be prosecuted under s 841 when their activities fall outside the usual course of professional practice.
examined Cited as authority (quoted) United States v. Robinson (3×)
D.D.C. · 2017 · signal: see · quote attribution · 3 verbatim quotes · confidence high
registered physicians can be prosecuted under s 841 when their activities fall outside the usual course of professional practice.
examined Cited as authority (quoted) United States v. Zolot (3×)
D. Mass. · 2013 · quote attribution · 3 verbatim quotes · confidence low
registered physicians can be prosecuted under 841 when their activities fall outside the usual course of professional practice.
examined Cited as authority (quoted) United States v. Ricky Joe Nelson (2×)
10th Cir. · 2004 · quote attribution · 2 verbatim quotes · confidence low
registered physicians can be prosecuted under 841 when their activities fall outside the usual course of professional practice.
examined Cited as authority (quoted) Oregon v. Ashcroft (7×) also: Cited as authority (rule), Cited "see, e.g."
D. Or. · 2002 · signal: see · quote attribution · 3 verbatim quotes · confidence high
congress was concerned with the nature of the drug transaction, rather than with the status of the defendant
discussed Cited as authority (rule) United States v. George Naum, III (2×) also: Cited "see, e.g."
4th Cir. · 2025 · confidence medium
The Supreme Court held in United States v. Moore, 423 U.S. 122, 124 (1975), “that registered physicians can be prosecuted under § 841 when their activities fall outside the usual course of professional practice.” We have noted that there are no specific guidelines concerning whether a physician acts outside the usual course of professional practice and that a case-by-case analysis of evidence is required to determine whether a reasonable inference of guilt may be drawn from specific facts.
discussed Cited as authority (rule) United States v. Okafor
D.D.C. · 2025 · confidence medium
So the government’s task is to prove that Okafor’s prescription practices fit that description—that he acted “[i]n practical effect” “as a large-scale ‘pusher’ not as a physician.” United States v. Moore, 423 U.S. 122, 143 (1975).
discussed Cited as authority (rule) United States v. Bradshaw (2×) also: Cited "see"
W.D. Okla. · 2024 · confidence medium
Congress was particularly focused on the “need to prevent the diversion of drugs from legitimate to illicit channels.” Id. at 13 (citing United States v. Moore, 423 U.S. 122, 135 (1975) and H.R.
discussed Cited as authority (rule) United States v. Okafor
D.D.C. · 2024 · confidence medium
They fall in the heartland of the statute, which aims to criminalize those who sell drugs “not for legitimate purposes, but primarily for the profits to be derived,” with a particular concern for “the diversion of drugs from legitimate channels to illegitimate channels.” United States v. Moore, 423 U.S. 122, 135 (1975) (cleaned up).
discussed Cited as authority (rule) United States v. Lamartiniere (2×)
5th Cir. · 2024 · confidence medium
The statute underlying Lamartiniere’s convictions, 21 U.S.C. § 841 (a)(1), makes it unlawful, “[e]xcept as authorized[,] . . . for any person knowingly or intentionally . . . to manufacture, distribute, or dispense . . . a controlled substance.”22 In turn, § 822(b) provides that medical practitioners registered with the Attorney General “are authorized to possess, manufacture, distribute, or dispense” controlled substances “to the extent authorized by their registration and in conformity with the other provisions” of the Controlled Substances Act (“CSA”).23 In other words, …
discussed Cited as authority (rule) United States v. Wilson
10th Cir. · 2024 · confidence medium
But these practitioners “can be prosecuted under § 841 when their activities fall outside the usual course of professional practice,” United States v. Moore, 423 U.S. 122, 124 (1975), or when their prescriptions are not for a “legitimate medical purpose,” United States v. MacKay, 715 F.3d 807, 814 (10th Cir. 2013).
discussed Cited as authority (rule) United States v. AMERISOURCEBERGEN CORPORATION
E.D. Pa. · 2023 · confidence medium
It was specifically aware that “registrants, who have the greatest access to controlled substances and therefore the greatest opportunity for diversion, were responsible for a large part of the illegal drug traffic.” United States v. Moore, 423 U.S. 122, 135 (1975).
discussed Cited as authority (rule) Xiulu Ruan v. United States
SCOTUS · 2022 · confidence medium
As we have previously interpreted it, this authorization does not allow physicians to dispense controlled substances by prescription for any reason they choose; instead, the au- thorization “is limited to the dispensing and use of drugs ‘in the course of professional practice or research.’ ” United States v. Moore, 423 U. S. 122, 141 (1975) (quoting §802(20) (1970 ed.)).
cited Cited as authority (rule) United States v. Jackson Noel
6th Cir. · 2021 · confidence medium
United States v. Moore, 423 U.S. 122, 124 (1975).
discussed Cited as authority (rule) Doe v. Franklin Square Union Free School District
E.D.N.Y · 2021 · confidence medium
And in another case, it held that physicians could be prosecuted under the federal Controlled Substances Act for prescribing drugs outside “the usual course of professional practice.” United States v. Moore, 423 U.S. 122, 138 (1975).
discussed Cited as authority (rule) United States v. James Wilson (2×) also: Cited "see, e.g."
9th Cir. · 2021 · confidence medium
Wilson’s status as a nonphysician does not undermine his conviction because the Supreme Court has recognized that “[b]y its terms, § 841 reaches ‘any person’” and is “concerned with the nature of the drug transaction, rather than the status of the defendant.” Moore, 423 U.S. at 131, 134 .
discussed Cited as authority (rule) United States v. Emma Semler
3rd Cir. · 2021 · confidence medium
Swiderski, 548 F.2d at 450 . 4 See, e.g., United States v. Moore, 423 U.S. 122, 124 (1975) (physician prescribing controlled substance “outside the usual course of professional practice”); United States v. Tighe, 551 F.2d 18, 19 (3d Cir. 1977) (same); United States v. Figueroa, 729 F.3d 267, 274 (3d Cir. 2013) (police officer planting drugs); United States v. Cortes-Caban, 691 F.3d 1, 18 (1st Cir. 2012) (same); United States v. Wallace, 532 F.3d 126 , 128–29 (2d Cir. 2008) (social sharing of drugs without a sale); United States v. Washington, 41 F.3d 917, 920 (4th Cir. 1994) (same); Unit…
cited Cited as authority (rule) Vincent Hager v. M & K Construction (084045) (Statewide)
N.J. · 2021 · confidence medium
“Congress intended [for] the CSA to strengthen rather than to weaken the prior drug laws.” United States v. Moore, 423 U.S. 122, 139 (1975).
cited Cited as authority (rule) Vincent Hager v. M & K Construction (084045) (Statewide)
N.J. · 2021 · confidence medium
“Congress intended [for] the CSA to strengthen rather than to weaken the prior drug laws.” United States v. Moore, 423 U.S. 122, 139 (1975).
discussed Cited as authority (rule) United States v. George Naum, III (2×) also: Cited "see, e.g."
4th Cir. · 2020 · confidence medium
The Supreme Court held in United States v. Moore, 423 U.S. 122, 124 (1975), “that registered physicians can be prosecuted under § 841 when their activities fall outside the usual course of professional practice.” We have noted that there are no specific guidelines concerning whether a physician acts outside the usual course of professional practice and that a case-by-case analysis of evidence is required to determine whether a reasonable inference of guilt may be drawn from specific facts.
cited Cited as authority (rule) United States v. Milad Shaker
3rd Cir. · 2020 · confidence medium
United States v. Moore, 423 U.S. 122, 124 (1975).
examined Cited as authority (rule) State v. C. Christensen (7×) also: Cited "see"
Mont. · 2020 · confidence medium
Federal courts have routinely held that physicians and 48 practitioners remain subject to criminal prosecution under § 841 when their activities fall “outside the usual course of a professional practice.” United States v. Moore, 423 U.S. 122, 124 , 96 S. Ct. 335, 337 (1975); United States v. Larson, 507 F.2d 385, 388 (9th Cir. 1974); United States v. Mackay, 715 F.3d 807, 824-25 (10th Cir. 2013). ¶101 Indeed, in enacting Montana’s drug legislation, the Montana Legislature has long relied on the CSA for guidance.
discussed Cited as authority (rule) United States v. Felix Brizuela, Jr.
4th Cir. · 2020 · confidence medium
The government called two of the five patients whose treatments were the subject of the indictment to testify about the prescriptions they received 4 See United States v. Moore, 423 U.S. 122, 124 (1975) (holding “that registered physicians can be prosecuted under § 841 when their activities fall outside the usual course of professional practice”); see also United States v. Tran Trong Cuong, 18 F.3d 1132, 1137 (4th Cir. 1994) (“[A] licensed physician who prescribes controlled substances outside the bounds of his professional medical practice is subject to prosecution and is no different …
discussed Cited as authority (rule) United States v. Michael Ludwikowski
3rd Cir. · 2019 · confidence medium
Unlike the Jacobs defendant, however, Ludwikowski continued to cooperate because the extortion needed to be solved, not because he was misled by law enforcement. 21 A medical professional like Ludwikowski may be convicted under 21 U.S.C. § 841 if he dispenses a controlled substance “outside the usual course of professional practice.” United States v. Moore, 423 U.S. 122, 124 (1975).
discussed Cited as authority (rule) United States v. Alan Godofsky (2×) also: Cited "see, e.g."
6th Cir. · 2019 · confidence medium
A physician is not guilty of distributing drugs if “he acted ‘in good faith.’” United States v. Hughes, 895 F.2d 1135, 1141 (6th Cir. 1990) (quoting United States v. Moore, 423 U.S. 122, 140 (1975)).
discussed Cited as authority (rule) United States v. Jeffrey Bado
3rd Cir. · 2019 · confidence medium
“We review the District Court’s evidentiary rulings 5 United States v. Moore, 423 U.S. 122, 124 (1975). 6 Caraballo-Rodriguez, 726 F.3d at 431 . 7 Id. (quoting Coleman v. Johnson, 566 U.S. 650, 656 (2012)). 8 In denying Bado’s motion for a new trial, the District Court astutely observed the fact that, “the jury found [Bado] not guilty of thirteen discrete counts within the Superseding Indictment speaks to the jury’s dedication to unbiased assessment of the evidence supporting each individual criminal charge.” United States v. Bado, No. 15-cr-37, 2017 WL 2362401 , at *5 (E.D.
discussed Cited as authority (rule) Gaetan H. Bourgoin v. Twin Rivers Paper Company, LLC
Me. · 2018 · confidence medium
The United States Supreme Court has characterized the CSA as “a closed regulatory system making it unlawful to manufacture, distribute, dispense, or possess any controlled substance except in a manner authorized by the CSA.” Raich, 545 U.S. at 13 ; see also 21 U.S.C.S. § 801 (1)-(6) (establishing Congressional “findings and declarations” regarding controlled substances); United States v. Moore, 423 U.S. 122, 134-35 (1975) (discussing the legislative history of the CSA). [¶13] The CSA classifies substances subject to that legislation into five schedules that are differentiated based o…
discussed Cited as authority (rule) United States v. Schneider
10th Cir. · 2013 · confidence medium
As an initial matter, we reject the Schneiders’ claim that there is no precedential support for the phrase “beyond the bounds of medical practice.” See United States v. Moore, 423 U.S. 122, 140 (1975) (discussing physicians who “operate beyond the bounds of professional practice”).
examined Cited as authority (rule) United States v. Christopher Tobin (3×) also: Cited "see"
11th Cir. · 2012 · confidence medium
United States v. Moore, 423 U.S. 122, 135 , 96 S. Ct. 335, 342 (1975).
discussed Cited as authority (rule) United States v. Algirdas Krisciunas
11th Cir. · 2011 · confidence medium
Practitioners can be prosecuted, under § 841, however, for dispensing controlled substances “when their activities fall outside the usual course of professional practice” and are not prescribed “for a legitimate medical purpose.” United States v. Moore, 423 U.S. 122, 124 (1975) (usual course of professional practice); see also United States v. Betancourt, 734 F.2d 750 , 757 & n.7 (11th Cir. 1984) (legitimate medical purpose).
discussed Cited as authority (rule) United States v. Young
D.C. Cir. · 2011 · confidence medium
The statute applies to “any person.” 21 U.S.C. § 841 (a); United States v. Moore, 423 U.S. 122, 124-25, 131 , 96 S.Ct. 335 , 46 L.Ed.2d 333 (1975) (holding that 21 U.S.C. § 841 prohibits “any person” from possessing with intent to distribute, manufacture, or dispense a controlled substance).
examined Cited as authority (rule) Emerald Steel Fabricators, Inc. v. BOLI OF LABOR AND INDUSTRIES (10×) also: Cited "see"
Or. · 2010 · signal: cf. · confidence medium
See Webster’s Third New Int’l Dictionary 2296 (unabridged ed 2002) (defining supervise as “coordinate, direct, and inspect continuously and at first hand the accomplishment of’ a task); cf. Moore, 423 US at 143 (holding that a physician who prescribed methadone, a Schedule II controlled substance, without regulating his patients’ dosage and with no precautions against his patients’ misuse of methadone violated section 841 of the Controlled Substances Act).
examined Cited as authority (rule) United States v. Christopher Smith (3×) also: Cited "see", Cited "see, e.g."
8th Cir. · 2009 · confidence medium
If Smith’s argument that § 1306.04’s use of the word “his” establishes a subjective standard were to prevail, it would allow an individual doctor to define the parameters of his or her practice and effectively shield the practitioner from criminal liability despite the fact that the practitioner may be acting as nothing more than a “large-scale ‘pusher.’” Moore, 423 U.S. at 143 (finding criminal liability when a practitioner ceases to act as a physician and instead acts as a drug pusher).
discussed Cited as authority (rule) Commonwealth v. Brown (2×) also: Cited "see"
Mass. App. Ct. · 2009 · confidence medium
L. c. 94C, § 1; 21 U.S.C. § 802 (11) (2006). 11 Without discussing the form of the indictment that charged the defendant with “knowing and unlawful distribution and dispensation” of controlled substances, the United States Supreme Court in United States v. Moore, 423 U.S. 122, 124 (1975), held that the defendant, a registered physician, could be prosecuted under 21 U.S.C. § 841 for dispensing or distributing controlled substances.
discussed Cited as authority (rule) United States v. Armstrong (2×) also: Cited "see"
5th Cir. · 2008 · confidence medium
The Supreme Court in United States v. Moore limited the scope of the § 841 exception by holding that an authorized physician who issues prescriptions outside the usual course of professional practice is subject to punishment under § 841(a)(1) just as any other “drug pusher.” Moore, 423 U.S. 122, 138, 142-43 , 96 S.Ct. 335 , 46 L.Ed.2d 333 (1975).
examined Cited as authority (rule) Commonwealth v. Kobrin (3×) also: Cited "see"
Mass. App. Ct. · 2008 · confidence medium
L. c. 94C, § 19(a), then, are those who, in essence, act not as physicians when they write such prescriptions but act instead as “pushers.” See United States v. Moore, 423 U.S. 122, 138 (1975).
discussed Cited as authority (rule) United States v. Birbragher (2×) also: Cited "see"
N.D. Iowa · 2008 · confidence medium
Moore, 423 U.S. at 124, 140-42 , 96 S.Ct. 335 .
discussed Cited as authority (rule) United States v. Bek, Jong Hi
7th Cir. · 2007 · confidence medium
But to convict Bek, a practitioner registered to distribute controlled substances, of violating § 841(a)(1), the government must show that he prescribed controlled substances outside “the course of professional practice.” See United States v. Moore, 423 U.S. 122, 141 (1975); United States v. Green, 511 F.2d 1062, 1067 (7th Cir. 1975); see also United States v. McIver, 470 F.3d 550, 564 (4th Cir. 2006).
discussed Cited as authority (rule) United States v. McIver
4th Cir. · 2006 · confidence medium
Jury Instructions for § 841(a)(1) Charges Under § 841(a)(1), the government must prove (1) that Appellant knowingly or intentionally distributed a controlled substance; (2) with knowledge that it was controlled under the law; and (3) that he did so "outside the usual course of professional practice." United States v. Moore, 423 U.S. 122, 124 (1975); see also United States v. Tran Trong Cuong, 18 F.3d 1132, 1137 (4th Cir. 1994) (setting out ele- ments of § 841(a)(1) charge).
United States
v.
Moore
74-759.
Supreme Court of the United States.
Dec 10, 1975.
423 U.S. 122
Paul L. Friedman argued the cause for the United States. With him on the briefs were Solicitor General Bork, Assistant Attorney General Thornburgh, Acting Assistant Attorney General Keeney, and Sidney M. Glaser., Raymond W. Bergan argued the cause for respondent. With him on the brief were Edward Bennett Williams and Harold Ungar.
Powell.
Cited by 314 opinions  |  Published
3 passages pin-cited by 5 cases
Pinpoint authority: #16,830 of 633,719
Citer courts: District of Columbia (6) · D. Massachusetts (3) · D. Oregon (3) · Tenth Circuit (2)
Mr. Justice Powell

delivered the opinion of the Court.

The issue in this case is whether persons who are registered under the Controlled Substances Act (CSA or Act), 84 Stat. 1242, 21 U. S. C. § 801 et seg., can be prosecuted under § 841 for dispensing or distributing controlled substances. The United States Court of Appeals for the District of Columbia Circuit reversed the conviction of respondent, a licensed physician registered under the Act, on the ground that he was exempted from prosecution under § 841 by virtue of his status as a registrant. We reverse and hold that registered physicians can be prosecuted under § 841 when their activities fall outside the usual course of professional practice.

I

Dr. Moore was charged, in a 639-count indictment, with the knowing and unlawful distribution and dispensation of methadone (Dolophine), a Schedule II controlled substance, [1] in violation of 21 U. S. C. §841 (a)(1). That subsection provides:

“Except as authorized by this subchapter, it shall be unlawful for any person knowingly or intentionally' — •
“(1) to manufacture, distribute, or dispense, or[*125] possess with intent to manufacture, distribute, or dispense, a controlled substance . . .

The indictment covered a 5%-month period from late August 1971 to early February 1972. It was reduced before trial to 40 counts, and the jury convicted respondent on 22 counts. He was sentenced to concurrent terms of five to 15 years’ imprisonment on 14 counts, and to concurrent terms of 10 to 30 years on the remaining eight counts. The second set of sentences was to be consecutive with the first. Fines totaling $150,000 were also imposed. [2]

Methadone is an addictive drug used in the treatment of heroin addicts. If taken without controls it can, like heroin, create euphoric “highs,” but if properly administered it eliminates the addict’s craving for heroin without providing a “high.” The two principal methods of treating heroin addicts with methadone are “detoxification” and “maintenance.” Under a maintenance program, the addict is given a fixed dose once a day for an indefinite period to keep him from using heroin. In detoxification the addict is given a large dose of methadone during the first few days of treatment to keep him free of withdrawal symptoms. Then the dose is gradually reduced until total abstinence is reached.

Maintenance is the more controversial method of treatment. During the period covered by the indictment, registration under § 822, in itself, did not entitle a physician to conduct a maintenance program. In addition to a § 822 registration, the physician who wished to conduct such a program was required to[*126] obtain authorization from the Food and Drug Administration for investigation of a new drug. Dr. Moore's authorization by the FDA was revoked in the summer of 1971, and he does not claim that he was conducting an authorized maintenance program. Instead, his defense at trial was that he had devised a new method of detoxification based on the work of a British practitioner. He testified that he prescribed large quantities of methadone to achieve a “blockade” condition, in which the addict was so saturated with methadone that heroin would have no effect, and to instill a strong psychological desire for detoxification. The Government’s position is that the evidence established that Dr. Moore’s conduct was inconsistent with all accepted methods of treating addicts, that in fact he operated as a “pusher.”

Respondent concedes in his brief that he did not observe generally accepted medical practices. He conducted a large-scale operation. Between September 1971 and mid-February 1972 three District of Columbia pharmacies filled 11,169 prescriptions written by Dr. Moore. These covered some 800,000 methadone tablets. On 54 days during that period respondent wrote over 100 prescriptions a day. In billing his patients he used a “sliding-fee scale” pegged solely to the quantity prescribed, rather than to the medical services performed. The fees ranged from $15 for a 50-pill prescription to $50 for 150 pills. In five and one-half months Dr. Moore’s receipts totaled at least $260,000.

When a patient entered the office he was given only the most perfunctory examination. Typically this included a request to see the patient’s needle marks (which in more than one instance were simulated) and an unsupervised urinalysis (the results of which were regularly ignored). A prescription was then written for the amount requested by the patient. On return visits — for[*127] which appointments were never scheduled — no physical examination was performed and the patient again received a prescription for whatever quantity he requested. Accurate records were not kept, and in some cases the quantity prescribed was not recorded. There was no supervision of the administration of the drug. Dr. Moore’s instructions consisted entirely of a label on the drugs reading: “Take as directed for detoxification.” Some patients used the tablets to get “high”; others sold them or gave them to friends or relatives. Several patients testified that their use of methadone increased dramatically while they were under respondent’s care. [3]

The Court of Appeals, with one judge dissenting, assumed that respondent acted wrongfully but held that he could not be prosecuted under § 841. [4] 164 U. S.[*128] App. D. C. 319, 505 F. 2d 426 (1974). The court found that Congress intended to subject registered physicians to prosecution only under §§ 842 and 843, [5] which pre[*129] scribe less severe penalties than § 841. [6] The court reasoned:

". . . Congress intended to deal with registrants} pri[*130] marily through a system of administrative controls, relying on modest penalty provisions to enforce those controls, and reserving the severe penalties provided for in § 841 for those seeking to avoid regulation entirely by not registering.” 164 U. S. App. D. C., at 323, 505 F. 2d, at 430.

It said, further, that §§ 842 and 843 were enacted to enforce that scheme, while § 841 was reserved for prosecution of those outside the “legitimate distribution chain.” Persons registered under the Act were “authorized by [the] subchapter” within the meaning of § 841 and thus were thought to be immunized against prosecution under that section. [7]

[*131] Respondent advances two basic arguments, contending that each requires affirmance of the Court of Appeals: (i) as that court held, registered physicians may be prosecuted only under § § 842 and 843; and (ii) in any event, respondent cannot be prosecuted under § 841 because his conduct was “authorized by [the] subchapter” in question. We now consider each of these arguments.

II

A

Section 841 (a)(1) makes distribution and dispensing of drugs unlawful “[e]xcept as authorized by this subchapter . . . Relying on this language, the Court of Appeals held that a physician registered under the Act is per se exempted from prosecution under § 841 because of his status as a registrant. We take a different view and hold that only the lawful acts of registrants are exempted. By its terms § 841 reaches “any person.” It does not exempt (as it could have) “all registrants” or “all persons registered under this Act.”

The Court of Appeals relied also on § 822 (b), which provides: “Persons registered . . . under this subchap-ter to . . . distribute, or dispense controlled substances are authorized to possess, . . . distribute, or dispense such substances ... to the extent authorized by their registration and in conformity with the other provisions of this subchapter.” This is a qualified authorization of certain activities, not a blanket authorization of all acts by certain persons. This limitation is emphasized by the subsection’s heading “Authorized activities,” which parallels the headings of §§ 841-843 “Unlawful acts.” We think the statutory language cannot fairly be read to support the view that all activities of registered physi[*132] cians are exempted from the reach of § 841 simply because of their status.

If § 822 (b) were construed to authorize all such activities, thereby exempting them from other constraints, it would constitute a sharp departure from prior laws. . But there is no indication that Congress had any such intent. Physicians who stepped outside the bounds of professional practice could be prosecuted under the Harrison Act (Narcotics) of 1914, 38 Stat. 785, the predecessor of the CSA. In Jin Fuey Moy v. United States, 254 U. S. 189 (1920), the Court affirmed the conviction of a physician on facts remarkably similar to those before us (e. g., no adequate physical examination, the dispensing of large quantities of drugs without specific directions for use, and fees graduated according to the amount of drugs prescribed). A similar conviction was upheld in United States v. Behrman, 258 U. S. 280 (1922), where the defendant-doctor had prescribed heroin, morphine, and cocaine to a person whom he knew to be an addict.

In enacting the CSA Congress attempted to devise a more flexible penalty structure than that used in the Harrison Act. H. R. Rep. No. 91-1444, Pt. 1, pp. 1, 4 (1970). [8] Penalties were geared to the nature of the violation, including the character of the drug involved. But the Act was intended to “strengthen,” rather than to weaken, “existing law enforcement authority in the field of drug abuse.” 84 Stat. 1236 (1970) (preamble). See also H. R. Rep. No. 91-1444, p. 1.

Section 822 (b) was added to the original bill at a late date [9] to “make it clear that persons registered under[*133] this title are authorized to deal in or handle controlled substances.” H. R. Rep. No. 91-1444, p. 38. It is unlikely that Congress would seek, in this oblique way, to carve out a major new exemption, not found in the Harrison Act, for physicians and other registrants. Rather, § 822 (b) was added merely to ensure that persons engaged in lawful activities could not be prosecuted.

B

Respondent nonetheless contends that §§ 841 and 822 (b) must be interpreted in light of a congressional intent to set up two separate and distinct penalty systems: Persons not registered under the Act are to be punished under § 841, while those who are registered are to be subject only to the sanctions of §§ 842 and 843. The latter two sections, the argument goes, establish modest penalties which are the sole sanctions in a system of strict administrative regulation of registrants.

The operative language of those sections provides no real support for the proposition that Congress intended to establish two mutually exclusive systems. It is true that the term “registrants” is used in §§ 842 and 843, and not in § 841. But this is of limited significance. All three sections provide that “[i]t shall be unlawful for any person ... [to commit the proscribed acts].” Two of the eight subsections of § 842 (a), one of the five subsections of § 843 (a), and § 842 (b) further qualify “any person” with “who is a registrant.” The other subsections of § § 842 and 843 are not so limited. In context, “registrant” is merely a limiting term, indicating that the only “persons” who are subject to these subsections are “registrants.” [10] There is no indication that “persons”[*134] means “nonregistrants” when introducing the other subsections.

There are other indications that § 841, and §§ 842 and 843, do not constitute two discrete systems. Section 843 (b), for example, makes it unlawful for any person to use a communication facility in committing a felony under any provision of the subchapter. But violations of both § 841 and § 843 lead to felony convictions; criminal violations of § 842 are misdemeanors. [11] §§ 842 (c)(2)(A), 802 (13); 18 U. S. C. §1. And counsel for respondent agreed at oral argument that registrants can be prosecuted under §841 (a)(2), which prohibits the creation, distribution, dispensing, or possession with intent to distribute or dispense of a “counterfeit substance.”

The legislative history indicates that Congress was concerned with the nature of the drug transaction, rather than with the status of the defendant. The penalties now embodied ,in §§ 841-843 originated in §§ 501-503 of the Controlled Dangerous Substances Act of 1969. The Report of the Senate Judiciary Committee on that bill described § 501 (the counterpart of § 841) as applying to “traffickers.” S. Rep. No. 91-613, p. 8[*135] (1969). Section 502 provided “[ajdditional penalties ... for those involved in the legitimate drug trade,” and “[fjurther penalties ... for registrants” were specified in § 503. S. Rep. No. 91-613, p. 9. The House Committee Report on the bill that was to become the CSA explains: “The bill provides for control... of problems related to drug abuse through registration of manufacturers, wholesalers, retailers, and all others in the legitimate distribution chain, and makes transactions outside the legitimate distribution chain illegal.” H. R. Rep. No. 91-1444, p. 3. Although this language is ambiguous, the most sensible interpretation is that the penalty to be imposed for a violation was intended to turn on whether the “transaction” falls within or without legitimate channels. All persons who engage in legitimate transactions must be registered and are subject to penalties under §§ 842 and 843 for “[mjore or less technical violations.” H. R. Rep. No. 91-1444, p. 10. But “severe criminal penalties” were imposed on those, like respondent, who sold drugs, not for legitimate purposes, but “primarily for the profits to be derived therefrom.” Ibid.

C

Congress was particularly concerned with the diversion of drugs from legitimate channels to illegitimate channels. Id., at 6; S. Rep. No. 91-613, p. 4; 116 Cong. Rec. 996 (1970) (remarks of Sen. Dodd). It was aware that registrants, who have the greatest access to controlled substances and therefore the greatest opportunity for diversion, were responsible for a large part of the illegal drug traffic. See id., at 1663 (remarks of Sen. Hruska); id., at 998 (remarks of Sen. Griffin).

Recognizing this concern the Court of Appeals suggested that Dr. Moore could be prosecuted under § 842[*136] (a)(1) for having violated the provisions of § 829 with respect to the issuing of prescriptions. [12] Whether Dr. Moore could have been so prosecuted is not before the[*137] Court. [13] We note, however, that the penalties for such a violation could hardly have been deemed by Congress to be an appropriate sanction for drug trafficking by a registered physician. Indeed, the penalty for conviction under § 842 would be significantly lighter than, for example, that applicable to a registrant convicted under § 843 for using a suspended registration number. [14] Moreover, a physician who wished to traffic in drugs without threat of criminal prosecution could, if violation of § 829 were the sole basis for prosecution, simply dispense drugs directly without the formality of issuing a prescription. Direct dispensing is exempt from § 829 and thus is not reached by any subsection of § 842 or[*138] § 843 so long as the technical requirements are complied with.

But we think it immaterial whether Dr. Moore also could have been prosecuted for his violation of statutory provisions relating to dispensing procedures. There is nothing in the statutory scheme or the legislative history that justifies a conclusion that a registrant who may be prosecuted for the relatively minor offense of violating § 829 is thereby exempted from prosecution under § 841 for the significantly greater offense of acting as a drug “pusher.” [15]

III

Respondent argues that even if Congress did not intend to exempt registrants from all prosecutions under § 841, he cannot be prosecuted under that section because the specific conduct for which he was prosecuted was “authorized by [the] subchapter” and thus falls within the express exemption of the section.

The trial judge assumed that a physician’s activities are authorized only if they are within the usual course of professional practice. He instructed the jury that it had to find

“beyond a reasonable doubt that a physician, who knowingly or intentionally, did dispense or distribute[*139] [methadone] by prescription, did so other than in good faith for detoxification in the usual course of a professional practice and in accordance with a standard of medical practice generally recognized and accepted in the United States.” App. 123.

The Court of Appeals did not address this argument because it concluded that registrants could not be prosecuted under § 841 under any circumstances. But it suggested that if a registrant could be reached under § 841 he could not be prosecuted merely because his activities fall outside the “usual course of practice.” 164 App. D. C., at 322 n. 11, 505 F. 2d, at 429 n. 11.

Under the Harrison Act physicians who departed from the usual course of medical practice were subject to the same penalties as street pushers with no claim to legitimacy. Section 2 of that Act required all persons who sold or prescribed certain drugs to register and to deliver drugs only to persons with federal order forms. The latter requirement did not apply to “the dispensing or distribution of any of the aforesaid drugs to a patient by a physician . . . registered under this Act in the course of his professional practice only.” 38 Stat. 786. As noted above, Congress intended the CSA to strengthen rather than to weaken the prior drug laws. There is no indication that Congress intended to eliminate the existing limitation on the exemption given to doctors. [16] The difficulty[*140] arises because the CSA, unlike the Harrison Act, does not spell out this limitation in unambiguous terms.

Instead of expressly removing from the protection of the Act those physicians who operate beyond the bounds of professional practice, the CSA uses the concept of “registration.” Section 822 (b) defines the scope of authorization under the Act in circular terms: “Persons registered ... under this subchapter ... are authorized [to dispense controlled substances] ... to the extent authorized by their registration and in conformity with the other provisions of this subchapter.” But the scheme of the statute, viewed against the background of the legislative history, reveals an intent to limit a registered physician’s dispensing authority to the course of his “professional practice.”

Registration of physicians and other practitioners [17] is mandatory if the applicant is authorized to dispense drugs or conduct research under the law of the State in which he practices. [18] § 823 (f). In the case of a physi[*141] cian this scheme contemplates that he is authorized by the State to practice medicine and to dispense drugs in connection with his professional practice. [19] The federal registration, which follows automatically, extends no further. It authorizes transactions within “the legitimate distribution chain” and makes all others illegal. H. R. Rep. No. 91-1444, p. 3. Implicit in the registration of a physician is the understanding that he is authorized only to act “as a physician.”

This is made explicit in § 802 (20), which provides that “practitioner” means one who is “registered ... by the United States or the jurisdiction in which he practices or does research, to distribute, dispense, conduct research with respect to, administer, or use in teaching or chemical analysis, a controlled substance in the course of professional practice or research.” This section defines the term “practitioner” for purposes of the Act. It also describes the type of registration contemplated by the Act. That registration is limited to the dispensing and use of drugs “in the course of professional practice or research.”

Other provisions throughout the Act reflect the in[*142] tent of Congress to confine authorized medical practice within accepted limits. Section 812 (b) (2) includes in its definition of Schedule II drugs a requirement that “[t]he drug [have] a currently accepted medical use with severe restrictions.” Registration under the CSA to dispense or to conduct research with Schedule I drugs, which are defined as having “no currently accepted medical use in treatment in the United States,” § 812 (b) (1)(B), does not follow automatically from state registration as it does with respect to drugs in Schedules II through V, all of which have some accepted medical use. § 823 (f). The record and reporting requirements of § 827 are made inapplicable with respect to narcotic drugs in Schedules II through V when they are prescribed or administered “by a practitioner in the lawful course of his professional practice.” § 827 (c) (1) (A). Section 828 (a) prohibits the distribution of Schedule I and II drugs unless pursuant to specified order forms; § 828 (e) makes it unlawful for “any person” to obtain drugs with these order forms “for any purpose other than their use, distribution, dispensing, or administration in the conduct of a lawful business in such substances or in the course of his professional practice or research.” Section 844 (a) prohibits possession of controlled substances unless the drug was obtained “from a practitioner, while acting in the course of his professional practice, or except as otherwise authorized . . . .” See also § 885 (a) (2).

The evidence presented at trial was sufficient for the jury to find that respondent’s conduct exceeded the bounds of “professional practice.” [20] As detailed above, he gave inadequate physical examinations or none at all.[*143] He ignored the results of the tests he did make. He did not give methadone at the clinic and took no precautions against its misuse and diversion. He did not regulate the dosage at all, prescribing as much and as frequently as the patient demanded. He did not charge for medical services rendered, but graduated his fee according to the number of tablets desired. In practical effect, he acted as a large-scale “pusher” — not as a physician.

IV

Respondent further contended at trial that he was experimenting with a new “blockade” theory of detoxification. The jury did not believe him. Congress understandably was concerned that the drug laws not impede legitimate research and that physicians be allowed reasonable discretion in treating patients and testing new theories. But respondent’s interpretation of the Act would go far beyond authorizing legitimate research and experimentation by physicians. It would even compel exernption from the provisions of § 841 of all “registrants,” including manufacturers, wholesalers, and pharmacists — in addition to physicians.

In enacting the Comprehensive Drug Abuse Prevention and Control Act of 1970, 84 Stat. 1236, Title II of which is the CSA, Congress faced the problem directly. Because of the potential for abuse it decided that some limits on free experimentation with drugs were necessary. But it was also aware of the concern expressed by the Prettyman Commission:

“[A] controversy has existed for fifty years over the extent to which narcotic drugs may be administered to an addict solely because he is an addict.
“The practicing physician has . . . been confused as to when he may prescribe narcotic drugs for an[*144] addict. Out of a fear of prosecution many physicians refuse to use narcotics in the treatment of addicts except occasionally in a withdrawal regimen lasting no longer than a few weeks. In most instances they shun addicts as patients.” [21]

Congress’ solution to this problem is found in § 4 of Title I of the 1970 Act, 42 U. S. C. § 257a. That section requires the Secretary of Health, Education, and Welfare, after consultation with the Attorney General and national addict treatment organizations, to “determine the appropriate methods of professional practice in the medical treatment of... narcotic addiction_” It was designed “to clarify for the medical profession . . . the extent to which they may safely go in treating narcotic addicts as patients.” H. R. Rep. No. 91-1444, p. 14. Congress pointed out that “criminal prosecutions” in the past had turned on the opinions of federal prosecutors. Under the new Act, “[t]hose physicians who comply with the recommendations made by the Secretary will no longer jeopardize their professional careers . . . .” Id., at 15. The negative implication is that physicians who go beyond approved practice remain subject to serious criminal penalties.

In the case of methadone treatment the limits of approved practice are particularly clear. As Dr. Moore admitted at trial, [22] he was authorized only to dispense methadone for detoxification purposes. His authorization by the FDA to engage in a methadone maintenance program had been revoked. Nor was respondent unfamiliar with the procedures for conducting a legitimate detoxification program. Charges arising[*145] out of his 1969 treatment program, which involved a combination of “long term” and “short term” detoxification, were dropped after he testified before a grand jury and agreed to abide by certain medical procedures in future methadone programs. These included obtaining a medical history of each patient, conducting a reasonably thorough physical examination, abiding by the results of urine tests, recording times and amounts of dosages, and either administering the methadone in his office or prescribing no more than a daily dosage. [23] At trial respondent admitted that-he had failed to follow these procedures. [24]

V

Respondent argues finally that the statute is sufficiently ambiguous that it must be construed in his favor despite the clear intent of the Congress. It is true that “when choice has to be made between two readings of what conduct Congress has made a crime, it is appropriate, before we choose the harsher alternative, to require that Congress should have spoken in language that is clear and definite.” United States v. Universal C. I. T. Credit Corp., 344 U. S. 218, 221-222 (1952). In this case, however, the principle set forth in United States v. Brown, 333 U. S. 18, 25-26 (1948), is appropriately followed:

“The canon in favor of strict construction [of criminal statutes] is not an inexorable command to override common sense and evident statutory purpose. . . . Nor does it demand that a statute be given the ‘narrowest meaning’; it is satisfied if the words are given their fair meaning in accord with the manifest intent of the lawmakers.”

[*146] The judgment of the Court of Appeals is reversed. Because of its disposition of the case, that court did not reach the question whether respondent could be sentenced under 21 U. S. C. § 845, which provides a higher penalty for distribution of controlled substances to persons under 21 years of age. We remand for the sole purpose of considering respondent's claim that he was improperly sentenced under that section.

So ordered.

1

A substance listed in Schedule II has “a high potential for abuse,” “a currently accepted medical use in treatment in the United States or a currently accepted medical use with severe restrictions,” and is a drug the abuse of which “may lead to severe psychological or physical dependence.” 21 U. S. C. § 812 (b)(2). Methadone is listed as a Schedule II drug in §812 (c), Schedule II (b) (11).

2

In addition, Dr. Moore’s license to practice medicine was revoked pursuant to D. C. Code Ann. § 2-131 (1973), which authorizes revocation upon the conviction of “any felony.” An appeal from the conviction acts “as a supersedeas to the judgment . . . revoking his license . . . .”

3

One patient testified that he was taking approximately two to three pills per day when he started visiting Dr. Moore. By the end of his visits he was taking 30 to 35 pills a day. App. 43. Another patient increased his intake from five to 10 pills a day to almost 70. Id., at 53-54. A third addict, relying on Dr. Moore for drugs, increased his intake from seven pills a day to over 100. Tr. 310.

4

Section 841 (a) provides, in full:

“Except as authorized by this subchapter, it shall be unlawful for any person knowingly or intentionally—

“(1) to manufacture, distribute, or dispense, or possess with intent to manufacture, distribute, or dispense, a controlled substance; or

“(2) to create, distribute, or dispense, or possess with intent to distribute or dispense, a counterfeit substance.”

“Dispense” is defined in § 802 (10) to mean “to deliver a controlled substance to an ultimate user ... by, or pursuant to the lawful order of, a practitioner, including the prescribing and administering of a controlled substance . . . .” Section 802 (11) defines “distribute” to mean “to deliver (other than by administering or dispensing) a controlled substance.” “Administer” refers to “the direct application of a controlled substance to the body of a patient . . . .” § 802 (2).

5

lection 842 in relevant part provides:

“(a) Unlawful acts.

“It shall be unlawful for any person—

“(1) who is subject to the requirements of part C to. distribute or dispense a controlled substance in violation of section 829 of this title;

“(2) who is a registrant to distribute or dispense a controlled substance not authorized by his registration to another registrant or other authorized person or to manufacture a controlled substance not authorized by his registration;

“(3) who is a registrant to distribute a controlled substance in violation of section 825 of this title;

“(4) to remove, alter, or obliterate a symbol or label required by section 825 of this title;

“(5) to refuse or fail to make, keep, or furnish any record, report, notification, declaration, order or order form, statement, invoice, or information required under this subchapter or sub-chapter II of this chapter;

“(6) to refuse any entry into any premises or inspection authorized by this subchapter or subchapter II of this chapter;

“(7) to remove, break, injure, or deface a seal placed upon controlled substances pursuant to section 824 (f) or 881 of this title or to remove or dispose of substances so placed under seal; or

“(8) to use, to his own advantage, or to reveal, other than to duly authorized officers or employees of the United States, or to the courts when relevant in any judicial proceeding under this sub-chapter or subchapter II of this chapter, any information acquired in the course of an inspection authorized by this subchapter concerning any method or process which as a trade secret is entitled to protection.

“(b) Manufacture.

“It shall be unlawful for any person who is a registrant to manufacture a controlled substance in Schedule I or II which is—

“(1) not expressly authorized by his registration and by a quota assigned to him pursuant to section 826 of this title; or

“(2) in excess of a quota assigned to him pursuant to section 826 of this title.”

[*129] Section 843 provides:

“(a) Unlawful acts.

“It shall be unlawful for any person knowingly or intentionally—

“(1) who is a registrant to distribute a controlled substance classified in schedule I or II, in the course of his legitimate business, except pursuant to an order or an order form as required by section 828 of this title;

“(2) to use in the course of the manufacture or distribution of a controlled substance a registration number which is fictitious, revoked,, suspended, or issued to another person;

“(3) to acquire or obtain possession of a controlled substance by misrepresentation, fraud, forgery, deception, or subterfuge;

“(4) to furnish false or fraudulent material information in, or omit any material information from, any application, report, record, or other document required to be made, kept, or filed under this subehapter or subchapter II of this chapter; or

“(5) to make, distribute, or possess any punch, die, plate, stone, or other thing designed to print, imprint, or reproduce the trademark, trade name, or other identifying mark, imprint, or device of another or any likeness of any of the foregoing upon any drug or container or labeling thereof so as to render such drug a counterfeit substance.

“(b) Communication facility.

“It shall be unlawful for any person knowingly or intentionally to use any communication facility in committing or in causing or facilitating the commission of any act or acts constituting a felony under any provision of this subchapter or subchapter II of this chapter. Each separate use of a communication facility shall be a separate offense under this subsection. For purposes of this subsection, the term 'communication facility’ means any and all public and private instrumentalities used or useful in the transmission of writing, signs, signals, pictures, or sounds of all kinds and includes mail, telephone, wire, radio, and all other means of communication.”

6

Violations of § 841, under which respondent was convicted, carry sentences of up to 15 years, fines as high as $25,000,[*130] or both. § 841 (b). Knowing violators of § 842 are subject at most to imprisonment for one year, a fine of $25,000, or both. There also may be a civil penalty of $25,000 for violation of § 842. §842 (c). The penalties for violation of §843 are imprisonment for not more than four years, a fine of not more than $30,000, or both. §843 (c). All three sections impose higher penalties for violations after the first conviction.

7

The decision below stands alone. At the time it was issued it conflicted with the rulings of four other Circuits. Courts of Appeals for the First, Fifth, and Tenth Circuits had held squarely that physicians may be prosecuted under § 841. See United States v. Badia, 490 F. 2d 296 (CA1 1973); United States v. Collier, 478 F. 2d 268 (CA5 1973); United States v. Leigh, 487 F. 2d 206 (CA5 1973); United States v. Bartee, 479 F. 2d 484 (CA10 1973); United States v. Jobe, 487 F. 2d 268 (CA10 1973). The Ninth Circuit also had affirmed the conviction of a physician under § 841 (a) (1). United States v. Larson, 507 F. 2d 385 (1974). Since the ruling in this case, two other decisions have considered the issue and expressly rejected the analysis of the Court of Appeals for the District of Columbia Circuit. See United States v. Rosenberg, 515 F. 2d 190 (CA9 1975); United States v. Green, 511 F. 2d 1062 (CA7 1975). The Sixth Circuit has implicitly agreed. It reversed the conviction of a physician and remanded the case for a new trial because the trial court had failed to instruct the jury that physicians are exempt from prosecution under § 841 (a)(1) when they dispense or prescribe controlled substances in good faith to patients in the regular course of[*131] professional practice. United States v. Carroll, 518 F. 2d 187 (1975).

8

To this end controlled substances were classified in five categories according to their potential for abuse, their promise for treatment, and their psychological and physical effects. § 812.

9

Section 822 (b) was added by the House Committee on Interstate and Foreign Commerce. No comparable section was in the Act when it passed the Senate on January 28,1970.

10

This represents a commonsense recognition by Congress that only a registrant could, for example, distribute drugs “not authorized by his registration,” §842 (a)(2), or manufacture substances “not expressly authorized by his registration” or “in excess of [his][*134] quota.” §§ 842 (b) (1), (2). Nor would there be any reason to apply to nonregistrants the penalties for distributing drugs without complying with the labeling and order-form requirements of the Act, §§ 842 (a) (3), 843 (a) (1), for nonregistrants are barred from making any distributions whatsoever.

11

Another subsection which can be sensibly interpreted only if it reaches nonregistrants is § 842 (a) (1), which is limited to “any person — who is subject to the requirements of part C.” Part C of the Act, §§ 821-829, covers the provisions for registration and applies to “[ejvery person who manufactures, distributes, or dispenses any controlled substance or who proposes” to do so. §822 (a). Presumably, § 842 (a) (1) is so phrased in order to reach those who should have registered but failed to do so.

12

Section 829 provides, in part:

“(a) Schedule II substances.

“Except when dispensed directly by a practitioner, other than a pharmacist, to an ultimate user, no controlled substance in schedule II, which is a prescription drug as determined under the Federal Food, Drug, and Cosmetic Act, may be dispensed without the written prescription of a practitioner, except that in emergency situations, as prescribed by the Secretary by regulation after consultation with the Attorney General, such drug may be dispensed upon oral prescription in accordance with section 353 (b) of this title. Prescriptions shall be retained in conformity with the requirements of section 827 of this title. No prescription for a controlled substance in schedule II may be refilled.

“(b) Schedule III and IV substances.

“Except when dispensed directly by a practitioner, other than a pharmacist, to an ultimate user, no controlled substance in schedule III or IV, which is a prescription drug as determined under the Federal Food, Drug, and Cosmetic Act, may be dispensed without a written or oral prescription in conformity with section 353 (b) of this title. Such prescriptions may not be filled or refilled more than six months after the date thereof or be refilled more than five times after the date of the prescription unless renewed by the practitioner.

“(c) Schedule V substances.

“No controlled substance in schedule V which is a drug may be distributed or dispensed other than for a medical purpose.”

The Attorney General's regulations enacted pursuant to § 829 required:

“A prescription for a controlled substance to be effective must be issued for a legitimate medical purpose by an individual practitioner acting in the usual course of his professional practice. The responsibility for the proper prescribing and dispensing of controlled substances is upon the prescribing practitioner, but a corresponding responsibility rests with the pharmacist who fills the prescription. An order purporting to be a prescription issued not in the usual course of professional treatment or in legitimate and authorized research is not a prescription within the meaning and intent of[*137] section 309 of the Act (21 U. S. C. 829) and the person knowingly filling such a purported prescription, as well as the person issuing it, shall be subject to the penalties provided for violations of the provisions of law relating to controlled substances.” 21 CFR § 306.04 (a) (1973) (redesignated as 21 CFR § 1306.04 (a) (1975)).

The court below suggested that a violation of the “medical purpose” requirement of § 306.04 (a) makes a prescription something other than the “written prescription” required by § 829. The dissent, which agreed that Dr. Moore could be prosecuted under §842 (a)(1), did not rely on the regulations. It found inherent in the statutory term “prescription” a requirement that the order be issued for a valid medical purpose.

13

On its face § 829 addresses only the form that a prescription must take. A written prescription is .required for Schedule II substances. § 829 (a). Either a written or an oral prescription is adequate for drugs in Schedules III and IV. § 829 (b). The only limitation on the distribution or dispensing of Schedule V drugs is that it be “for a medical purpose.” § 829 (c). The medical purpose requirement explicit in subsection (c) could be implicit in subsections (a) and (b). Regulation § 306.04 makes it explicit. But § 829 by its terms does not limit the authority of a practitioner.

14

In addition, a doctor who dispenses a controlled substance not authorized by his registration to another registrant is also covered by § 842 and would thus be punished as severely as a doctor who sold drugs solely for financial profit to nonregistrants. § 842 (a) (2).

15

Respondent argues that the proper sanction for trafficking physicians is not criminal prosecution, but deregistration or refusal to reregister. But, under respondent's analysis, at the time he was convicted neither penalty could be imposed as a sanction for the conduct in which he engaged. Registration was mandatory for practitioners with state licenses, § 823 (f), and could only be suspended or revoked if the state license was revoked or suspended, if the practitioner had “materially falsified” an application under the Act, or if he had been convicted of a drug-related felony. § 824 (a). Conviction for a misdemeanor under § 842 would be insufficient to support revocation.

16

The Narcotic Addict Treatment'Act of 1974 (NATA), 88 Stat. 124, 21 U. S. C. §§ 802, 823, 824 (1970 ed., Supp. IV), modified the registration and revocation procedures provided in the CSA in order to facilitate “more expeditious” criminal prosecutions by making revocation easier.

There was no indication that Congress thought that trafficking doctors could escape felony prosecution altogether under pre-NATA law. Rather, it sought to “cure the present difficulty in such prosecutions because of the intricate and nearly impossible burden of establishing what is beyond 'the course of professional practice’ for[*140] criminal law purposes when such a practitioner speciously claims that the practices in question were ethical and humanitarian in nature.” S. Rep. No. 93-192, p. 14 (1973). Dr. Moore’s conviction was cited to illustrate that successful criminal actions could be brought only “in the most aggravated of circumstances . . . after prolonged effort to make undercover penetrations.” Id., at 13.

17

“Practitioner” means “a physician, dentist, veterinarian, scientific investigator, pharmacy, hospital, or other person licensed, registered, or otherwise permitted, by the United States or the jurisdiction in which he practices or does research, to distribute, dispense, conduct research with respect to, administer, or use in teaching or chemical analysis, a controlled substance in the course of professional practice or research.” § 802 (20).

18

Under § 823, registration of manufacturers and nonpraetitioner distributors (such as suppliers) is discretionary with the Attorney General. He first must make a finding that registration is consistent (in the case of manufacturers of Schedule I and II drugs) or not inconsistent (in the case of manufacturers of Schedule III-V[*141] drugs and all distributors) with the public interest. In evaluating the public interest the Attorney General is to consider, for example, “maintenance of effective controls against diversion,” compliance with applicable state and local law, prior conviction record in drug-related charges, past experience, and (in the case of manufacturers) promotion of technical advances in manufacturing and the development of new substances. Practitioners and pharmacies are automatically entitled to registration to handle drugs in Schedules II-V “if they are authorized to dispense . . . under the law of the State in which they practice.” § 823 (f).

19

The House Report described the rationale behind § 823 (f) as follows: “Practitioners . . . engaged in the distribution chain would be required to be registered, but registration would be as a matter of right where the individual or firm is engaged in activities involving these drugs which are authorized or permitted under State law . . . .” H. R. Rep. No. 91-1444, p. 23 (1970) (emphasis added).

20

The jury was instructed that Dr. Moore could not be convicted if he merely made “an honest effort” to prescribe for detoxification in compliance with an accepted standard of medical practice. App. 124.

21

Report of the President’s Advisory Commission on Narcotic and Drug Abuse 56-57 (1963), quoted in H. R. Rep. No. 91-1444, pp. 14 — 15.

22

App. 101.

23

Id., at 97-100, 116, 136-138.

24

Id., at 97-100.