A West Virginia judge this week sentenced a local doctor to 20 years in prison for improper distribution of prescription opiates, including issuing 22,000 oxycodone pills to 273 patients in a single day. 

Dr. Michael Kostenko, who ran pain management classes from his home clinic in southern West Virginia, accepted a guilty plea to one of the 22 felony counts he faced. 

“You are, in my opinion, the worst kind of drug dealer,” Judge Irene C. Berger told Kostenko. “You poured thousands of prescription opiates into the streets, to people you knew weren’t taking them as prescribed.”

Kostenko faced one count of maintaining a drug-involved premises; 19 counts of distributing oxycodone not for legitimate medical purposes; and two counts of distribution not for medical purposes resulting in the death of two patients. He pleaded guilty to one count of distribution not for legitimate medical purposes. 

The judge said the doctor’s exams, pill counts and urine screens were inadequate. She also cited a single day in December 2013 when Kostenko wrote 375 prescriptions without actually seeing the 271 patients. The prescriptions totaled more than 22,000 oxycodone pills and more than $20,000 was collected in cash that day.

After his 20 years in prison, the 61-year-old must serve five years supervised release, and he must pay a $50,000 fine. Berger said had he been financially capable, she would have imposed a greater fine. 

“I recognize this is a lengthy sentence… but it is arguably less than your conduct has earned,” the judge said.

West Virginia is the epicenter for America’s drug overdose crisis, which experts say is reaching epidemic levels. 

According to the most recent data compiled by the Centers for Disease Control and Prevention, West Virginia’s 2015 drug overdose death rate stood at 41.5 cases per 100,000 residents, the highest rate in the country and nearly three times the national average.

More than 800 people died due to overdose in 2016. According to a February 2017 analysis done by the West Virginia Health Statistics Center, 703 of 818 overdose deaths involved at least one opioid.

The West Virginia county with the nation’s highest drug overdose death rate filed a lawsuit last year against three national distributors of prescription painkillers and a local doctor, contending they are responsible for the county’s addiction epidemic.

The suit was submitted in state court by the McDowell County Commission, citing federal Drug Enforcement Agency records showing the distributors shipped 423 million hydrocodone and oxycodone pills to West Virginia pharmacies and doctors from 2007 through 2012.

The suit accused defendants of devastating the local economy and the county’s budget as well as destroying “the lives of many residents” in order to reap millions of dollars in profit. 

Kostenko’s conviction stems from his osteopathic pain self-management practice he opened out of his Daniels, West Virginia, home in 2005. Kostenko saw approximately 1,200 patients, about half of who were prescribed pain medication. 

Kostenko’s medical license was revoked in June 2016 after the West Virginia Board of Osteopathic Medicine found probable cause of unprofessional and unethical conduct that may have contributed to the overdose deaths of three patients. He was arrested in December 2016.

Christina Kostenko, Michael Kostenko’s daughter and former attorney, indicated this week he plans to repeal his conviction. 

Wendy Holdren writes for the Beckley, West Virginia Register-Herald.