Jason Cole Votrobek and Roland Rafael Castellanos were among five defendants indicted in June 2011 just weeks after the Bartow-Cartersville Drug Task Force closed out an investigation that began more than a year earlier. The two men went on trial March 5 in U.S. District Court for the Northern District of Georgia in Rome on federal drug and money laundering charges for owning and operating a “pill mill” pain clinic that dispensed massive amounts of addictive pain killers. Votrobek had previously been acquitted in Florida of similar charges stemming from his ownership of a Florida pain clinic.
The jury found Votrobek guilty of selling, distributing or dispensing a controlled substance; money laundering — selling, distributing or dispensing a controlled substance; four counts of money laundering — interstate commerce; and interstate commerce. Castellanos was found guilty of selling, distributing or dispensing a controlled substance; money laundering — selling, distributing or dispensing a controlled substance; four counts of money laundering — interstate commerce; and interstate commerce. They will be sentenced at a later date.
“... There was a lot, over a year, went into that investigation, so the fact that the verdict came back so quickly was a testament to what kind of job the guys did making the case,” DTF Commander Capt. Mark Mayton said of the jury’s 3 1/2-hour deliberation.
More than a year prior to the June 2011 raid on the Cartersville clinic, authorities became concerned that the “doctor’s office” was not what it appeared.
“Actually there was several things that brought it to our attention,” Mayton said. “One thing we noticed was the excessive out-of-town traffic at the business. It was a doctor’s office — that was our perception of things. ... Why would 98 percent of the business there be from Tennessee, Kentucky, Missouri, etc., etc., etc.? Why would they be coming to Cartersville, Ga., to see a doctor? That was one red flag.”
Uniform patrol officers from the Bartow County Sheriff’s Office and Cartersville police stopping impaired drivers and finding large quantities of prescription pain medications raised red flags.
“Those people had what they believed [were] excessive amounts of prescription pain medications. The drivers were a lot of the times impaired from the pain medication,” Mayton said, “so those were like two of the biggest key indicators coupled with the fact that we were getting complaints from some of the local businesses because of the amount of traffic, the element of people that were showing up for the doctor’s office. Also, we got calls from some of the local pharmacists complaining about the amount of pain medication that was being prescribed. Actually, most of them refused to dispense those amounts because it was unreasonable.”
The investigation revealed that Votrobek, 30, of Vero Beach, Fla.; Castellanos, 34, of Hollywood, Fla.; and Jesse Violante, 35, of Vero Beach, Fla., financed and operated the clinic. Tara Atkins, 36, of Cartersville served as the office manager. Dr. James Chapman, 64, of Macon served as the primary doctor, according to a federal press release. In their respective capacities, Votrobek and Castellanos worked to procure and distribute oxycodone pills to addicts and distributors and directed the clinic’s doctor to see as many patients as possible, and to prescribe as many oxycodone pills as possible, in order to generate mass profits. Chapman allegedly did so, however, without conducting sufficient medical examinations and, indeed, was frequently incapacitated due to intoxication. Atkins herself filled out prescriptions for the doctor to sign, and the amounts of pills distributed to patients were excessive with unusual dosage patterns.
The clinic operated as a drug distribution operation with more than 98 percent of patients traveling to the clinic from surrounding states — the majority from Kentucky and Tennessee.
According to the federal release, the clinic engaged in unusual practices like permitting non-medical staff to assist with medical procedures, such as taking blood pressure, to maximize the number of patients seen. Indeed, in 2011, the clinic was one of the top 15 purchasers of oxycodone in the nation.
In the one year the clinic operated, Votrobek and Castellanos made millions of dollars, establishing multiple bank accounts — many in third party names — to conceal the windfall profits.
In 2013, Violante and Atkins entered guilty pleas in connection with the case.
Violante faced six counts — selling, distributing or dispensing a controlled substance; money laundering — controlled substance selling, distributing or dispensing; two counts of laundering of monetary instruments; laundering of monetary instruments; and engaging in monetary transactions, according to documents filed in U.S. District Court for the Northern District of Georgia. According to a Jan. 17, 2013, plea agreement, Violante pleaded guilty to the first count — selling, distributing or dispensing a controlled substance — with the remaining charges dropped under the deal.
The deal said Violante’s criminal activity and that of “others acting in concert with involved 61,908 (30mg) and 10,564 (15mg) pills of Oxycodone ... .”
Atkins on Jan. 22, 2013, pleaded guilty to withholding information on a crime. Under the plea agreement, the additional charges she faced — controlled substance selling, distributing or dispensing; money laundering — controlled substance selling, distributing or dispensing; and laundering of monetary instruments — were dismissed.
Violante and Atkins will be sentenced at a later date. Chapman is presently awaiting trial.
“The abuse of pain medication has become epidemic and now accounts for more six times more deaths than that of all of the traditional illegal drugs combined,” said United States Attorney Sally Quillian Yates in the release. “The defendants in this case preyed upon on those addicted to prescription drugs in order to line their own pockets. The abuse of prescription drugs and its related criminal activity has become a danger in many of our communities — one we have made a central focus of our office. Today justice has been served.”
In the months leading up to the 2011 Atlanta Medical Group raid, legislation targeting the abuse of prescription passed the Georgia Legislature and the following month a jury would convict 13 of trafficking oxycodone and other prescription drugs.
The Georgia General Assembly passed legislation on April 19, 2011, approving a prescription drug monitoring program, which will allow law enforcement and the medical board to more effectively identify and prevent the diversion and misuse of oxycodone and other abused prescription drugs. That program did not become operational until 2013.
A second step at the state level to target illegal pain clinics passed last year. The law aims to license and regulate pain management clinics, and require the owner to be a doctor. The law stopped short of requiring doctors or pharmacists to use a state registry to track how much of a painkiller a person is receiving, which some neighboring states have done.
Locally, the city of Cartersville in 2012 approved an ordinance that tightened regulations surrounding the establishments known as pill mills in hopes of detering their existence within the community.
The push in recent years to curtail pill mills and prescription drug abuse appears, perhaps, to be making an impact.
“All I can speak for is, it’s worked here. There’s no more pain clinics, there’s no more pill mills here in Bartow County,” Mayton said.
“... I think locally the amount of pain medicine being dispensed has slowed some, but overall, in the big picture, prescription diversion has not changed at all,” he added. “The only thing we have seen the rise in is the use of heroin, which is the ... illegal version of the prescription medication. It’s their way of getting it without having to go to the doctor. Actually, it sent a pretty strong message to those that are profitting ... from people’s addictions.
“I said it was tapering it off. There are still locations in Florida. ... They can still travel to Florida and other surrounding areas to get those pain medications.”
Appearances may be deceiving. Mayton said those looking to circumvent the law find a way, many times at the expense of authorities.
“One small reason that we have seen a decline in that is the fact that we kind of ... sometimes we educate our criminals. During the course of a trial, they get to see who, what, when, where and how,” he said, “so now when they go to a pain clinic somewhere else and they get these prescriptions, instead of traveling with them back to their home location, they’ll FedEx them back so they don’t have to travel with the pills in their possession. That’s another approach folks are looking at now to try to interdict and find a way to combat that problem.
“It’s a never-ending. It’s never going to change. Every time we make a step forward with the criminal element, by the time we arrest them and go to trial, then they’re going to discover our methods of investigation and they’re going to adjust to that.”
According to information from the U.S. Department of Justice website last year, abuse of prescription drugs is the fastest-growing segment for illegal drug use. More people abuse prescription drugs than the number of people who use cocaine, methamphetamine and heroin combined.
“I would not hesitate to agree with that. It’s hard for me to agree with that simply because our primary drugs are marijuana, meth and cocaine and heroin. It’s the illicit, illegal drugs. It’s not the prescription drugs we see,” Mayton said. “I think it gives weight to the study and statistics that that could be accurate because most of those drugs are not illegal and they’re usually right inside someone’s home. It’s not like they have to go somewhere to get them, so you know, I would not disagree with that statistic.”
According to estimates from the Georgia Drugs and Narcotics Agency, there were fewer than 10 pill mills in the state in 2010, while the number has exploded since then, fluctuating between 90 and 140 between 2012 and 2013.
Because some pain clinics are legitimate, prosecuting those that aren’t can be difficult, said Barbara Heath, the head of the Drug Enforcement Administration’s diversion program in Georgia, Tennessee, North Carolina and South Carolina, last year. If the prescriber is a doctor — and not someone forging prescriptions — prosecutors must prove the pills aren’t for a medical need.
“We looked at it early on and seen that everywhere one of these pain clinics would pop up at, or pill mills — whatever you choose to call them — the local governing authority would strap on some type of punitive ... penalties or administrative penalties and/or fines,” Mayton said. “... That means that, if a particular doctor was in there, they would pull that doctor’s license or they would suspend their business license, which would cause them to move to a different location. So they really weren’t prosecuting the pain clinics; they were just moving the problem. That’s one thing we were proud of — that we actually did not take that path here. We actually chose to do a criminal case and prosecute them criminally, so that’s one thing. ... We determined early on that we weren’t going to be the ones to move them to somebody else’s county to be a problem for them — we were going to deal with them here. ... This will strengthen future cases. It will set the tone and the pace for prosecuting these.”
“Georgia citizens who served on the federal jury in this case sent a clear message that operating pill mills and the illicit diversion of controlled substances will not be tolerated in our state. As law enforcement saw the early migration of pill mills to Georgia we quickly began investigating organizations involved in this activity. The GBI is very pleased a multi-agency effort resulted in the conviction of these individuals,” said Vernon Keenan, director of Georgia Bureau of Investigation, in the federal press release Wednesday.
The local pill mill case was investigated by the Drug Enforcement Administration’s Diversion Group, GBI, Bartow/Cartersville Drug Task Force, Georgia Drugs and Narcotics Agency, the Internal Revenue Service-Criminal Investigation, with special assistance from the Tennessee Bureau of Investigation and the Kentucky State Police.
“Not only from the drug task force’s point of view but our federal and state partners, we worked very close to that. But somebody who didn’t get a lot of credit for this, the uniform guys, both for the sheriff’s office and the city of Cartersville, they were intricate in helping us develop information by stopping these illegal drivers and these persons that were going to these pain clinics. It give us an opportunity to engage those folks, so without that uniform presence there, it would have taken us a lot longer,” Mayton said. “... Nobody worked by the shape of their badge, they worked to solve a problem, and that was great.”