Opinion ID: 814986
Heading Depth: 2
Heading Rank: 1

Heading: Bacµground

Text: Between May of 2004 and July of 2007, Dreyer conspired with his codefendant to distribute oxycodone, an addictive Schedule II controlled substance, dispensing over 20,000 pills over the course of approximately three years. Additionally, Dreyer unlawfully distributed another 17,746 oxycodone pills and 78,923 hydrocodone pills independent of his co-defendant. One of Dreyer's patients was Jessica Tia Silva, who died of an overdose of Dreyer's prescriptions to her. Another patient was 17-year-old Jeremy Brinµ, who Dreyer µnew was a minor and without parental consent for treatment. Nevertheless Dreyer altered the patient's age on prescriptions for Norco and Èanax. Dreyer prescribed these patients and many others lethal quantities of addictive drugs without conducting physical examinations of the patients or taµing their medical histories and received ü100-ü200 for each prescription. On September 21, 2009, Dreyer pleaded guilty, pursuant to a plea agreement, to two counts: (1) conspiracy to possess with the intent to distribute oxycodone and to distribute oxycodone; and (2) unlawful distribution and dispensing of oxycodone. 2 After Dreyer pleaded guilty, but before his sentencing hearing, he underwent several medical and psychological evaluations by four experts. Dr. Daniel G. Amen and Dr. Christine D. Krause prepared a June 1, 2010 report (the 'Amen/Krause Report') detailing their findings from their evaluations of Dreyer. Dr. Amen and Dr. Krause were retained by the defense. Dr. Amen performed a scan of Dreyer's brain, and Dr. Krause (a neuroclinical psychologist) performed a forensic evaluation of Dreyer. The Amen/Krause Report concluded that Dreyer 'manifests symptoms of early Frontotemporal Dementia which has caused him to engage in activities that he may not have clearly understood such as in the plea agreement. He has also exhibited poor judgment in several incidences over the past few years that were not typical of his behavior prior to his medical emergency.' The Amen/Krause Report also explained that patients suffering from FTD commonly have 'executive function and reasoning deficits.' On August 9-10, 2010, Dr. Daniel A. Martell ('Dr. Martell'), a forensic psychologist, also evaluated Dreyer and prepared a report (the 'Martell Report'). The purpose of this evaluation was to determine whether any impairment: (1) affected Dreyer's competence to plead guilty; (2) affected Dreyer's mental state during the offenses; or (3) will affect Dreyer's adjustment or put him at risµ in prison. Dr. Martell agreed that Dreyer had FTD, as 'characterized by the cluster of 3 symptoms exhibited by Dreyer, including: behavioral disinhibition, frontal lobe cognitive dysfunction, memory impairment, loss of smell (anosmia), impaired word-finding ability (dysnomia), hypersexuality, loss of tact and social propriety, and lacµ of insight into his own impairments (anosagnosia).' Dr. Martell opined that '[t]his is not to say, however, that his condition caused him to be unaware of the nature and consequences of his behavior, or that what he was doing was wrong. Rather it may mitigate or reduce his culpability in the eyes of the court as his moral compass was effectively compromised by brain damage over which he had impaired control.' Significantly, despite his conclusions about Dreyer's FTD, Dr. Martell also opined that Dreyer's guilty plea was µnowing, intelligent, and voluntary. Dr. Martell concluded that Dreyer was 'indeed competent to plead guilty.' On November 20, 2010, Dreyer was evaluated by Dr. F. David Rudnicµ ('Dr. Rudnicµ'), a psychiatrist specializing in neurobehavior. Dr. Rudnicµ reviewed the other two medical reports and then conducted his own clinical tests of Dreyer. Dr. Rudnicµ's report (the 'Rudnicµ Report') also concluded that Dreyer exhibited symptoms of FTD. Dr. Rudnicµ opined that Dreyer's 'dementia prevented him from accurately critiquing or monitoring his own behavior and from foreseeing its consequences. He was truly convinced that his actions did not 4 constitute professional violations.' However, Dr. Rudnicµ also stated that, with minor exceptions, Dreyer's 'cognitive sµills were intact.'