## Facts

- A licensed physician registered under the Controlled Substances Act (CSA) operated a methadone clinic.
- The government indicted him for knowing and unlawful distribution and dispensation of methadone, a Schedule II controlled substance, under 21 U.S.C. § 841(a)(1).
- Trial evidence indicated he dispensed unusually large quantities of methadone without adequate physical examinations or individualized treatment plans.
- He allegedly failed to give specific instructions for methadone use and structured fees based on the quantity dispensed rather than medical services.
- A large multi-count indictment was narrowed before trial; a jury convicted him on multiple § 841(a)(1) counts, and the court imposed imprisonment and fines.
- The court of appeals reversed, reasoning that registered physicians could be prosecuted only under CSA regulatory provisions with lesser penalties, not under § 841.
- The Supreme Court granted review.

## Issues

1. Whether a physician registered under the CSA may be prosecuted under 21 U.S.C. § 841(a)(1) for dispensing controlled substances.
2. Whether § 841(a)(1)’s “except as authorized” clause excludes a registrant’s conduct that is outside the usual course of professional practice.
3. Whether Congress created mutually exclusive penalty schemes separating nonregistrants (§ 841) from registrants (§§ 842–843).

## Decision

- The Supreme Court reversed the court of appeals and held that registered physicians are not categorically exempt from prosecution under § 841(a)(1).
- The Court concluded that § 841(a)(1) applies to “any person,” including registrants, and a physician’s registration authorizes dispensing only within the scope of professional practice and CSA conformity.
- The Court rejected the view that §§ 842 and 843 provide the exclusive criminal provisions for registrants.
- The case was remanded for proceedings consistent with the Court’s holding, reinstating the legal basis for the convictions under § 841(a)(1).

## Legal Principles

- A CSA registrant may be prosecuted under 21 U.S.C. § 841(a)(1) when dispensing or distributing controlled substances outside the usual course of professional practice.
- The “except as authorized” limitation in § 841(a)(1) exempts only conduct that is lawful under the CSA, including compliance with registration limits and governing rules.
- The CSA does not establish two separate, status-based and mutually exclusive penalty systems; §§ 842–843 address regulatory violations but do not displace § 841 when the conduct constitutes unlawful distribution or dispensation.
- Whether a physician acted within the usual course of professional practice may be determined by the factfinder based on evidence of medical standards and the manner of prescribing or dispensing.

## Conclusion

The Court held that a physician’s CSA registration does not shield conduct that functions as drug distribution; when dispensing controlled substances departs from professional practice, the physician may be prosecuted under § 841(a)(1) like any other person.


United States v. Moore, 423 U.S. 122 (1975)