Introduction
The Drug Enforcement Administration issued a final order on October 17, 2025, denying the application of David S. Pecora, a physician assistant in Bemidji, Minnesota, for a DEA Certificate of Registration to handle controlled substances. The denial stems from an Order to Show Cause served on Pecora in August 2024, to which he did not respond, resulting in a default. The agency determined that Pecora materially falsified multiple applications between 2012 and 2023 by failing to disclose suspensions of state licenses and prior surrenders of DEA registrations. Additionally, the DEA found that his registration would be inconsistent with the public interest under the Controlled Substances Act, citing his admissions of diverting and abusing controlled substances like carisoprodol and propofol over several years. This decision underscores the DEA's rigorous scrutiny of applicants with histories of noncompliance and substance misuse, potentially affecting how similar cases are handled in the future.
Background and Procedural History
Pecora applied for DEA registration under Control Number W23054133M in May 2023, seeking authority to handle controlled substances as a practitioner. The DEA issued an Order to Show Cause on August 16, 2024, alleging material falsification of this and prior applications, as well as conduct inconsistent with the public interest. Under 21 CFR 1301.43, Pecora had 30 days to request a hearing or file an answer but did neither, leading to a default determination. The agency then proceeded to a final order based on the uncontested allegations.
This case arises under the Controlled Substances Act, which requires the DEA Administrator to deny registrations if they are inconsistent with the public interest or involve material falsification (21 U.S.C. 823(g)(1) and 824(a)(1)). The decision references key precedents, including Kungys v. United States (1988) for defining materiality as having a natural tendency to influence agency decisions, and cases like Frank Joseph Stirlacci, M.D. (2020) for applying falsification standards to DEA applications.
Key players include Pecora as the applicant and the DEA, represented by Diversion Investigators who served the OSC in person on August 26, 2024. State medical boards in Minnesota, Florida, West Virginia, and North Dakota played roles in prior disciplinary actions against Pecora's licenses, which he failed to disclose.
Material Falsification Findings
The DEA found that Pecora materially falsified five applications by omitting required disclosures about adverse actions on his state licenses and prior DEA registrations. Materiality is established when false statements or omissions relate to statutory factors under 21 U.S.C. 823, such as state licensure status, which can lead to denial or revocation.
In his January 2012 application (W12001098M), Pecora answered "no" to a question about state license suspensions, omitting 2007 and 2008 suspensions of his nursing licenses in West Virginia and Florida. The October 2013 application (W13085169M) repeated this omission and added the failure to disclose a 2012 denial of a physician assistant license in North Dakota.
The January 2016 application (W16005281M) included partial disclosures but omitted multiple suspensions of Pecora's Minnesota physician assistant license in 2014 and 2015, as well as the earlier West Virginia, Florida, and North Dakota actions. A 2020 renewal for registration MP4140478 falsely stated "nothing new to report," perpetuating these omissions.
Finally, the 2023 application at issue omitted two prior surrenders of DEA registrations in 2013 and 2015, along with additional Minnesota license suspensions up to 2023. The agency cited cases like Emed Medical Company LLC (2023) to support that such omissions are material because they affect evaluations of public interest factors.
Public Interest Determination
Beyond falsification, the DEA analyzed the public interest under 21 U.S.C. 823(g)(1), focusing on Factors B (experience dispensing controlled substances), D (compliance with laws), and E (other conduct threatening public health). Pecora's admissions established a pattern of substance abuse and diversion.
In 2007, Pecora was addicted to zolpidem, a Schedule IV depressant, and underwent treatment. By 2013, he abused carisoprodol, issuing prescriptions to volleyball teammates in exchange for pills, violating 21 CFR 1306.04(a) which requires prescriptions for legitimate medical purposes. He also ordered carisoprodol online while in treatment, not for medical needs.
Further incidents include positive carisoprodol tests in 2014 without prescriptions and stealing propofol in 2020 for personal use. Minnesota Board of Medical Practice orders in 2015 and 2021 mandated treatment, monitoring, and sobriety demonstrations, reflecting ongoing issues.
The decision draws on precedents like Michael E. Smith, D.V.M. (2022) for diversion via illegitimate prescriptions and Brewster Drug, Inc. (2020) for self-abuse as a public safety threat. These factors weighed heavily against granting the registration.
Implications and Perspectives
This denial highlights tensions between professional rehabilitation and regulatory enforcement. From the DEA's perspective, Pecora's repeated nondisclosures and abuse history justify denial to protect against diversion risks. Critics might argue that default procedures limit due process, though the OSC provided notice and opportunity for response.
Short-term implications include Pecora's inability to handle controlled substances in Minnesota, effective November 17, 2025. Long-term, it may influence how practitioners with addiction histories approach disclosures, emphasizing transparency. Different stakeholders, such as medical boards, view such cases as opportunities for oversight, while advocates for healthcare professionals stress the need for supportive recovery paths without automatic registration barriers.
Conclusion
The DEA's order denies Pecora's application based on clear evidence of material falsifications and public interest violations, reinforcing the agency's gatekeeping role under the Controlled Substances Act.