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The ruling was unanimous, though the justices disagreed on the precise rationale. They were united, however, in saying that prosecutors needed to prove more than that the doctors had violated objective standards. Justice Stephen G. Breyer, writing for six members of the court, said that, so long as doctors were authorized to dispense controlled substances, prosecutors “must prove beyond a reasonable doubt that the defendant knew that he or she was acting in an unauthorized manner, or intended to do so.” (Liptak, 6/27)

The Supreme Court on Monday unanimously ruled that prosecutors need to prove that doctors knowingly prescribed drugs in aberrant ways to win convictions against them for unlawful distribution of controlled medicines. The decision came in a case brought by two doctors who were sentenced to decades in prison for unlawfully prescribing opioids. The doctors had argued they were acting in “good faith” trying to provide care for their patients. (Joseph, 6/27)

Oklahoma Attorney General John O’Connor announced a $250 million settlement on Monday with three companies that distributed opioids in the state, and he said the money will be used to prevent and treat opioid addiction. The settlement with McKesson Corp., Cardinal Health Inc. and AmerisourceBergen Corp. must be approved by local government leaders in Oklahoma. Attorneys' fees will not be taken out of the $250 million but will be paid separately. O’Connor announced the settlement a day ahead of his Republican primary contest on Tuesday with Tulsa attorney Gentner Drummond. (Casteel, 6/27)

A newly formed nonprofit is in charge of $440 million secured by Ohio from lawsuits against opioid distributors, but an advocate is raising questions about transparency. There's been only two meetings so far of the 29-member OneOhio Recovery Foundation Board, the most recent being Thursday, in addition to further meetings of "working groups." Despite the amount of money at stake, public notices were hard to find. Working group meetings are private. Basic details of the meetings are scant. (Wu, 6/27)

Emergency departments (EDs) are an important point of care for people with opioid use disorder. But EDs in the United States have been slow to meet patient needs for opioid use treatments like buprenorphine, past research shows. A new tool developed by Yale researchers aims to close this gap by helping physicians feel more prepared to offer these medications. In a recent trial, the researchers found that the tool — called EMergency department-initiated BuprenorphinE for opioid use Disorder (EMBED) — increased the number of physicians initiating buprenorphine treatment in the ED. Their findings were reported June 27 in the BMJ, a global medical journal. (Locklear, 6/27)