United States of America v. Lonnie Joseph Parker

United States Court of Appeals
For the Eighth Circuit
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No. 24-2813
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United States of America
Plaintiff - Appellee
v.
Lonnie Joseph Parker
Defendant - Appellant
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Appeal from United States District Court
for the Western District of Arkansas - Texarkana
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Submitted: June 13, 2025
Filed: August 1, 2025
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Before COLLOTON, Chief Judge, ARNOLD and GRUENDER, Circuit Judges.
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GRUENDER, Circuit Judge.
A jury found Lonnie Parker, a licensed medical practitioner, guilty of
distributing oxycodone and promethazine HCl with codeine solution in a manner
unauthorized by the Controlled Substances Act. See 21 U.S.C. § 841(a)(1). The

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district court1 sentenced Parker to 87 months’ imprisonment. On appeal, Parker
contends that the evidence was insufficient to support his convictions, the jury
instructions were improper, and the district court committed procedural error in
sentencing. Finding no reversible error, we affirm.
I.
On August 3, 2018, an officer in Plano, Texas pulled an individual—whom
we will refer to as N.C.—over for reckless driving. N.C. was visibly impaired and
had a yellow stain on his mouth. The officer asked N.C. if he had taken any
medication, and N.C. responded that he had taken Lyrica for hand or back pain.
After arresting N.C., the officer searched N.C.’s car and discovered numerous
prescription bottles which listed Parker as the prescribing physician. N.C. was
transported to the Plano City Jail and died later that same day.
The Drug Enforcement Administration (“DEA”) began suspecting that Parker
was operating his medical clinic in Texarkana, Arkansas as a “pill mill” from which
he illegally distributed various opioid prescriptions. On October 8, 2019, the DEA
executed a search warrant at Parker’s clinic and seized numerous patient records.
The DEA retained an independent pain treatment expert—Dr. Mark Rubenstein—to
review a subset of those records. Rubenstein reviewed N.C.’s patient record, as well
as the patient records of four individuals whom we will refer to here as J.F., L.H.,
G.T., and K.J. The Government subsequently determined that Parker had distributed
oxycodone—a schedule II controlled substance—and promethazine HCl with
codeine solution—a schedule V controlled substance—in violation of the Controlled
Substances Act.
On June 15, 2022, a grand jury returned an indictment charging Parker with
unauthorized distribution of oxycodone to N.C., J.F., and L.H., and unauthorized
1 The Honorable Susan O. Hickey, Chief Judge, United States District Court
for the Western District of Arkansas.

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distribution of promethazine HCl with codeine solution to G.T. and K.J. See id. The
indictment also charged Parker with causing the death of N.C. See id.
§ 841(b)(1)(C).
During an eight-day jury trial, the Government presented testimony from
sixteen witnesses. As relevant here, the Government called Rubenstein as an expert
witness in the area of pain management. Rubenstein explained Arkansas’s
regulations regarding legitimate medical practice in pain management. He testified
that Parker had not conformed his conduct to those regulations. According to
Rubenstein, Parker had failed to conduct necessary physical examinations for his
patients, prescribed oxycodone and promethazine HCl with codeine solution
inappropriately, and maintained deficient and internally inconsistent patient records.
At the close of trial, the district court gave various instructions to the jury.
Instruction No. 6 instructed the jury that “[t]he terms ‘legitimate medical purpose’
and ‘usual course of professional practice’ mean acting in accordance with
appropriate criteria for prescribing controlled substances in the State of Arkansas.”
Instruction No. 14 instructed the jury that it could find that Parker “acted knowingly
if [it found] . . . that the defendant believed there was a high probability that [N.C.,
L.H., and J.F.] were addicted to oxycodone, and that [G.T. and K.J.] were diverting
promethazine with codeine cough syrup, and that he took deliberate actions to avoid
learning of that fact.”
The jury found Parker guilty of the unauthorized distribution of oxycodone to
N.C. and L.H., and the unauthorized distribution of promethazine HCl with codeine
solution to G.T. and K.J. It found Parker not guilty of the unauthorized distribution
of oxycodone to J.F. and also not guilty of causing the death of N.C. At sentencing,
the parties disputed the quantity of controlled substances that should be used to
calculate Parker’s base offense level under the sentencing guidelines. Parker argued
that the district court should consider only those controlled substances that were
prescribed to N.C., L.H., G.T., and K.J. on the date set forth in the indictment. The
Government argued that the district court should also include uncharged

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prescriptions written by Parker to N.C., L.H., G.T., and K.J. outside of that date as
relevant conduct. See U.S.S.G. § 1B1.3. The district court agreed with the
Government and calculated Parker’s base offense level as 28. After accounting for
a two-level enhancement for using a special skill to facilitate the offense, the district
court calculated Parker’s total offense level as 30. Parker’s total offense level of 30
combined with a criminal history category of II resulted in an advisory sentencing
guidelines range of 108 to 135 months’ imprisonment. The district court varied
downwards and sentenced Parker to 87 months’ imprisonment. The district court
noted that, even if it had ruled in Parker’s favor on quantity, it nonetheless would
have imposed the same sentence.
II.
On appeal, Parker asserts that the evidence was insufficient to support his
convictions and that the jury instructions were erroneous. He also contends that the
district court miscalculated the quantity of controlled substances used in determining
his base offense level. We address each claim in turn.
A.
We first address whether the evidence was sufficient to convict Parker of the
unauthorized distribution of oxycodone and promethazine HCl with codeine
solution. We review sufficiency of the evidence challenges de novo, “viewing the
evidence and the jury’s credibility determinations in the light most favorable to its
verdict and reversing only if no reasonable jury could have found [the defendant]
guilty.” United States v. Obi, 25 F.4th 574, 577 (8th Cir. 2022).
To prove Parker guilty of the unauthorized distribution of oxycodone and
promethazine HCl with codeine solution, the Government had to show that Parker
“knowingly or intentionally” distributed the controlled substances in a manner not
“authorized” by the Controlled Substances Act. 21 U.S.C. § 841(a)(1). A licensed
medical practitioner is “authorized” to prescribe controlled substances when he

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issues a prescription “for a legitimate medical purpose . . . acting in the usual course
of his professional practice.”2 21 C.F.R. § 1306.04(a) (2025). Parker contends that
the evidence was insufficient because the Government did not prove that he acted
without a “legitimate medical purpose.” But Rubenstein reviewed Parker’s patient
files and testified that, with respect to each patient named in the indictment, Parker
either prescribed controlled substances that were not appropriate for the claimed
ailment or prescribed excessive amounts of controlled substances. See United States
v. Heaton, 59 F.4th 1226, 1246 (11th Cir. 2023) (noting that a physician violates
§ 841(a)(1) when he prescribes “an excessive quantity of controlled substances” or
prescribes controlled substances that have “no logical relationship to the treatment
of the patient’s alleged condition”). Rubenstein also testified that Parker prescribed
controlled substances without performing physical examinations that would have
informed him if such prescriptions were necessary. See id. (noting that a physician
violates § 841(a)(1) when he distributes controlled substances without physically
examining patients). The jury was entitled to accept Rubenstein’s testimony, which
provided sufficient evidence to conclude that Parker had prescribed oxycodone and
promethazine HCl with codeine solution without “a legitimate medical purpose.” 21
C.F.R. § 1306.04(a); see United States v. Cole, 721 F.3d 1016, 1022 (8th Cir. 2013)
(“[I]n reviewing a sufficiency-of-the-evidence challenge, we are obliged to defer to
the jury’s determination of the credibility of the witnesses.” (internal quotation
marks omitted)). Accordingly, we reject Parker’s challenge to the sufficiency of the
evidence.
2 Parker asks this court to decide whether the terms “legitimate medical
purpose” and “in the usual course of his professional practice” should be considered
in the conjunctive or disjunctive. 21 C.F.R. § 1306.04(a) (2025). Because the jury
was instructed on the conjunctive and the Government does not challenge this
determination, we take no position on whether the terms “legitimate medical
purpose” and “usual course of his professional practice” should be considered in the
conjunctive or disjunctive.

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B.
We next address Parker’s challenge to the jury instructions—specifically,
Instructions No. 6 and 14. Because Parker raised these arguments for the first time
on appeal, Parker has forfeited them and we review only for plain error. See United
States v. Ford, 888 F.3d 922, 925-26 (8th Cir. 2018). To establish plain error, Parker
“must show that there is (1) error, (2) that is plain, and (3) that affects substantial
rights.” Id. at 926 (internal quotation marks omitted). If all three conditions are met,
“an appellate court may then exercise its discretion to notice a forfeited error, but
only if (4) the error seriously affects the fairness, integrity, or public reputation of
judicial proceedings.” Id.
Parker argues that Instruction No. 6, which instructed the jury that “[t]he terms
‘legitimate medical purpose’ and ‘usual course of professional practice’ mean acting
in accordance with appropriate criteria for prescribing controlled substances in the
State of Arkansas,” wrongly limited the jury to consider only the criteria set forth by
a single state. According to Parker, the district court should have instead instructed
the jury on a national standard, namely the regulations set forth by the Centers for
Disease Control and Prevention (“CDC”). However, there is nothing in the language
of § 841(a)(1) that suggests that a physician’s conduct must be compared to a
national standard. And, contrary to Parker’s assertion that the Supreme Court in
Ruan v. United States, 597 U.S. 450 (2022) disavowed reference to a state standard,
Ruan addressed only the mens rea required under § 841(a)(1). See id. at 457. Parker
therefore has not identified an error in Instruction No. 6 that is plain. Moreover, he
fails to show how the instruction affected his “substantial rights.” Ford, 888 F.3d at
926. He does not identify a meaningful distinction between the standards set forth
by the CDC and the State of Arkansas that would justify reversal in this case.
Accordingly, we reject Parker’s challenge to Instruction No. 6.
As for Instruction No. 14, it instructed the jury that it could find that Parker
“acted knowingly if [it found] . . . that the defendant believed there was a high
probability that [N.C., L.H., and J.F.] were addicted to oxycodone, and that [G.T.

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and K.J.] were diverting promethazine with codeine cough syrup, and that he took
deliberate actions to avoid learning of that fact.” Parker asserts that the instruction
was erroneous because it wrongfully equated treating addicted patients with criminal
conduct. While we agree with Parker that treating addicted patients is not in and of
itself criminal conduct, we cannot say that he has established that he is entitled to
relief. “In determining the effect of [a challenged] instruction on the validity of [a]
conviction, [courts] accept at the outset the well-established proposition that a single
instruction to a jury may not be judged in artificial isolation, but must be viewed in
the context of the overall charge.” Boyde v. California, 494 U.S. 370, 378 (1990).
Before closing arguments, the district court instructed the jury on the basic elements
of the charged offenses, informing the jury that the Government had to show that
Parker acted without “a legitimate medical purpose” and outside “the usual course
of his professional practice” in order to be convicted. Instruction No. 6, which
reiterated those basic requirements to the jury, never equated treating addicted
patients with criminal conduct. And Instruction No. 13 clarified that, if Parker
“dispense[d] a drug in good faith, in medically treating a patient,” then “he has
dispensed the drug lawfully.” Instruction No. 13 did not draw artificial lines
between treating patients who were addicted and those who were not. Moreover,
while it is true that Instruction No. 14 referred to addiction, the same instruction also
stated that a “willfully blind defendant is one who takes deliberate actions to avoid
confirming a high probability of wrongdoing and who can almost be said to have
actually known the critical facts.” Because we cannot view the “addicted” language
in Instruction No. 14 in artificial isolation—and the jury instructions as a whole
clarified what constituted criminal conduct—we cannot say that Parker has
established entitlement to relief for plain error. See Greer v. United States, 593 U.S.
503, 508 (2021) (noting that establishing plain error is “difficult”).
In addition, Parker argues that the jury instructions were erroneous because
the district court gave Instruction No. 14 without explicitly reciting to the jury a
particular fact that Parker took deliberate action to avoid learning. Parker contends
that such a reference is mandated by the Supreme Court’s decision in Global-Tech
Appliances, Inc. v. SEB S.A., 563 U.S. 754 (2011). However, the portion of the

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opinion cited by Parker only states the basic requirements for the doctrine of willful
blindness, namely that “[t]he defendant must subjectively believe that there is a high
probability that a fact exists” and that “the defendant must take deliberate actions to
avoid learning of that fact.” Id. at 769. The opinion nowhere states that the district
court must specifically identify that fact for the jury. Accordingly, we reject Parker’s
challenge to Instruction No. 14.
C.
Finally, we address Parker’s claim of procedural error in his sentencing.
“Procedural error includes failing to calculate (or improperly calculating) the
Guidelines range, treating the Guidelines as mandatory, failing to consider the
§ 3553(a) factors, selecting a sentence based on clearly erroneous facts, or failing to
adequately explain the chosen sentence . . . .” United States v. Feemster, 572 F.3d
455, 461 (8th Cir. 2009) (en banc) (internal quotation marks omitted). In
determining whether a district court committed procedural error, “we review the
district court’s factual findings for clear error, and its interpretation and application
of the Guidelines, de novo.” United States v. Frisch, 704 F.3d 541, 543 (8th Cir.
2013) (alteration omitted).
Parker contends that the district court erred in calculating the quantity of
controlled substances used to determine his base offense level. He asserts that the
district court’s calculation should not have included conduct outside of the
indictment. He also claims that some of his prescriptions to the individuals named
in the indictment were legitimate and therefore should not be included in quantity.
We need not address the merits of Parker’s contention as any error is harmless. We
have held that, even when a district court miscalculates a sentence, any error is
harmless “when the district court indicates it would have alternatively imposed the
same sentence even if a lower guideline range applied.” United States v. Hamilton,
929 F.3d 943, 948 (8th Cir. 2019). Here, the district court stated that it would have
“impose[d] [the] same sentence regardless” of its ruling on quantity. Thus, any error
was harmless and we reject Parker’s challenge to his sentence.

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III.
For the foregoing reasons, we affirm the judgment of the district court.
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