The U.S. Supreme Court on Monday unanimously ruled to send the cases of former Casper Dr. Shakeel Kahn and another pain medication doctor back to federal appeals courts for reconsideration.

The court dealt with the question of when or if doctors legitimately prescribing painkillers such as oxycodone shifted at some point to their supporting addiction, and when or if they knew that.

Wyoming and federal agencies began investigating Kahn in early 2016. He was arrested in November and eventually charged with more than twenty counts and noted he wrote prescriptions for 2.2 million pills, most of them for oxycodone.

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A jury convicted him in May 2019 for prescribing drugs outside the standard of care, operating an ongoing criminal enterprise, prescribing controlled substances resulting in death and other crimes.

In August, U.S. District Court Judge Alan Johnson sentenced him to 25 years imprisonment.

The Denver-based 10th U.S. Circuit Court of Appeals upheld the conviction and sentence in February 2021.

The other petitioner to the court was Dr. Xiulu Ruan of Mobile, Alabama, who was convicted of overprescribing opioids. He was sentenced to 21 years imprisonment. The Atlanta-based 11th U.S. Circuit Court of Appeals upheld Ruan’s conviction.

Kahn and Ruan filed separate writs of certiorari with the Supreme Court, which combined them into one case.

Prosecutors needed to prove that Kahn and Ruan illegally prescribed pain medications in a way that violated the Controlled Substances Act.

But in the the 9-0 opinion written by Justice Stephen Breyer, the court ruled that if the doctors believed they were acting properly under the Controlled Substances Act, prosecutors “must prove beyond a reasonable doubt that the defendant knowingly or intentionally acted in an unauthorized manner.

“We vacate the judgments of the Courts of Appeals below and remand the cases for further proceedings consistent with this opinion."

Justices Samuel Alito wrote a concurring opinion and that was joined by Justices Clarence Thomas and Amy Coney Barrett.

This story will be updated.

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