Notice2025-19062

Jody Adams, N.P.; Decision and Order

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Published
September 30, 2025

Issuing agencies

Justice DepartmentDrug Enforcement Administration

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<title>Federal Register, Volume 90 Issue 187 (Tuesday, September 30, 2025)</title>
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[Federal Register Volume 90, Number 187 (Tuesday, September 30, 2025)]
[Notices]
[Pages 46921-46923]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2025-19062]


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DEPARTMENT OF JUSTICE

Drug Enforcement Administration


Jody Adams, N.P.; Decision and Order

    On June 21, 2024, the Drug Enforcement Administration (DEA or 
Government) issued an Order to Show Cause (OSC) to Jody Adams, N.P., of 
Ridgeland, Mississippi (Respondent). Request for Final Agency Action 
(RFAA), Exhibit (RFAAX) 2, at 1, 5. The OSC proposed the denial of 
Respondent's application for DEA registration, Control No. W24008696M, 
alleging that Respondent's registration would be inconsistent with the 
public interest. Id. at 1 (citing 21 U.S.C. 823(g)(1)). More 
specifically, the OSC alleged that Respondent illegally issued three 
prescriptions for controlled substances without a DEA Registration. Id. 
at 3. The OSC alleged that the issuance of these prescriptions violated 
both state and federal law.\1\ Id. (citing 21 U.S.C. 822; 21 CFR 
1301.11; 30 Miss. Code R. 2840-1.5).
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    \1\ The Agency need not adjudicate the criminal violations 
alleged in the instant OSC. Ruan v. United States, 597 U.S. 450 
(2022) (decided in the context of criminal proceedings).
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    On January 15, 2025, the Government submitted an RFAA requesting 
that the Agency issue a default final order denying Respondent's 
application for registration. RFAA, at 4.\2\ After carefully reviewing 
the entire record and conducting the analysis as set forth in more 
detail below, the Agency grants the Government's request for final 
agency action and denies Respondent's application for registration.
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    \2\ The RFAA states that ``the Administrator is authorized to 
render the Agency's final order without . . . making a finding of 
fact.'' RFAA, at 4 (citing 21 CFR 1301.43(c), (f), and 1301.46). 
However, 21 CFR 1316.67 requires that the Administrator's final 
order ``set forth the final rule and the findings of fact and 
conclusions of law upon which the rule is based.'' See JYA LLC d/b/a 
Webb's Square Pharmacy, 90 FR 31244, 31246 n.7 (2025).
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I. Default Determination

    Under 21 CFR 1301.43, a registrant entitled to a hearing who fails 
to file a timely hearing request ``within 30 days after the date of 
receipt of the [OSC] . . . shall be deemed to have waived their right 
to a hearing and to be in default'' unless ``good cause'' is 
established for the failure. 21 CFR 1301.43(a) & (c)(1). In the absence 
of a demonstration of good cause, a registrant who fails to timely file 
an answer also is ``deemed to have waived their right to a hearing and 
to be in default.'' 21 CFR 1301.43(c)(2). Unless excused, a default is 
deemed to constitute ``an admission of the factual allegations of the 
[OSC].'' 21 CFR 1301.43(e).
    Here, the OSC notified Respondent that should she request a hearing 
and file an answer and then fail to appear at the designated hearing, 
she would be deemed to have waived her right to a hearing and be in 
default. RFAAX 2, at 3 (citing 21 CFR 1301.43). Respondent timely filed 
a request for a hearing and an answer; however, on September 10, 2024, 
Respondent withdrew her hearing request. RFAA, at 2.\3\ Subsequently, 
the Administrative Law Judge issued an order terminating the 
proceeding. Id.
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    \3\ As Respondent filed a request for a hearing, the Agency 
finds that the Government's service of the OSC was adequate.
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    Consistent with the intent and purpose of the default provisions, 
the Agency has determined that a voluntary withdrawal of a hearing 
request demonstrates a respondent's desire to no longer defend his/her 
case and contest the allegations of the OSC. See 21 CFR 1301.43(c); see 
also Default Provisions for Hearing Proceedings Relating to the 
Revocation, Suspension, or Denial of a Registration, 87 FR 68036,

[[Page 46922]]

68037-38 (Nov. 14, 2022). Accordingly, the Agency has determined that a 
voluntarily withdrawal constitutes a default under 21 CFR 1301.43(c) 
for failure to defend. See Salman Akbar, M.D., 89 FR 82259, 82259 
(2024) (``By voluntarily withdrawing his hearing request, Respondent 
`fail[ed] to . . . otherwise defend.' '')). Thus, the Agency finds that 
Respondent is in default and therefore has admitted to the factual 
allegations in the OSC. 21 CFR 1301.43(e).

II. Applicable Law

    As the Supreme Court stated in Gonzales v. Raich, 545 U.S. 1 
(2005), ``the main objectives of the [Controlled Substances Act (CSA)] 
were to conquer drug abuse and control the legitimate and illegitimate 
traffic in controlled substances.'' Id. at 12. Gonzales v. Raich 
explained that:

    Congress was particularly concerned with the need to prevent the 
diversion of drugs from legitimate to illicit channels. To 
effectuate these goals, Congress devised a closed regulatory system 
making it unlawful to manufacture, distribute, dispense, or possess 
any controlled substance except in a manner authorized by the CSA . 
. . . The CSA and its implementing regulations set forth strict 
requirements regarding registration, labeling and packaging, 
production quotas, drug security, and recordkeeping.

Id. at 12-14.
    The CSA requires that ``every person who dispenses, or who proposes 
to dispense, any controlled substance, shall obtain from the [DEA] a 
registration.'' 21 U.S.C. 822(a)(2); see also Gonzales v. Raich, 545 
U.S. at 27-28. The term ``dispense'' means ``to deliver a controlled 
substance to an ultimate user or research subject by, or pursuant to 
the lawful order of, a practitioner, including the prescribing and 
administering of a controlled substance and the packaging, labeling or 
compounding necessary to prepare the substance for such delivery.'' 21 
U.S.C. 802(10). Moreover, under Mississippi law, ``every APRN 
authorized to practice in Mississippi who prescribes any controlled 
substance within Mississippi . . . must be registered with and act in 
abidance with the [DEA] in compliance with Title 21 CFR part 1301 Food 
and Drugs.'' 30 Miss. Code R. 2840-1.5(c)(1).

III. Findings of Fact

    In light of Respondent's default, the factual allegations in the 
OSC are deemed admitted. 21 CFR 1301.43(e). Accordingly, Respondent 
admits that between January 18, 2023, and January 29, 2024, she 
illegally issued three prescriptions for controlled substances without 
a DEA registration, including two prescriptions for testosterone, a 
Schedule III controlled substance, and one prescription for pregabalin, 
a Schedule V controlled substance. RFAAX 2, at 3.\4\
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    \4\ Respondent previously had two DEA registrations (MA1562657 
and MA5540554) but voluntarily surrendered them on February 2, 2016, 
and October 11, 2022, respectively. RFAAX 2, at 2-3. At the time 
Respondent issued these prescriptions, she had not had an active DEA 
registration since October 11, 2022. Id. at 3.
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    Accordingly, the Agency finds more than substantial record evidence 
that Respondent issued three prescriptions for controlled substances 
without a DEA registration.

IV. Public Interest Determination

A. Legal Background on Public Interest Determinations

    When the CSA's requirements are not met, the Attorney General ``may 
deny, suspend, or revoke [a] registration if . . . the [registrant's] 
registration would be `inconsistent with the public interest.' '' 
Gonzales v. Oregon, 546 U.S. 243, 251 (2006) (quoting 21 U.S.C. 
824(a)(4)). In the case of a ``practitioner,'' Congress directed the 
Attorney General to consider five factors in making the public interest 
determination. Id.; 21 U.S.C. 823(g)(1)(A-E).\5\
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    \5\ The five factors are:
    (A) The recommendation of the appropriate State licensing board 
or professional disciplinary authority.
    (B) The applicant's experience in dispensing or conducting 
research with respect to controlled substances.
    (C) The applicant's conviction record under Federal or State 
laws relating to the manufacture, distribution, or dispensing of 
controlled substances.
    (D) Compliance with applicable State, Federal, or local laws 
relating to controlled substances.
    (E) Such other conduct which may threaten the public health and 
safety.
    21 U.S.C. 823(g)(1)(A-E).
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    The five factors are considered in the disjunctive. Gonzales v. 
Oregon, 546 U.S. at 292-93 (Scalia, J., dissenting) (``It is well 
established that these factors are to be considered in the 
disjunctive'' (quoting In re Arora, 60 FR 4447, 4448 (1995))); Robert 
A. Leslie, M.D., 68 FR 15227, 15230 (2003). Each factor is weighed on a 
case-by-case basis. David H. Gillis, M.D., 58 FR 37507, 37508 (1993). 
Any one factor, or combination of factors, may be decisive, id., and 
the Agency ``may give each factor the weight . . . deem[ed] appropriate 
in determining whether a registration should be revoked or an 
application for registration denied.'' Morall, 412 F.3d. at 185 n.2 
(Henderson, J., concurring) (quoting Robert A. Smith, M.D., 70 FR 
33207, 33208 (2007)); see also Penick Corp. v. Drug Enf't Admin., 491 
F.3d 483, 490 (D.C. Cir. 2007).
    Moreover, while the Agency is required to consider each of the 
factors, it ``need not make explicit findings as to each one.'' MacKay 
v. Drug Enf't Admin., 664 F.3d 808, 816 (10th Cir. 2011) (quoting 
Volkman v. U.S. Drug Enf't Admin., 567 F.3d 215, 222 (6th Cir. 2009)); 
Jones Total Health Care Pharmacy, LLC v. Drug Enf't Admin., 881 F.3d 
823, 830 (11th Cir. 2018); Hoxie v. Drug Enf't Admin., 419 F.3d 477, 
482 (6th Cir. 2005). ``In short, . . . the Agency is not required to 
mechanically count up the factors and determine how many favor the 
Government and how many favor the registrant. Rather, it is an inquiry 
which focuses on protecting the public interest; what matters is the 
seriousness of the registrant's misconduct.'' Jayam Krishna-Iyer, M.D., 
74 FR 459, 462 (2009). Accordingly, as the Tenth Circuit has 
recognized, Agency decisions have explained that findings under a 
single factor can support the revocation of a registration. MacKay, 664 
F.3d at 821; see also Robert Wayne Locklear, M.D., 86 FR 33738, 33744-
45 (2021) (explaining the statutory bases to revoke a registration may 
also serve as bases to deny an application).
    The Government has the burden of proof in this proceeding. 21 CFR 
1301.44(d) (granting or denying an application).

B. Respondent's Registration Is Inconsistent With the Public Interest

    While the Agency has considered all the public interest factors of 
21 U.S.C. 823(g)(1),\6\ the Government's evidence in support of its 
prima facie case is confined to Factors B and D. RFAAX 2, at 1. 
Evidence is considered under Factors B and D when it reflects

[[Page 46923]]

compliance or non-compliance with laws related to controlled substances 
and experience dispensing controlled substances. Kareem Hubbard, M.D., 
87 FR 21156, 21162 (2022).
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    \6\ As to Factor A, there is no record evidence of disciplinary 
action against Respondent's state nurse practitioner license or 
Respondent's state registered nurse license for prescribing without 
DEA authority. 21 U.S.C. 823(g)(1)(A). However, ``[t]he fact that 
the record contains no evidence of a recommendation by a state 
licensing board does not weigh for or against a determination as to 
whether continuation of the Respondent's DEA certification is 
consistent with the public interest.'' Roni Dreszer, M.D., 76 FR 
19434, 19444 (2011). As to Factor C, there is no evidence in the 
record that Respondent has been convicted of any federal or state 
law offense ``relating to the manufacture, distribution, or 
dispensing of controlled substances.'' 21 U.S.C. 823(g)(1)(C). 
However, as Agency cases have noted, ``the absence of such a 
conviction is of considerably less consequence in the public 
interest inquiry'' and is therefore not dispositive. Dewey C. 
MacKay, M.D., 75 FR 49956, 49973 (2010). As to Factor E, the 
Government's evidence fits squarely within the parameters of Factors 
B and D and does not raise ``other conduct which may threaten the 
public health and safety.'' 21 U.S.C. 823(g)(1)(E). Accordingly, 
Factor E does not weigh for or against Respondent.
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    Here, as the Agency found above, and Respondent is deemed to have 
admitted, that Respondent issued three controlled substance 
prescriptions without a DEA registration. Accordingly, there is 
substantial record evidence in support of the Agency's finding that 
Respondent violated both federal and Mississippi state law, namely 21 
U.S.C 822; 21 CFR 1301.11; and 30 Miss. Code R. 2840-1.5. The Agency 
further finds that after considering the factors of 21 U.S.C. 
823(g)(1), Respondent's registration would be ``inconsistent with the 
public interest.'' 21 U.S.C. 824(a)(4); see also Richard J. Settles, 
D.O., 81 FR 64940, 64947 (2016) (finding respondent's registration 
would be inconsistent with the public interest where he prescribed 
controlled substances without a DEA registration); John V. Scalera, 78 
FR 12092, 12098 (2013) (same); Belinda R. Mori, N.P., 78 FR 36582, 
36588 (2013) (same); Leo A. Farmer, M.D., 78 FR 27997, 27999 (2013) 
(same); Glenn D. Krieger, M.D., 76 FR 20020, 20024 (2011) (same).
    Accordingly, the Government satisfied its prima facie burden of 
showing that Respondent's registration would be ``inconsistent with the 
public interest.'' 21 U.S.C. 824(a)(4). The Agency also finds that 
there is insufficient mitigating evidence to rebut the Government's 
prima facie case. Thus, the only remaining issue is whether, in light 
of the Agency's finding that Respondent violated the law, Respondent 
can be trusted with a registration.

V. Sanction

    Where, as here, the Government has met the burden of showing that 
Respondent's registration would be inconsistent with the public 
interest, the burden shifts to Respondent to show why she can be 
entrusted with a registration. Morall, 412 F.3d. at 174; Jones Total 
Health Care Pharmacy, 881 F.3d at 830; Garrett Howard Smith, M.D., 83 
FR 18882, 18904 (2018). The issue of trust is necessarily a fact-
dependent determination based on the circumstances presented by the 
individual respondent. Jeffrey Stein, M.D., 84 FR 46968, 46972 (2019); 
see also Jones Total Health Care Pharmacy, 881 F.3d at 833. Moreover, 
as past performance is the best predictor of future performance, the 
Agency requires that a registrant who has committed acts inconsistent 
with the public interest accept responsibility for those acts and 
demonstrate that she will not engage in future misconduct. See Jones 
Total Health Care Pharmacy, 881 F.3d at 833; ALRA Labs, Inc. v. Drug 
Enf't Admin., 54 F.3d 450, 452 (7th Cir. 1995). The Agency requires a 
registrant's unequivocal acceptance of responsibility. Janet S. 
Pettyjohn, D.O., 89 FR 82639, 82641 (2024); Mohammed Asgar, M.D., 83 FR 
29569, 29573 (2018); see also Jones Total Health Care Pharmacy, 881 
F.3d at 830-31. In addition, a registrant's candor during the 
investigation and hearing is an important factor in determining 
acceptance of responsibility and the appropriate sanction. See Jones 
Total Health Care Pharmacy, 881 F.3d at 830-31; Hoxie, 419 F.3d at 483-
84. Further, the Agency considers the egregiousness and extent of the 
misconduct as significant factors in determining the appropriate 
sanction. See Jones Total Health Care Pharmacy, 881 F.3d at 834 & n.4. 
The Agency also considers the need to deter similar acts by a 
respondent and by the community of registrants. Jeffrey Stein, M.D., 84 
FR at 46972-73.
    Here, Respondent requested a hearing and filed an answer to the OSC 
but later withdrew her request for a hearing. Thus, there is no record 
evidence that Respondent takes responsibility, let alone unequivocal 
responsibility, for the misconduct. Accordingly, she has not convinced 
the Agency that her future controlled-substance-related actions will 
comply with the CSA such that she can be entrusted with the 
responsibilities of a registration.
    Further, the interests of specific and general deterrence weigh in 
favor of denial. Respondent's conduct in this matter concerns the CSA's 
strict requirements regarding registration and, therefore, goes to the 
heart of the CSA's ``closed regulatory system'' specifically designed 
``to conquer drug abuse and to control the legitimate and illegitimate 
traffic in controlled substances.'' Gonzales v. Raich, 545 U.S. at 12-
14. If the Agency were to issue a registration to Respondent under 
these circumstances, it would send a dangerous message that compliance 
with the law is not essential to obtaining a registration.
    In sum, Respondent has not offered any credible evidence on the 
record that rebuts the Government's case for denial of her 
registration, and Respondent has not demonstrated that she can be 
entrusted with the responsibility of registration. Accordingly, the 
Agency will order the denial of Respondent's application for 
registration.

Order

    Pursuant to 28 CFR 0.100(b) and the authority vested in me by 21 
U.S.C. 823(g)(1), I hereby deny the application for a DEA Certificate 
of Registration, Control No. W24008696M, submitted by Jody Adams, N.P., 
as well as any other pending application of Jody Adams, N.P., for 
registration in Mississippi. This Order is effective October 30, 2025.

Signing Authority

    This document of the Drug Enforcement Administration was signed on 
September 25, 2025, by Administrator Terrance Cole. That document with 
the original signature and date is maintained by DEA. For 
administrative purposes only, and in compliance with requirements of 
the Office of the Federal Register, the undersigned DEA Federal 
Register Liaison Officer has been authorized to sign and submit the 
document in electronic format for publication, as an official document 
of DEA. This administrative process in no way alters the legal effect 
of this document upon publication in the Federal Register.

Heather Achbach,
Federal Register Liaison Officer, Drug Enforcement Administration.
[FR Doc. 2025-19062 Filed 9-29-25; 8:45 am]
BILLING CODE 4410-09-P


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Indexed from Federal Register on September 30, 2025.

This is legal information, not legal advice. Laws vary by jurisdiction and change frequently. Always verify current law with official sources and consult a licensed attorney in your jurisdiction for advice on your specific situation.