In Ruan v. United States, 597 U.S. ___ (2022), this Court answered the question on whether a physician alleged to have prescribed controlled substances outside the usual course of professional practice could be convicted of unlawful distribution under 21 U.S.C. §841(a)(1) regardles s of whether he "reasonably believed" or "subjectively intended" that his prescriptions fell within that course of professional practice. This Court ruled that the crime of prescribing controlled substances outside the usual course of professional practic e, in violation of 21 U.S.C. §841(a)(1), requires that the defendant "knowingly or intentionally" acted in an unauthorized manner.

The question presented for review in this Petition is whether the Fourth Circuit unconstitutionally applied the plain error standard to affirm Dr. Naum's conviction where the court admitted and agreed that the jury instructions misstated the law after Ruan v. United States; jury instructions which failed to consider Dr. Naum's subjective intent. The Fourth Circuit's ruling completely disregarded the basic tenets and purpose jury instructions. Jury instructions affect juror decision making by providing gui dance on the evidence presented and play a critical role in shaping how jurors evaluate evidence. Nonetheless, the efficacy of jury instructions depends on factors such as timing, content, and jurors' psychological tendencies. In this case, where the district court precluded the admission of the very evidence to support Dr. Naum's subjective intent, no "plain error" can exist when the district court precluded Dr, Naum from introducing the medical standard upon which he based his subjective suboxone prescribing practice.

Whether the Fourth Circuit unconstitutionally applied the plain error standard to affirm a physician's conviction where jury instructions misstated the law after Ruan v. United States by failing to consider the defendant's subjective intent