Health care professionals across the eastern half of the United States, including doctors, a dentist, a nurse and medical clinic operators, have been charged with illegally distributing prescriptions for more than 5 million pain pills, federal authorities said Wednesday.

Fourteen defendants were accused of crimes including illegally obtaining painkillers for personal use, unnecessarily prescribing painkillers to obtain Medicare and Medicaid payments, and filling out prescriptions in the names of current and former hospice patients, the government said.

In Alabama, Francene Aretha Gayle, 48, of Orlando, Florida, and Schara Monique Davis, 46, of Huntsville, Alabama, were charged with conspiracy to unlawfully distribute controlled substances, conspiracy to commit health care fraud, and health care fraud. Gayle was also charged with several substantive counts of illegally issuing opioid prescriptions.

According to the indictment, between 2015 and March 2020, Gayle and Davis operated three medical clinics in Huntsville, Athens, and Killen, Alabama, where Gayle served as the sole physician and Davis served as the business manager. The clinics billed insurers for millions of dollars in patient office visits that Gayle supposedly conducted, but Gayle was allegedly absent from the clinics and other staff conducted patients visits instead. During these visits, patients regularly received opioid prescriptions that Gayle allegedly pre-signed.

In one case, a Kentucky dentist was charged with illegally prescribing opioids to a patient three times in five days, with the patient dying of a morphine overdose from one prescription, according to the Justice Department.

Other defendants lived or worked in Florida, New Jersey, Ohio, West Virginia and Tennessee.

“We will continue to bring coordinated enforcement actions to address the opioid scourge plaguing the region,” said Kenneth Parker, U.S. Attorney for the Southern District of Ohio.

Overdose deaths attributed to opioids have continued to rise in the country, even as the crisis was overshadowed by the coronavirus pandemic. Last year, for the first time more than 100,000 Americans died of drug overdoses over a 12-month period.