Whether the phrase to measure authorization under 21 U.S.C. § 841(a) can be applied in the disjunctive

QUESTION PRESENTED The Circuits have applied vastly different interpretations of the ambiguous phrase “outside the usual course of his professional practice, other than for a legitimate medical purpose.” Ruan v. United States, 597 U.S. 450, 459 (2022); Gonzales v. Oregon, 546 U.S. 243, 258 (2006); United States v. Moore, 423 U.S. 122, 135 (1975). Circuits applying this phrase in the disjunctive have convicted physicians of a “knowing or intentional” deviation from an unenumerated “standard of care.” The questions presented are: Whether the phrase to measure authorization under 21 U.S.C. § 841(a) can be applied in the disjunctive. If the phrase is applied in the disjunctive, whether the prosecution of a physician for a deviation of an unenumerated “standard of care” is an improper exercise of the Commerce Clause.