Craig A. Spiegel, 69, pleaded guilty to three federal counts and faces sentencing next year.
ST. LOUIS — A former St. Louis County pediatrician admitted Thursday that he wrote prescriptions for controlled substances in exchange for sex acts, nude photos or cash, ending a yearslong case that began with his 2024 indictment and stretched across multiple agencies.
Prosecutors said Craig A. Spiegel pleaded guilty to one count of illegal distribution of controlled substances, one count of making false statements related to health care matters and one count of conspiracy to distribute controlled substances. The plea caps an investigation into prescriptions issued from at least 2014 through May 2023. Investigators said the conduct reached patients he first met as children at his Bridgeton office, and that public health programs lost money as prescriptions flowed without a valid medical purpose. A sentencing hearing is set for March 24, 2026, when a judge will decide his punishment.
According to court filings and statements made in court, Spiegel wrote prescriptions for opioids, benzodiazepines, stimulants and other drugs to adult women in exchange for sex acts or explicit photos. At times, the exchanges happened at his pediatric practice in Bridgeton, investigators said. Prosecutors said Spiegel knew some recipients had substance use disorders and were at heightened risk of overdose. One woman performed sex acts at his office or sent nude photos in return for pain pills or Adderall, according to the plea. Another received an opioid, a benzodiazepine and a stimulant or muscle relaxer even though she struggled with addiction. In a separate admission, Spiegel acknowledged lying under oath during an April 2025 hearing while trying to suppress evidence from his cellphone, falsely claiming officers conducted an illegal search.
Officials said the Medicare, Missouri Medicaid and Illinois Medicaid programs sustained $114,480 in losses tied to the illegal prescriptions. Prosecutors also outlined Spiegel’s relationship with co-defendant April Bingham, 48, saying he issued her prescriptions in exchange for sexual favors and knew she sold some of the drugs. Investigators said Spiegel used the names of Bingham’s ex-husband, mother and friends on some prescriptions to exploit their insurance benefits and obscure how frequently she received controlled substances. Bingham pleaded guilty to conspiracy earlier; she was sentenced in 2024 to 21 months in prison. In a prior motion seeking detention, investigators said they had identified at least 25 people who received drugs or prescriptions through the scheme. The Drug Enforcement Administration, Bridgeton police, federal health investigators and the Missouri Attorney General’s Medicaid fraud unit worked the case.
Spiegel’s plea follows a March 2024 indictment that accused him of ignoring clear red flags, including repeated requests for specific combinations of Adderall, Xanax and Percocet. In one example described in charging documents, a patient was told he would write “any prescription she desired” if she performed a sex act while topless, and prescriptions followed for multiple drugs. Prosecutors said Spiegel pressured reluctant women into sex acts or to send nude photos in exchange for scripts. The allegations drew comparisons to prior prosecutions of medical professionals who violated prescribing rules as the region tries to curb misuse of powerful medications. Authorities said the case also touched on recordkeeping and billing: prescriptions without legitimate purpose can trigger losses for taxpayer-funded programs and expose pharmacies to risk.
Under federal law, the illegal distribution and conspiracy counts each carry a maximum of 20 years in prison and a $1 million fine. The false statements count carries up to five years and a $250,000 fine. A federal judge will weigh advisory guidelines, any victim statements and Spiegel’s admissions at the March 24 hearing in St. Louis. Prosecutors identified Assistant U.S. Attorneys Amy Sestric and Jonathan Clow as handling the case. The court has not ruled on the ultimate restitution figure, and whether additional victims or losses will be added remains unclear. Spiegel’s medical licensing status was not addressed in Thursday’s plea hearing. The U.S. Attorney’s Office said anyone with concerns could contact federal health investigators; authorities did not announce additional arrests.
Outside the courthouse, officials emphasized the breach of trust. Michael Davis, the Drug Enforcement Administration’s special agent in charge for Missouri, Kansas and southern Illinois, said medical professionals who fuel misuse of potent drugs will be investigated with urgency. Bridgeton police and federal agents were credited for building the case through patient interviews, prescription reviews and phone records. Neighbors near the former practice described heavy traffic in past years; one said she noticed “people in and out at all hours” before the office closed. Former patients reached by reporters said the charges left them “angry and shocked,” while advocates for people in recovery called the conduct “predatory” and said they hoped the plea would speed accountability.
Spiegel remains scheduled for sentencing on March 24, 2026, in federal court in St. Louis. Prosecutors said additional filings will outline guideline calculations in the coming weeks. The judge could set deadlines for victim impact statements early next year.
Author note: Last updated December 12, 2025.