CINCINNATI — Lisa Anne Hawkey lay down for a nap on Valentine’s Day 2016.

She never woke up.

The 51-year-old woman left behind eight children and stepchildren, and 10 grandchildren. Her daughter, Marilyn Fields, believed Hawkey had suffered a heart attack after a prolonged struggle with high blood pressure and excruciating back pain.

Autopsy results revealed the true cause of death: a prescription drug overdose.

Hawkey had a slew of prescription drugs in her system — opioids, heart medicine, anti-depressants, anti-convulsants and sedatives, according to the Butler County coroner’s report.

“I was thinking, you know, maybe she accidentally took … too much," said Fields, who said her mother wasn't an addict.

Two years later, a federal grand jury charged her mother’s doctor, Dr. Saad Sakkal, in her death.

“That was rough. Just knowing that somebody killed her, you know,” Fields said. “She could have still been here, seeing her grandkids growing up.”

Sakkal faces a jury trial on April 1 in U.S. District Court in Cincinnati on a 39-count indictment that could send him to prison for life if he is convicted. His attorney, Richard Goldberg, declined comment.

The Syrian-born Sakkal was indicted as part of the largest national healthcare fraud and opioid takedown in American history — a sting that caught 76 doctors, 23 pharmacists, 19 nurses and other medical personnel across the nation.

“Much of this fraud is related to our ongoing opioid crisis, which is tremendously dangerous for America,” then-U.S. Attorney General Jeff Sessions said at a June 28, 2018 press conference announcing the charges. “It’s the deadliest drug epidemic in the history of this country. We’ve never seen anything like it.”

Whatever jurors believe about the true nature of Sakkal’s practice at Lindenwald Medical Associates in Hamilton could determine his fate.

Sakkal’s family testified at earlier court hearings that the 70-year-old doctor tried to wean patients off pain medications and reduce how many of his 4,000 active patients used these drugs.

During phone calls from jail, Sakkal told his brother, a West Virginia cardiologist, that he never prescribed any medication to patients that they weren’t already on, according to court documents.

However, prosecutors and law enforcement accuse Sakkal of selling addictive pain pills that eventually led to overdoses.

“Almost nothing going on in the community is more dangerous, cancerous, deadly, and awful to the community and to everyone in it, especially those addicted, than the opioid epidemic, which is sponsored by those persons such as this defendant,” assistant U.S. Attorney Tim Mangan wrote in a motion that resulted in a judge denying Sakkal bond and sending him to jail, where he awaits trial.

A grand jury charged Sakkal with illegally prescribing pain medication that led to the overdose deaths of two patients: Hawkey, of Hamilton, and Ashley Marie Adkins of Middletown. Each charge carries a mandatory minimum penalty of 20 years to life in prison.

Sakkal also faces 30 counts of illegal distribution of controlled substances and seven counts of using another doctor's registration number in order to issue prescriptions.

His indictment also mentions six other patients who died in 2016 from drug use complications, including prescribed drugs. He is not charged in those deaths.

Sakkal, who has been practicing medicine for 40 years, began working at Lindenwald in February 2015. He also owned and operated the Metabolic Care Center in Mason.

“After Sakkal joined Lindenwald … the types of patients changed, with patients waiting long periods of time in order to see Sakkal, including waiting outside in the parking lot for the practice to open,” U.S. Attorney Ben Glassman said at a press conference last June.

Sakkal frequently diagnosed patients with fibromyalgia or lower back pain and prescribed pain medicine after performing “superficial” physical exams and with no treatment plan in place, the indictment stated.

He allegedly prescribed dangerous combinations such as “Prescriptive Speedball,” “Triple Threat Heaven,” and “Holy Trinity” — an opiate, a benzodiazepine and a muscle relaxer that produces heroin-like euphoria and can be lethal, according to the indictment.

Many of Sakkal’s patients were drug users, and prosecutors accuse him of ignoring symptoms such as failed drug screens and slurred speech while continuing to prescribe them pills, according to the indictment.

Angela Adkins said her sister, Ashley, who died of an overdose at age 31, was a longtime prescription drug user who sought out doctors who would give her the drugs she needed to get high.

“She was just addicted to the pain pills and she would go to different doctors and they would prescribe her what she wanted,” Adkins said. “I’m just furious about this whole thing. Whoever gave my sister these drugs, they had to know she was an addict.”

Ashley Adkins’ boyfriend found her dead on the couch of their Middletown home on the morning of Jan. 20, 2018, two days after Sakkal prescribed her Oxycodone, an opiate pain medicine, and Alprazolam, an anti-anxiety drug also known as Xanax, according to court records and autopsy reports.

The concentration of those two drugs in Ashley Adkins’ system was double the therapeutic range level, according to the coroner’s report.

“She had went to the doctor a day before and got all that medication and she just thought she could just handle it and take however much she wanted and it killed her,” Angela Adkins said. “That’s exactly what happened.”

Many local pharmacies stopped filling Sakkal’s prescriptions and some pharmacists called to warn him of the risky way he prescribed drugs, according to the indictment.

In response, on Dec. 31, 2016, Sakkal led a small group of his patients on a series of protests at local pharmacies, demanding that they continue to fill his prescriptions, according to the indictment.

“Some of our most trusted medical professionals look at their patients as vulnerable people suffering from addiction and they see dollar signs,” Sessions said at a June press conference.

Mauricio Jimenez, assistant special agent in charge of the Drug Enforcement Agency’s Southwest Ohio office, said the current heroin epidemic began years ago with doctors overprescribing drugs.

“When people get addicted to the opioids … eventually that source dries up, be it the doctors realize that the patient has a problem or it gets too expensive,” Jimenez said. “So what ends up happening to those people who are addicted is, they turn to the streets.”

After Sakkal left his practice in Hamilton, he began working as a contract doctor at a medical clinic at Wright Patterson Air Force Base in 2017. He is currently under investigation for alleged inappropriate touching of two patients there, according to court documents.

Sakkal then moved to Florida in January 2018, where he practiced medicine at Santa Rosa Medical Center near Pensacola until agents arrested him in June 2018. He is on a leave of absence from that practice pending the outcome of trial, according to court documents.

Family members of both Hawkey and Adkins will be at the trial, hoping to find closure to their grief.

“If you’re being prescribed way too much medication and you’ve got a handful of pills that you’re taking each month, look into it,” Fields said. “Don’t assume that just because the doctor gave it to you, it’s right.”