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LOUISVILLE, Ky. (AP) Doctors and pain clinic owners in three states were charged Friday in five cases with making millions of dollars by illegally distributing prescription drugs in the Appalachian region of Kentucky, where drug abuse is rampant.

Federal indictments unsealed in Pikeville detail schemes by doctors in Texas, Florida and Kentucky and pain clinic owners in Kentucky, Ohio and Florida to distribute hundreds of thousands of prescription pills in an area ravaged by prescription drug addiction.

Charged were Dr. Linda Roos, 46, of Houston, Texas, who faces counts of conspiring to distribute pills in Pike County. Prosecutors say Roos prescribed more than 125,000 Oxycodone pills from September 2006 until July 2011 and faxed many of her prescriptions to a pharmacy in Pikeville so the patients who visited her could pick them up on their way home from Texas. Prosecutors say Roos also often allowed patients to obtain a prescription by faxing her a form.

Two of Roos's patients, Dennis and Helen Varney, are charged with conspiracy to distribute prescription drugs. Authorities say they found hundreds of Oxycodone pills while searching the Varney's residence. Dennis Varney, 62, is charged with multiple counts of distributing Oxycodone pills. Six other people are also charged in that case.

The second case involves Pikeville pharmacy manager Beverly Lockhart, 58, who is charged with conspiring with Dr. Thad Manning of Pikeville to sell prescription drug samples. Lockhart is also charged with defrauding Medicare by submitting reimbursement claims for medications the pharmacy never provided to the customers. A third eastern Kentucky man is also charged.

A third case charges 39-year-old Tammy Cantrell and 50-year-old Shelby Lackey, co-owners of Caremore pain clinic in Johnson County, with conspiring with a doctor to distribute Hydrocodone to Johnson County residents. Prosecutors say the pair made nearly $2 million in drug proceeds.

A fourth indictment alleges that the co-owners of Auto Accident and Health Care in Auxier, in Floyd County, Ray Douglas Stapleton, 34, and his wife Tina Marie Stapleton, 33, conspired with two doctors, Stephen C. Arney of Shelbyville and Emmanuel Acosta of Auxier.

Prosecutors say they schemed to unlawfully dispense Oxycodone, Hydrocodone and Xanax to Johnson County residents and made approximately $1.5 million from July 2010 through June 2012.

A fifth case charges 37-year-old Jody Robinson of Portsmouth, Ohio, who owns pain clinic in Florida, conspired with Dr. Clara S. Roriguez-Izanga of Miami Beach, Fla., and a third person to launder money and illegally dispense prescription drugs to patients from Boyd, Greenup, and Lawrence counties. Prosecutors say the clinic allegedly made about $2 million in just over a year.

Court records did not list attorneys for any of the people charged.

A Louisiana pain clinic owner was sentenced earlier this month to 15 years in federal prison for the illegal distribution of prescription pills in eastern Kentucky. Prosecutors in Lexington described that case as the first in which a clinic owner had been prosecuted for the offense.

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Follow Associated Press reporter Brett Barrouquere on Twitter: http://twitter.com/BBarrouquereAP