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A Lexington doctor, James Randall Long, has pleaded guilty to unlawful distribution of fentanyl, a Schedule II controlled substance.

Long, 56, appeared before U.S. Magistrate Judge David Cayer on Monday. He was released on bond. He faces a maximum prison term of 20 years and a $1 million fine.

Long formally pleaded guilty to distribution and possession with intent to distribute fentanyl by an authorized registrant outside the scope of professional practice and not for a legitimate medical purpose.

According to the N.C. Medical Board, it appears Long still has his medical license in internal medicine.

Long admitted during a hearing in the Western District of N.C. that he prescribed the drug outside the scope of his professional practice to a woman with whom he was romantically involved. He said he knew she was abusing the drug to further her addiction to opiates.

Fentanyl is a powerful opioid drug typically prescribed by doctors to help patients manage chronic pain symptoms. Those addicted to opiates often turn to fentanyl for its intense euphoric effects and commonly rely on the drug as a substitute for heroin.

Fentanyl is significantly more potent than heroin with potentially fatal side effects.

“Dr. Long admitted he abused the public trust placed in him as a physician authorized to dispense controlled substances and misused his medical license to prescribe a potentially lethal drug to a woman he knew had a substance abuse problem,” said Jill Westmoreland Rose, a U.S. attorney.

“From the street corner to a doctor’s office, anyone who distributes these potentially deadly substances poses a significant threat to public health safety and is subject to investigation and prosecution.”

According to court records and filed plea documents, Long said he met the woman in 2014. He provided fentanyl to her through July 2015 outside the scope of his professional practice and not for a legitimate medical purpose.

Long also admitted he wrote and authorized fentanyl prescriptions in the name of several other individuals, some of whom were not his patients and did not know prescriptions were being filled in their name.

It is not the first time that Long has faced legal consequences for his medical practices.

In October 2004, Long had his medical license actively suspended for 30 days — which covered the period of January 2005 — by the N.C. Medical Board based on allegations that he had a consensual sexual affair with a patient and wrote her undocumented prescriptions for painkillers. He was suspended for an entire year, but the suspension was stayed for all but 30 days.

The patient initially was a nursing student who became a nurse at Lexington Memorial Hospital. The nurse was fired from the hospital in June 2003 because an investigation determined that she had diverted drugs to her personal use and had tested positive for opiates.

At that time, Long was required to enroll with the state’s Physicians Health Program, which works to rehabilitate doctors.

In March 2008, according to a medical board consent order, Long pleaded guilty to a federal misdemeanor charge of intercepting radio communications with a “dreambox,” a device used to steal encrypted Dish Network satellite television signals, selling the signals through the dreamboxes in violation of federal law.

Long was reprimanded by the medical board and placed on probation for a year, but it did not affect his medical license.