A federal judge Thursday sentenced former Kauai physician Harold C. Spear III to 12 1⁄2 years in prison for unlawfully prescribing powerful pain medication to people here and on the mainland based solely on telephone conversations with them.

U.S. District Judge David A. Ezra ordered Spear, 60, to begin serving his 151-month prison term immediately because he said Spear posed a substantial risk of fleeing.

Spear also faces sentencing in state court next week for signing hundreds of blank prescription forms.

Spear said in court he always wanted to be a doctor to help people, and said he believes he got into trouble with the law because he practiced in an antiquated way, like Marcus Welby, with inadequate record-keeping.

"I’m not a drug dealer," Spear told Ezra. Ezra disagreed and found that Spear was motivated by financial greed to illegally dispense methadone and hydrocodone.

He said Spear was a flight risk based on his age, length of his sentence and what he called Spear’s erratic behavior.

While free on bond since 2007, Spear changed lawyers several times, used his father’s medical license to continue to prescribe drugs after his own license had been suspended, was arrested for domestic violence, bribed a drug tester and twice tried to withdraw his guilty pleas.

Ezra said that since 1996, Spear had been overprescribing pain medication for patients, causing them to become addicted. He said without being requested to do so by his patients, Spear had been increasing their dosages and continued to do so over pleas to stop from his patients’ family members and other physicians.

Spear was paid more than $400,000 to prescribe drugs over the telephone through a pharmacy in Alabama that delivered the drugs to buyers by FedEx, Ezra said.

Federal prosecutor William Shipley said Spear charged patients who visited his Hanapepe Clinic and website $125 to $175 per consultation for prescriptions. Patients had to pay by cash or credit card because HMSA had cut him off, Shipley said.

He said Spear paid his staff members commissions for the number of signed prescription forms they filled out and handed to patients.

Shipley said anyone who wanted drugs on Kauai knew where to go.

"He was, for all intents and purposes, Dr. Feelgood," he said.