Walgreens helped fuel San Francisco’s opioid crisis, judge rules

Walgreens helped fuel San Francisco's opioid crisis, judge rules
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Walgreens helped fuel San Francisco’s opioid epidemic by shipping and dispensing the addictive drugs without due diligence, a federal judge ruled Wednesday in what lawyers suing the retailer called a “wake-up call for businesses.”

U.S. District Judge Charles Breyer said Walgreens “substantially contributed” to one of the nation’s deadliest public health crises by failing to stop suspicious orders and dispensing drugs that were diverted for illicit uses, causing public nuisance in a major city It is among the most affected by addiction and overdose. Walgreens, responsible for shipments nearly 1 in 5 oxycodone and hydrocodone pills distributed nationwide during the height of the opioid crisisit was the only pharmaceutical company sued by San Francisco that did not settle, going to trial in April.

“Walgreens has a regulatory obligation to take reasonable steps to prevent drugs from being diverted and harming the public,” Breyer wrote. “The evidence at trial established that Walgreens breached these obligations.”

A trial will follow to determine how much the company should pay the city to address damages from the opioid crisis. The city does not yet have an estimate of what it will search for.

Walgreens spokesman Fraser Engerman said the company was “disappointed” with the decision and would appeal.

“As we have said throughout this process, we never manufacture or market opioids, or distribute them to the ‘pill mills’ and internet pharmacies that fueled this crisis,” he wrote in an email. “We stand behind the professionalism and integrity of our pharmacists, dedicated healthcare professionals who live in the communities they serve.”

City Attorney David Chiu said the first bench trial to find Walgreens liable in the opioid epidemic “has national significance” in a years-long effort to hold drug distributors and pharmacies accountable. As the company recently closed stores in the city, citing the effects of the drug epidemic, Chiu accused Walgreens of shifting the blame.

“This is similar to an arsonist complaining about the fire,” he told a news conference.

The verdict marks a second blow to the pharmaceutical giant, with thousands of other lawsuits by states, cities and counties remaining. Unlike the three largest drugmakers and distributors, Johnson & Johnson and Teva, Walgreens hasn’t struck a national deal. It did not go bankrupt like manufacturers Purdue Pharma, Mallinckrodt and Insys have.

In a 112-page opinion, Breyer laid out the details of the city’s drug crisis and the timeline of Walgreens’ response to drug abuse. Paul Geller, an attorney representing San Francisco and other communities across the country fighting drug companies, said the verdict “is anything but a run-of-the-mill legal ruling,” pointing to meticulous details about the crisis in the city. and the ways Walgreens contributed.

“I hope it gets circulated as required reading in Big Pharma boardrooms across the country,” Geller said, “because his painstakingly detailed ruling should be a wake-up call to companies and help ensure this never happens again.” happen”.

Peter Mougey, an attorney who also represents San Francisco and other communities, said the verdict will help other cases.

“Walgreens has been hiding, covering up and running from the truth for the entirety of this five-year litigation,” he said. “Walgreens knew its system to detect and stop suspicious orders did not exist, but continued to ship opioids at an alarming rate to boost profits. San Francisco is now one step closer to beginning the healing process.”

The decision comes after the company reached a $683 million settlement with the state of Florida in May, halting a lawsuit in state court. In November, a a jury in Ohio found that the company, along with CVS and Walmart, contributed to the opioid crisis in two counties — the first such decision in a pharmacy case.

Walgreens stopped distributing opioids after the Drug Enforcement Administration closed a store in 2012.

But the city argued that the impact of Walgreens shipping and distribution continues to reverberate as people who use drugs have moved from prescription pills to heroin and fentanyl as the illicit drug market has evolved.

Opioid overdoses, including heroin and fentanyl, have skyrocketed in San Francisco, where there was a 478 percent increase in those deaths between 2015 and 2020, reaching 584, according to city data. Opioid-related emergency room visits tripled at the same time, to nearly 3,000 in 2020.

During the trial, city officials tested the extent to which the crisis infiltrated everyday life. Needles were removed from city parks “like changing toilet paper in bathrooms,” a park ranger said. When paramedics respond to someone who has no pulse and is not breathing, they assume it is an opioid overdose.

The suspicious order monitoring system that Walgreens was required to maintain under the Controlled Substances Act was ineffective, the judge said. Thousands of suspicious orders were sent to their pharmacies without investigation.

Breyer’s verdict criticized the company and blamed executives who failed to stop drug siphoning and repeatedly denied internal requests for a central database of reports on suspicious customers. He said the compliance chief was “vague and evasive” on the stand.

The judge sided with the city, agreeing that the company was putting pressure on pharmacists, who had little time and supervision before dispensing drugs. Pharmacists completed due diligence forms on paper and stored them in filing cabinets rather than electronically. A pharmacist in one store could not access records from other locations.

If pharmacists refused to fill a prescription, they entered the refusal into the internal computer system, which was limited to 320 characters.

“Walgreens pharmacies operated in information silos,” Breyer said. “This didn’t have to be this way.”

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