Walgreens “substantially contributed” to San Francisco’s opioid epidemic by failing to perform due diligence on prescriptions that flooded into the city for 15 years, a federal judge has found.
The city won what local media has called a “landmark trial” against Walgreens, with the judge, Charles Breyer, finding that the pharmacy chain had failed to properly investigate suspicious opioid orders, dispensing “large volumes of medically illegitimate opioid prescriptions that were diverted for illicit use”.
From 2006 to 2020, “Walgreens pharmacies in San Francisco dispensed hundreds of thousands of red-flag opioid prescriptions without performing adequate due diligence,” Breyer wrote in his ruling. “The evidence showed that Walgreens did not provide its pharmacists with sufficient time, staffing, or resources to perform due diligence on these prescriptions.”
The company’s failures played a “substantial” role in a crisis that has had “catastrophic” effects on the city, Breyer wrote, overwhelming hospitals and devastating neighborhoods. The ruling states that the significant rise in opioid prescriptions brought “corresponding increases in opioid abuse, addiction, and overdoses”.
The city is seeing record numbers of fatal overdoses, with 650 people dying in 2021 and 712 deaths in 2020. Opioid overdoses have been the leading cause of death for unhoused people in the city since 2016, according to the ruling.
Nationwide, overdose deaths hit an all-time high in 2021, with experts saying the increase is driven by opioids including the synthetic opioid fentanyl.
San Francisco sued several companies for their alleged roles in the opioid crisis, accusing them of creating a “public nuisance” by flooding the city with prescription opioids and failing to prevent the drugs from being diverted for illegal use.
Unlike other companies, Walgreens had opted not to settle and will now have to pay the city an amount that will be determined in a later trial. Walgreens has already agreed to pay out millions to resolve claims it exacerbated the opioid crisis in Florida. Last year, a federal jury found the retailer, along with CVS and Walmart, sent addictive opioids into two Ohio counties and helped feed the opioid crisis.
The city, Breyer ruled, proved that Walgreens had played a substantial role in creating the crisis.
“Dozens of syringes have been found in the sandbox at children’s playgrounds and in the children’s reading area at the city library. City staff have been stuck with syringes, encountered opioid users overdosing, confronted opioid-related violence, and found dead bodies,” Breyer wrote. “The effects of the opioid epidemic on San Francisco have been catastrophic. The city has fought hard and continues to do so, but the opioid epidemic, which Walgreens helped fuel, continues to substantially interfere with public rights in San Francisco.”
The company told the Washington Post it planned to appeal Breyer’s ruling.
“As we have said throughout this process, we never manufactured or marketed opioids, nor did we distribute them to the ‘pill mills’ and internet pharmacies that fueled this crisis,” said Fraser Engerman, a Walgreens spokesperson. “We stand behind the professionalism and integrity of our pharmacists, dedicated healthcare professionals who live in the communities they serve.”