Walgreens exacerbated SF’s opioid epidemic, judge says

A federal judge ruled Wednesday that Walgreens “substantially contributed” to San Francisco’s opioid epidemic that for more than 20 years has strained hospitals, taxed city resources, exacerbated crime and homelessness, and forced closures of public roads and spaces, court records showed.  

Walgreens, the city’s largest retail pharmacy chain and dispenser of opioids, over-dispensed the prescription drugs and failed to report suspicious orders that may have been used illegally, Judge Charles Breyer of the U.S. District Court for the Northern District of California said in his decision.

“This decision gives voice to the thousands of lives lost to the opioid epidemic,” San Francisco City Attorney David Chiu said in a news release. “This crisis did not come out of nowhere. It was created by the opioid industry, and local jurisdictions like San Francisco have had to shoulder the burden for far too long.”

The United States Drug Enforcement Administration requires distributors to adopt and follow a system to identify medically illegitimate prescriptions that may have been forged or provided by unscrupulous doctors who write prescriptions in return for payment. The court found that Walgreens violated its regulatory duty for several years, the decision said.

San Francisco saw more than 163 million opioid pills distributed — enough for 22 pills a year for every person in the city — from 2006 to 2014, according to the city attorney’s news release. In the following five years, opioid-related overdose deaths skyrocketed 478%, and 25% of visits at Zuckerberg San Francisco General Hospital’s emergency department were associated with opioid use.

“Plaintiff proved that it is more likely than not that Walgreens pharmacies dispensed large volumes of medically illegitimate opioid prescriptions that were diverted for illicit use and that substantially contributed to the opioid epidemic in San Francisco,” Breyer wrote in his decision.

The decision also says San Francisco originally filed claims against dozens of defendants related to the opioid epidemic, but by the time of the trial that started April 25, only four defendants remained. Three defendants have since settled, leaving Walgreens the only remaining defendant. 

Last year, San Francisco City Attorney’s Office announced that it had secured more than $120 million from the opioid industry through this litigation, including $54 million from Allergan and Teva, $10 million from Endo and $60 million from Johnson & Johnson and McKesson, Cardinal Health and AmerisourceBergen. The money and supplies obtained will go toward fighting the opioid crisis and preventing overdose deaths, the city attorney’s office said.

The next stage in the trial is to determine how much Walgreens must pay San Francisco for the public nuisance they caused, the decision said.

Cities, counties and and even states have sued opioid manufacturers and distributors in recent years for their part in the crisis. Last year, Los Angeles, Orange and Santa Clara counties and the city of Oakland lost their lawsuit against pharmaceutical companies Johnson & Johnson, Allergan and others alleging they downplaying the risks of opioid use and misled the public.

Fraser Engerman, senior director of external relations for Walgreen Co., said in an email to SFGATE that the company disappointed with the judge’s ruling. “The facts and the law do not support the court’s decision,” Engerman wrote. “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. We stand behind the professionalism and integrity of our pharmacists, dedicated healthcare professionals who live in the communities they serve. The plaintiff’s attempt to resolve the opioid crisis with an unprecedented expansion of public nuisance law is misguided and unsustainable. We look forward to the opportunity to address these issues on appeal.”

Bay City News contributed to this story.

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