Federal judge rules Walgreens advanced San Francisco's opioid epidemic by dispensing 'hundreds of thousands of red flag prescriptions'

• A federal judge ruled Walgreens failed to investigate thousands of "suspicious orders" for opioids.
• "Walgreens pharmacies dispensed large volumes of medically illegitimate opioid prescriptions that were diverted for illicit use," the ruling states.

Walgreens has come under fire for its role in advancing the opioid epidemic in San Francisco.

A federal judge ruled on Wednesday that the pharmacy chain failed to investigate hundreds of "suspicious orders" for opioids it distributed between 2006 and 2020, a period during which the company filled and distributed an estimated 100 million prescriptions for the drugs.

In a 112-page opinion, US District Judge Charles Breyer wrote Walgreens "dispensed hundreds of thousands of red flag opioid prescriptions without performing adequate due diligence" adding that the prescriptions "were written by doctors with suspect prescribing patterns," according to court documents.

He added that evidence shows the company failed to provide pharmacists with the necessary staffing and resources needed to investigate the orders, and were often pressured to fill prescriptions quickly without sufficient review.

"As a result of Walgreens' fifteen-year failure to perform adequate due diligence ... 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.

The opioid epidemic has accelerated significantly in the city of San Francisco, with emergency-room visits tied to opioid abuse increasing threefold from 2015 to 2020, the court documents state. In 2019, the most recent year with available data, nearly 2,000 people died from opioid overdoses in the city, a rate of more than five a day.

Walgreens is the largest retail pharmacy chain in the city, and the second-largest in the nation behind CVS. A spokesperson for the company told Insider the company does "not support the court's decision" and plans to appeal.

"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," Walgreens spokesman Fraser Engerman said in a statement. "We stand behind the professionalism and integrity of our pharmacists, dedicated healthcare professionals who live in the communities they serve."