This is the news article that Blogspot is trying to suppress. The article discusses elements of fact and how government does what it does and how tat complicates things. Lets see if Blogspot deletes it again.
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Albertson's Pharmacy is being held to account for selling pain medicine to people who had prescriptions for them. Washington State claimed Albertsons pharmacists failed to turn away prescriptions from known 'pill mill' doctors even after competing chains had blocked them.
Under ordinary circumstances, a pharmacy fills a prescription written by a licensed doctor. However, for controlled substances (especially opioids), federal law imposes an extra layer of duty.
Federal regulations (21 CFR § 1306.04) state that while the doctor has the primary responsibility for issuing a prescription for a legitimate medical purpose, the pharmacist who fills it has a corresponding responsibility.
In plain terms:
A prescription is only valid if it is issued for a legitimate medical purpose by a practitioner acting in the usual course of professional practice.
A pharmacist is not required to fill a prescription that looks doubtful, questionable, or suspicious.
If a pharmacist knowingly fills a prescription that is not for a legitimate medical purpose, both the doctor and the pharmacist (and by extension the pharmacy) can be held liable.
This duty requires pharmacists to look for and resolve “red flags” — patterns that suggest the prescription may be illegitimate or intended for diversion (illegal resale or misuse). Examples include:
Extremely high volumes from a single doctor
Patients traveling long distances
Cash payments for large quantities
Combinations of drugs known as the “holy trinity” (opioid + benzodiazepine + muscle relaxant)
Doctors known in the industry as “pill mills”
What the Court Found in the Albertsons Case
According to the Washington state judgment (November 2026):
Albertsons pharmacies filled millions of opioid prescriptions that carried clear red flags without adequately investigating or documenting that they were legitimate.
The company discouraged or restricted its own pharmacists from refusing prescriptions written by known high-volume “pill mill” doctors, even after other pharmacy chains had already stopped accepting those doctors’ prescriptions.
Corporate policies prioritized volume/sales over stronger controls, and information about problematic prescribers was not effectively shared across stores.
The court concluded that this pattern violated both state and federal controlled-substance laws.
Common Red Flags
|
Category |
Specific Warning Signs |
Why It Raises Concern |
|---|---|---|
|
Geographic / Travel |
Patient lives far from the pharmacy or the doctor; patient drives past many closer pharmacies |
Suggests “doctor shopping” or seeking out a known high-volume prescriber |
|
Payment Method |
Patient pays cash for expensive opioids even though they have insurance that covers other medications |
Avoids insurance scrutiny and prescription-monitoring systems |
|
Prescriber Patterns |
Same doctor writes nearly identical high-dose opioid prescriptions for many unrelated patients |
Suggests “cookie-cutter” or “pill mill” prescribing rather than individualized care |
|
Drug Combinations |
Opioid + benzodiazepine + muscle relaxant (the “holy trinity”) |
High risk of overdose and frequently associated with abuse |
|
Dose & Duration |
Very high morphine-milligram-equivalent doses; long-term use of immediate-release opioids without clear justification |
Inconsistent with standard medical practice for chronic pain |
|
Early Refills / Frequency |
Patient repeatedly requests refills well before the prescription should run out |
Possible diversion or misuse |
|
Multiple Prescribers / Pharmacies |
Patient obtains controlled substances from several doctors or fills at multiple pharmacies |
Classic doctor-shopping pattern |
|
Specialty Mismatch |
Doctor’s specialty does not match the medication (e.g., a dentist writing large quantities of long-term opioids) |
Raises questions about whether the prescribing is within the usual course of practice |
|
Patient Behavior |
Patient appears impaired, aggressive about receiving the medication, or has inconsistent stories |
Suggests possible misuse |
How Pharmacists Are Expected to Respond
When a red flag appears, the pharmacist is expected to:
Recognize it.
Take reasonable steps to investigate (call the prescriber, check the state Prescription Drug Monitoring Program, speak with the patient, review the patient’s history, etc.).
Document the concern and the steps taken.
Decide whether the prescription is legitimate and either fill it or refuse it.
Simply filling the prescription without addressing the red flag is what creates legal risk. Documentation is critical — if there is no record that the pharmacist investigated, regulators and courts often treat it as if no investigation occurred.
Corporate / Chain-Level Red Flags
At the pharmacy-chain level (as in the Albertsons case), additional patterns can become red flags:
Extremely high overall volume of opioids compared with similar pharmacies
Continuing to fill prescriptions from doctors that other chains have already blocked
Policies that discourage pharmacists from refusing suspicious prescriptions
Failure to share information about problem prescribers across stores
In short, red flags are observable patterns that should prompt a pharmacist to pause and verify legitimacy rather than treat the prescription as routine. The presence of one or more unresolved red flags is the main basis on which pharmacies have been held liable for contributing to opioid diversion.
But if authorities knew certain 'pill mill' doctors were problem prescribers, it seems unfair that Albertsons is punished while those doctors were still allowed to practice.
That tension is real and has been widely discussed:
Medical boards and the DEA are often slow to suspend or revoke licenses. Investigations take time, and due-process requirements protect doctors until evidence is strong enough.
In the meantime, pharmacies are still expected to exercise independent professional judgment. Other chains did block certain doctors earlier; the court found Albertsons did not.
Liability does not require that the doctor’s license already be revoked. It requires that the pharmacy ignore clear warning signs that were available to it at the time.
In short, the system places parallel duties on both the prescriber and the dispenser. A pharmacy cannot simply say “the doctor wrote it, so we must fill it” when the volume and patterns strongly suggest the prescriptions are not legitimate.
This is why large pharmacy chains have faced (and settled or been judged liable in) numerous opioid-related cases across the country — the legal theory is that they failed in their corresponding responsibility to act as a check against diversion. This is clear evidence that the current legal and regulatory pressure has made many pharmacies and pharmacists more reluctant to dispense opioid pain medications, even for legitimate patients. This creates a real tension between preventing diversion and ensuring access to needed care.
The Chilling Effect Is Real
Surveys and reports from recent years show:
A large majority of chronic pain patients report difficulty filling opioid prescriptions. In one major survey, about 90% experienced delays or problems, and nearly 20% could not get their medication at all after trying multiple pharmacies.
Common reasons given by pharmacies include “not in stock,” corporate limits on high-dose opioids, fear of DEA scrutiny, or internal policies that discourage filling certain prescriptions.
Some pharmacies have stopped stocking certain opioids or refused new pain patients altogether to reduce their risk profile.
Even cancer and serious-illness patients have reported being turned away or delayed.
Pharmacists themselves often feel caught in the middle. They are trained as medication experts, not investigators. In busy retail settings they may have only a minute or two per prescription, yet they face potential career-ending liability, DEA investigations, corporate discipline, or large civil judgments if they fill a prescription later judged to have had unresolved “red flags.”
The Trade-Off
Busy pharmacists are being asked to perform a quasi-policing function in addition to their clinical role. This has several downstream effects:
Potential benefits
Reduced diversion of pills into the black market
Lower risk of pharmacies becoming passive enablers of “pill mills”
Potential harms
Legitimate pain patients suffer delayed or denied access
Pharmacists practice defensive medicine (refusing borderline but valid prescriptions out of fear)
Some patients turn to illicit sources or suffer uncontrolled pain
Independent and smaller pharmacies may exit high-risk markets more readily than large chains
This is a classic example of a regulatory response that solved one problem while creating another. The system prioritizes preventing the worst cases of diversion, but it does so by imposing high costs and risk on the people who stand between the doctor and the patient.
