Pharmacies Grapple Financially Against Opioid Crisis

Rite Aid filed for bankruptcy after falling $8.6 billion dollars in debt and experiencing slow sales at stores nationwide. But experts told Newsweek the chain's inability to keep up with the digital pharmacy movement wasn't the full story.

Hidden behind its debt were thousands of opioid crisis lawsuits that Rite Aid was not able to make its way through financially.

The U.S. Department of Justice (DOJ) was one of many that sued Rite Aid earlier this year, alleging the chain violated the Controlled Substances Act by illegally filling prescriptions for controlled substances like fentanyl. Rite Aid was also said to have ignored obvious "red flags" in doing so, even though the company denies this.

Beyond Rite Aid, the opioid crisis has posed many challenges for pharmacy chains nationwide, according to Sheila Camp, the outreach coordinator at Addiction Resource.

While overprescription by doctors and lack of sufficient monitoring gave way to the a drug problem estimated to reach 50,000 deaths yearly, the pharmacies themselves are now at a boiling point, with increased regulatory scrutiny and a range of legal battles coming their way.

Earlier this month, pharmacy workers started walking out on strike at CVS and Walgreens locations across the country as they demanded better pay and working conditions.

Pharmacies' Involvement

Rite Aid and other pharmacy chains were involved in the opioid crisis because they filled prescriptions for opioids that were written without a legitimate medical purpose, said Pauline Gray, a pharmacy technician living in Seguin, Texas.

"Pharmacies are required by law to gatekeep prescriptions, but some pharmacies failed to do this properly," Gray told Newsweek.

The pharmacy technician doesn't fully see it as the pharmacy's fault, with the marketing forces behind the pharmaceutical industry sharing a portion of the blame.

"The U.S. government did not do enough to regulate the pharmaceutical industry, allowing companies to engage in deceptive marketing and other practices that contributed to the opioid crisis," Gray said.

Pharmaceutical companies often offered doctors financial incentives to prescribe opioids, like kickbacks and speaking fees, ultimately creating a conflict of interest. More and more doctors were lured into the temptation of prescribing opioids even if they weren't the best course of treatment.

Still, pharmacies like Rite Aid, were on the line instead of the rest of the industry because they were the last stop to keep an illegal prescription from being filled, Ben Michael, an attorney at Texas-based Michael & Associates, said.

"The reason that pharmacies like Rite Aid, instead of prescribing doctors or opioid manufacturers, are on the hook in these cases is that they are the ones who filled the prescriptions, even though they were, in many cases, illegal," Michael told Newsweek. "This was a widespread practice, and it could spell serious trouble for other major pharmacy chains like Walgreens and CVS."

Today, it's costing the pharmacies billions of dollars in court fees and regulatory practices to keep opioid use safer, but your local CVS or Walgreens, along with the few independent pharmacies remaining, are likely to feel the brunt of the consequences.

In just one example, CVS, Walgreens and Walmart were ordered to pay $650.6 million to two Ohio counties over damages related to opioid abuse.

"This could make it more difficult for pharmacies to operate and increase their costs," Gray said of pharmacies' decreasing revenue as a result of the opioid crisis.

Camp said the pharmacy chains will have to adapt by prioritizing patient education, enhancing prescription monitoring,and supporting addiction treatment resources.

But the competition from online pharmacy options, like Amazon's two-day drug delivery, is also seizing into the brick and mortars' once steady profits.

"It's hard to run a profitable pharmacy these days, even without these crippling lawsuits," Michael said.

Opioid Crisis Explained

The opioid crisis occurred across the nation as pharmacists overprescribed opioids, leading to an addiction epidemic.

The crisis is ongoing, with a reported 80,000 opioid-related overdose deaths in 2021, according to CDC data.

Opioids were over prescribed as many doctors fell into the trap of believing pharmaceutical advertising campaigns espousing opioids as not addictive.

For chronic pain, acute or even post-operative pain, opioids were commonly recommended, even as the addictive nature of these drugs was called into question.

But the problem went far deeper than doctors mistakenly believing their patients wouldn't fall victim to opioids' addictive clutches.

Hospitals have routinely been funded based on patient satisfaction surveys, which are typically affected by the amount of pain the individual felt during recovery. If a patient is suffering postoperative pain without the aid of an opioid, they might say their surgeon gave inadequate treatment of post-surgical pain.

Other doctors overprescribed the medications because they could make a profit off the drugs, leading to unforeseen consequences.

As many as 29 percent of those prescribed opioids for chronic pain misuse them, according to Addiction Resource. And 8 to 12 percent end up becoming addicted. Down the line, four to six percent of people misusing opioid prescriptions switch to heroin once they no longer have access to the doctor-prescribed drug.

The good news is that scientists have just taken a step closer to developing a high-strength painkiller that is not as addictive as opioids.