Walgreens can be held responsible for contributing to San Francisco’s opioid crisis for over-dispensing highly addictive drugs for years without proper oversight, a federal judge has ruled.

According to a PBS report, U.S. District Judge Charles Breyer ruled that for 15 years, Walgreens dispensed hundreds of thousands of pills, eventually contributing to the city’s hospitals being overwhelmed with opioid patients, libraries being forced to close because of syringe-clogged toilets, and syringes littering children’s playgrounds in San Francisco.

In 2018, the city sued Walgreens and other drug manufacturers and distributors over San Francisco’s worsening opioid epidemic, claiming they created a “public nuisance” by flooding the city with prescription opioids.

San Francisco City Attorney David Chiu said the pharmacy chain “continually violated what they were required to do under the federal Controlled Substances Act,” failing to track opioid prescriptions, preventing pharmacists from vetting prescriptions and “nor did they see the many red flags of physicians and others who were dramatically over-prescribing,” PBS reported.

The other defendants previously settled with the city for a total of $114 million. Walgreens remains the sole defendant.

A Walgreens spokesman said the chain is disappointed in the outcome, maintaining it is not supported by the facts and the law, according to the PBS report.

“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,” spokesman Fraser Engerman said in a statement.

“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.”

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The opioid epidemic has been linked to more than 500,000 deaths in the United States over the past two decades, counting those from prescription painkillers such as OxyContin and generic oxycodone as well as illicit drugs such as heroin and illegally produced fentanyl.

In May, the Utah Attorney General Sean Reyes announced his office had filed a lawsuit on behalf of the state against Walgreens, Smith’s/Kroger and Rite-Aid.

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The lawsuit alleges the companies improperly distributed prescription pain medication and actively exacerbated the opioid crisis.

The lawsuit alleges some Walgreens stores were receiving so many deliveries from manufacturers that the stores ran out of space, forcing them to store boxes in unsecured locations. The lawsuit says the corporate office was receiving “bonuses” and “incentives” based on the number and speed of prescriptions filled.

It further alleges that Smith’s/Kroger failed to report suspicious orders or otherwise control the supply of opioids flowing into Utah. The suit also claims Kroger knew that people were traveling long distances to see prescribers or fill prescriptions; prescriptions were filled for drug “cocktails” known for their misuse potentials, such as oxycodone and benzodiazepine; and customers were receiving multiple prescriptions and paying for them in cash.

According to the lawsuit, a store in Price, a city of 8,216 people, had a higher-than-average amount of pills purchased. All told, it bought enough oxycodone and hydrocodone over seven years to supply 71 pills per person in the community

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