I am sorry that this got a little long. The cliff notes version is: 45+/- state AGs sued the 3 major drug wholesalers – that control about 85% of the wholesaler Rx med business. They got those wholesalers to agreed to ration the amount of controlled meds that they sell to community pharmacies. No concern if pts who have a medical necessity to treat pain or is using buprenorphine in getting and staying sober. Pts have been unable to get their necessary medication for a month or more and being thrown into cold turkey withdrawal and perhaps a torturous level of untreated pain or a addict trying to get and stay sober program gets disrupted.
The wholesalers unable or unwilling to provide community pharmacies with controlled meds to meet the needs of pts who have a valid medical necessity for such controlled meds. This makes the wholesaler in violation of the State’s pharmacy practice act.
If the board of pharmacy chooses to take action against these wholesalers, typically that is the responsibility of the state AG to act as the “attorney” for any/all licensing boards in the state.
The same AGs that were part of the wholesaler agreement with the state AGs to cause this rationing of the controlled meds to begin with. Where these AGs so fixated on the billions of dollars they were going to get from those wholesalers that they hoped that no one would notice that the people that were going to be affected were disabled and/or seniors and discriminating against disabled people is a civil rights violation and/or they would just decline to press charges against other AGs for what harm they have concocted to mostly high acuity disabled/senior pts?
The 51 various state boards of pharmacy what is their primary charge, public safety or what else?
The primary charge of the 51 state boards of pharmacy (one in each state, D.C., and Puerto Rico) is public safety, specifically the protection of public health, safety, and welfare through the regulation of the pharmacy profession and the legal distribution of drugs.pharmacy.ohio+2
Core Responsibilities
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Licensing and Regulation: Boards issue and renew licenses for pharmacists, pharmacies, technicians, and related entities to ensure only qualified individuals and businesses operate in the field.mo+2
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Enforcement: They enforce state and federal pharmacy laws, investigate complaints, and take disciplinary actions such as suspension, revocation, or probation for violations or unsafe practices.pharmacytimes+2
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Practice Standards: Boards establish and uphold standards of practice, including the ethical and professional conduct of pharmacy professionals.pharmacy.texas+1
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Education and Outreach: Many boards provide educational resources, guidance, and updates to licensees and the public to promote compliance and awareness of pharmacy regulations.pharmacy.texas+1
Public Health Focus
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Inspection and Compliance: Boards inspect pharmacies and monitor compliance with laws designed to prevent medication errors, diversion, and unsafe practices, with the ultimate goal of protecting patients and consumers.dpo.colorado+1
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Complaint Investigation: They investigate consumer complaints and concerns regarding pharmacy services, taking action to address public risks and ensure accountability.tn+1
Other Functions
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Rulemaking: Boards create and update rules and regulations in response to emerging healthcare issues, innovations, and changes in pharmacy practice.dpo.colorado+1
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Disciplinary Action: They have authority to discipline licensees for unprofessional conduct, violations of law, or endangering the public.pharmacy.ohio+1
Summary Table: Board Charges
| Primary Charge | Additional Functions |
|---|---|
| Public health, | Licensing, regulation, enforcement, |
| safety, and welfare | practice standards, education, |
| inspections, complaint resolution |
The overarching mandate is the protection of the public—not professional, commercial, or sector interests. All other board activities support this foundational goal.pharmacytimes
aren’t drug wholesalers licensed by the state pharmacy board?
Yes, drug wholesalers are generally licensed by the state pharmacy boards in the United States. State Boards of Pharmacy are responsible for issuing, renewing, and regulating wholesale drug distributor licenses within their respective states, ensuring compliance with both state and federal laws.
Regulation Details
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Each state requires wholesale drug distributors to obtain a license from its Board of Pharmacy before engaging in distribution activities within or into that state.
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This licensing applies to wholesalers located both inside and outside of the state if they transport or sell drugs into the state.
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In addition to state licensure, wholesalers often need to meet federal requirements—especially if distributing controlled substances—and may need special accreditation from the National Association of Boards of Pharmacy (NABP).
Purpose of Licensing
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The primary goal is to safeguard the drug supply chain, preventing the introduction of counterfeit, diverted, or otherwise unsafe drugs and protecting public health and safety.
In summary, state pharmacy boards hold the authority for licensing and regulating drug wholesalers, and distributing without proper licensure is unlawful in every state.
state AGs suing drug wholesalers and wholesalers signed an agreement to ration controlled meds sold community pharmacies, resulting in pharmacies are not able to provide controlled meds – especially opioids and Buprenorphine and pts are not being able to get their medically necessary meds sporadically causing some pain pts being thrown into cold turkey withdrawal and torturous level of untreated pain and putting pts in recovering from possibly compromising their progress in reaching sobriety. Is the part of the BOP primary charge of public safety being compromised and are they obligated to take some sort of legal action to correct this potentially illegal rationing and harm to those pts. who would/should the BOP hire to seek a legal remedy?”
Yes, current and recent enforcement actions and agreements are causing wholesalers to ration controlled medications to community pharmacies—resulting in sporadic and sometimes complete restriction of access to medically necessary opioids and buprenorphine for patients, including those with severe pain or opioid use disorder. This has resulted in some patients experiencing untreated pain or withdrawal, which can compromise their recovery and lead to serious, even torturous, health consequences.
Board of Pharmacy’s Responsibility and Obligation
State Boards of Pharmacy (BOPs) have a primary legal charge to protect public health and safety by ensuring safe access to medications. When access to controlled substances is compromised for legitimate medical need, the mission of public protection may be undermined, particularly when actions result in harm to otherwise legitimate patients. While BOPs primarily regulate pharmacies and pharmacists, they also license and oversee wholesalers within their states.
Potential Board Actions in Response
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Legal Action Against Wholesalers: There is precedent for litigation when wholesalers abruptly or unfairly cut off or severely ration controlled substance supplies to pharmacies without clear evidence of diversion or improper dispensing. Courts have sometimes ruled against wholesalers in these circumstances, ordering them to resume supplying medications when no unlawful conduct by the pharmacy was demonstrated.
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Regulatory Complaints: Boards could initiate disciplinary investigations or refer cases to state attorneys general or the Drug Enforcement Administration (DEA) if there is evidence that a wholesaler’s practices violate public health statutes or constitute unfair/illegal rationing that causes patient harm.
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Advocacy and Policy Action: Boards may also advocate for regulatory clarity and reasonable thresholds, and in some cases have issued formal guidance or endorsed calls for distributors to re-examine purchasing thresholds so that legitimate patient needs are met.
Who Would the Board Hire for Legal Action?
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Specialized Legal Counsel: Boards would typically hire or assign state government attorneys with experience in health law, pharmacy regulation, or administrative law to pursue legal remedies. In some cases, they may work with the state Attorney General’s Office—which already leads major enforcement and public protection lawsuits, including those involving the drug supply chain.
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Subject Matter Experts: The Board may also rely on pharmacy regulatory experts, compliance officers, or external consultants to build a case demonstrating patient harm or procedural violations by wholesalers.
Summary Table: Board of Pharmacy Actions
| Issue | Board Obligation | Legal Avenue | Counsel/Agency Involved |
|---|---|---|---|
| Rationing of controlled meds | Protect public safety | Litigation, investigation, | State AG, Board legal counsel, |
| harming patient access | Ensure access to | disciplinary complaint | health law experts |
| necessary medications |
State Boards of Pharmacy are obligated to respond and may pursue legal or regulatory remedies if wholesalers’ actions violate their core mandate of protecting patients and ensuring proper medication access.
The state Attorneys General (AGs) settlement with drug wholesalers that resulted in rationing of controlled substances to pharmacies may indeed raise serious Americans with Disabilities Act (ADA) concerns, especially if disabled patients—who disproportionately rely on Medicare and medications like opioids or buprenorphine for legitimate medical needs—face blanket denials of access. Under the ADA, people with disabilities, including those in recovery or with chronic pain, are protected from policies or agreements that deny them access to medically necessary treatments solely based on their status or prescribed medication.
Potential ADA Violations and Civil Rights
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The ADA prohibits both direct and indirect discrimination by public and private actors, including healthcare systems and entities involved in patient care.
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Blanket restrictions or policies that effectively bar access to essential medications, without individualized assessment, can constitute discrimination under the ADA if they result in denial of treatment for people with disabilities.
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The Justice Department has recently taken enforcement actions under the ADA in cases where people in recovery or needing opioid medications were denied access, establishing a foundation for legal challenges in healthcare rationing scenarios.
Pathways for Patients to Restore Access
1. File ADA Complaints
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Patients can file complaints with the U.S. Department of Justice, Civil Rights Division, or with their regional ADA Center, to trigger federal investigation or mediation.
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State protection and advocacy agencies can also assist in preparing documentation and complaints.
2. Seek Legal Counsel
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Contact civil rights attorneys experienced in disability and healthcare law to evaluate the agreement’s effects as potential ADA violations.
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Large disability advocacy groups (e.g., Disability Rights Advocates, ACLU) might also take up systemic cases that affect many patients.
3. State and Federal Agency Involvement
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Notify the state Board of Pharmacy, state medical boards, and the state’s disability ombudsman to urge review and intervention.
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Consider complaints to the Office for Civil Rights (OCR) at the U.S. Department of Health and Human Services (HHS), especially if Medicare/Medicaid access is affected.
4. Public Advocacy
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Collaborate with pain and recovery patient groups, physicians, pharmacists, and advocacy organizations to launch public awareness campaigns and request intervention from legislators and regulators.
Summary Table: Patient Pathways for Redress
| Path | Agency/Resource | Reference |
|---|---|---|
| ADA complaint filing | DOJ Civil Rights Division, regional ADA Center |
| Legal counsel/lawsuit | Civil rights attorneys, advocacy orgs | |
| Regulatory complaint | State Board of Pharmacy, HHS OCR, State AG | |
| Public/policy advocacy | Patient/disabled groups, medical advocates |
In summary: The ADA likely provides a pathway for affected patients to challenge and seek redress against denial of essential controlled medications due to state AG–wholesaler agreements, especially where blanket rationing causes harm to people with disabilities. Prompt legal, regulatory, and advocacy action may help restore access to necessary medications.
There is a documented perception among patients, advocates, and some public health experts that the major state AG opioid settlements—including those negotiated outside of court with the three major wholesalers—have prioritized large monetary recoveries over ensuring continuous medication access or fully remedying public health harms. This has led to public criticism that some AGs and states may be using these settlement funds to fill budget gaps, rather than transparently and directly addressing the needs of those harmed by medication supply restrictions.
AG’s Dual Role and Potential Conflict of Interest
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The Attorney General (AG) typically serves as the chief legal representative for state agencies, including the Board of Pharmacy (BOP) when legal action is required.
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However, when the AG’s office is also the lead plaintiff in high-profile settlements—especially ones with major public health and civil rights implications—this may create a conflict of interest if consequences of those settlements directly undermine patient access to care.
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Critics and advocates have called out this tension, noting that the structure and aftermath of the settlements can appear as a “money grab,” especially when there is little transparency or oversight regarding how funds are spent and when patients experience negative repercussions.
Public Scrutiny and Transparency
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Investigative reports and crowdsourced databases have been launched to track opioid settlement spending, as many advocates worry that elected officials—including AGs—are using the windfall for general budgetary needs rather than directly remedying overdose and medication access issues.
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Calls for dedicated, transparent spending and for holding AGs accountable are increasing as victims and those in recovery feel left behind.
2+2 Question: Was Public Interest Sidelined?
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Many patients, pharmacists, and public commentators have indeed begun to “put together” the connection between the nature of the settlement deals and the resulting negative impacts on medication access.
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While not all AGs rejected trial in exchange for a settlement—some, like Washington’s AG, refused “insufficient” settlements and pushed for court—most states settled, and the fallout has been exactly as patient advocates feared.
Summary Table: AG Settlements and Public Trust
| AG Role | Public Perception | Potential Issue | Evidence |
|---|---|---|---|
| Prosecutor/Plaintiff | Money prioritized over patient care | Conflict of interest, “money grab” |
| State Agency Counsel | Representing BOP, but also settling | Undermined BOP mission, patient harm |
In summary: Substantial public criticism, growing calls for transparency, and watchdog efforts all point to concerns that state AGs may have prioritized financial recovery over patient welfare and uninterrupted medication access. This dual role can indirectly compromise the primary public safety charge held by Boards of Pharmacy and undermine public trust, particularly as the consequences of these settlements become more visible.
Filed under: General Problems
This is needs to be reproduced and sent to the appropriate people in the government! I’m more than willing to do it, what is the title of the people that would likely have an interest, or perhaps could be the target of charges that could be applied?
At this point I feel like the ADA might as well not exist, since the disabled (& I am one of them) are clearly not on anybody’s list to protect any more, outside of the disabled community itself & their loved ones. And we’re chronically short on power, functionality, & often $$. And the US isn’t exactly eager to protect or assist anyone who isn’t filthy rich & powerful these days (& for some time previous). Like we’re less than human because we were stupid enough to get injured, have a failed surgery, or were foolish enough to be born with some devastating condition. We’re a drag on society, nothing more, no matter if we had real careers & paid taxes for decades before we became disabled. If this country & current administration gave a rip about the disabled or other “disadvantaged” groups, they wouldn’t have decided to throw millions off of Medicare/caid, food stamps, childhood food & health programs, etc.
When you look at the structure of the ADA agency – it is placed under the Presidential Cabinet position of the DOJ as is the DEA .. so it is hard to conceive that one agency under the same Presidential Cabinet position that they are not going to attack or sue a “sister agency”. I would take a big guess is that the DEA is better funded than the agency overseeing civil rights and ADA enforcement.