10 July 2023- U.S. District Judge Lydia K. Griggsby approved the United States’ consent decree with John A. Beckman, a Cumberland, Maryland based pharmacist, and Beckman’s Greene Street Pharmacy, Inc. (“Beckman’s Pharmacy”), resolving the United States’ civil allegations that Beckman and Beckman’s Pharmacy violated the Controlled Substances Act (“CSA”) in illegally dispensing controlled substances.
The consent decree was announced by United States Attorney for the District of Maryland Erek L. Barron; Principal Deputy Assistant Attorney General Brian M. Boynton, of the Justice Department’s Civil Division; and Special Agent in Charge Jarod A. Forget of the Drug Enforcement Administration – Washington Field Division.
“Irresponsible pharmacies and pharmacists fan the flames of the ongoing opioid epidemic,” said U.S. Attorney Erek L. Barron. “Our office intends to use all tools at our disposal—criminal and civil—to hold accountable those at every step in the supply chain who violate the CSA.”
“Pharmacies and pharmacists have an obligation to help stop the illegal distribution of controlled substances,” Principal Deputy Assistant Attorney General Brian M. Boynton, head of the Justice Department’s Civil Division. “The department will work with its law enforcement partners to hold responsible those who dispense potentially dangerous prescription drugs in violation of the law.”
“The devastating effects of opioid overdoses and poisonings have affected many lives in our local communities,” said Special Agent in Charge Jarod Forget for the DEA Washington Division. “Healthcare providers have a great responsibility as it relates to dispensing medications to meet the health needs of our citizens. This includes being vigilant for any signs of controlled substance diversion or misuse. Our team is committed to protecting the safety and health of all Americans, which includes ensuring that all licensed professionals comply with the law and report dangerous behaviors.”
The Government alleges that at least since 2017, Beckman and Beckman’s Pharmacy knowingly filled fraudulent prescriptions for controlled substances, ignoring red flags that should have acted as warning signs that the prescriptions were not legitimate. More specifically, the Government alleges that, since at least 2017, Beckman and Beckman’s Pharmacy would often dispense dangerous combinations of controlled substances which are known to be pursued by drug abusers, but which seriously increase the risk of respiratory distress, overdose, and death, and did so without noting any reasonable explanation for these dangerous combinations. These combinations included the extremely dangerous “holy trinity,” which combines an opioid, a benzodiazepine, and carisoprodol. Additionally, Beckman and Beckman’s Pharmacy often dispensed a combination of an opioid and buprenorphine, a drug which is generally used to treat opioid dependence and regularly filled prescriptions for controlled substances that were paid for with cash even though the patient had insurance available to pay for the patient’s prescriptions.
The Centers for Disease Control and Prevention generally recommends that individuals should avoid daily dosages of opioids over 90 morphine milligram equivalents (MME), but Beckman and Beckman’s Pharmacy routinely dispensed prescriptions to patients causing their MME levels to be many times that amount—and upwards of 1000 daily MME. The Government alleges that Beckman and Beckman’s Pharmacy dispensed opioids to more than ten patients who subsequently died within ten days of the date of the prescription for those opioids.
Under the consent decree, Beckman and Beckman’s Pharmacy agree to pay a $120,000 civil monetary penalty and are required to identify certain red flags—including when a patient has traveled a long distance to the pharmacy, and when a patient is receiving an opioid and a benzodiazepine. Before filling prescriptions bearing those and other red flags, the consent decree requires Beckman and Beckman’s Pharmacy to document in detail any indications of abuse or diversion and the steps they took to ensure that the prescription was valid and was issued for a legitimate medical purpose, and that the prescription would not be abused or diverted for illegitimate purposes. Additionally, under the consent decree, Beckman and Beckman’s Pharmacy are prohibited from filling certain prescriptions, including when a patient presents prescriptions that, if filled, would cause the patient to take more than 90 daily MME; a combination of an opioid, a benzodiazepine, and carisoprodol; most prescriptions for buprenorphine without naloxone; any controlled substance paid for with cash even though the patient has insurance available to pay for the patient’s prescriptions; and any prescription for a controlled substance if the patient is an employee of Beckman’s Pharmacy.
Under the consent decree, if the DEA determines that Beckman or Beckman’s Pharmacy have violated any provision of the consent decree or if Beckman or Beckman’s Pharmacy do not implement the corrective action the DEA orders, the DEA can order Beckman and Beckman’s Pharmacy to cease ordering or dispensing controlled substances immediately.
The consent decree is not an admission of liability by Beckman or Beckman’s Pharmacy, nor a concession by the United States that its claims are not well founded.
The Court’s approval of this consent decree—the fourth such consent decree in the District of Maryland in the past two years—should again remind pharmacists and pharmacies of their corresponding responsibility to confirm the legitimacy of the prescriptions that they fill and that the Department of Justice intends to use all tools at its disposal—both criminal and civil—to combat the controlled substances epidemic which continues to plague our country, including here in Maryland.