Attorneys made closing arguments Tuesday in a seven-week trial in which New Mexico alleges that lax opioid dispensing by pharmacy giant Walgreens helped unleash an ongoing addiction crisis in the state.

Walgreens was the last remaining defendant in the trial following the state’s recent settlements with pharmacy retailers Walmart and Kroger.

An attorney for the state told the judge that Walgreens dispensed 360 million opioid pills in New Mexico from 2006 to 2016, helping fuel a costly crisis that continues today.

“Walgreens’ failure to follow its own policies and train its own people was the significant link in the opioid epidemic in New Mexico,” said Daniel Alberstone, an attorney who represented New Mexico in the seven-week trial.

An attorney for pharmacy retailer Walgreens responded that New Mexico failed to show that Walgreens pharmacists dispensed opioids that they knew had no legitimate medical purpose.

“The state’s allegation that prescriptions were dispensed without a legitimate medical purpose must be evaluated in light of the state’s own standard of care,” said Daniel Taylor, an attorney for the Deerfield, Illinois-based pharmacy chain.

The case will be decided by 1st Judicial District Court Judge Francis Mathew and not a jury. Attorneys in the case are expected to file additional statements in writing before Mathew issues a ruling.

The suit, filed by the New Mexico Attorney General’s Office, alleged that Walgreens, Walmart and Kroger pharmacies failed to investigate suspicious opioid orders and reaped large profits selling addictive drugs to New Mexicans.

Luis Robles, an Albuquerque attorney representing the Attorney General’s Office, said the state reached settlements during the trial with Walmart, a Bentonville, Arkansas, retailer, and Kroger, the Cincinnati, Ohio-based parent company of Smith’s Food and Drug Center.

The details of those settlements have not been finalized and settlement amounts remain confidential, Robles said.

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Alberstone said in closing statements that the distribution of prescription opioids initiated a crisis that has resulted in death and suffering statewide and an “explosion of people in the criminal justice system” requiring expensive solutions.

“The opioid crisis in New Mexico is real,” Alberstone said. “The crisis has shattered the lives of individuals and families and it has ravaged communities.”

Witnesses for the state testified that as many as 80 percent of people who began using heroin in the past two decades first became addicted to prescription opioids, Alberstone said.

One witness testified that an estimated 49,000 children in New Mexico have been exposed to parental opioid use, and approximately 40 percent of foster care placements are due to parental drug use, he said.

“The state has proven that the opioid crisis existing in New Mexico was the foreseeable consequence of Walgreens’ conduct,” he said.

Witnesses for the state testified that 55 percent of prescriptions dispensed by Walgreens from 2006 to 2016 — a total of 3.6 million prescriptions — were “red flagged” based on Walgreens own policies, Alberstone said. A red flagged prescription is one that should have alerted pharmacists that the pills were being illegally diverted.

“Three million plus prescriptions in New Mexico were red flagged using the good-faith dispensing checklist that Walgreens had in its own policy as a basis for those red flags,” Alberstone said.

Walgreens’ attorney countered that the state offered no evidence that the retailer and its New Mexico pharmacists failed to follow policies intended to promote responsible prescription practices.

Taylor said statements published by the New Mexico Medical Board and the New Mexico Board of Pharmacy in 2005 show that the use of opioids in treating pain was considered a legitimate medical purpose.

“If the prescription had a legitimate medical purpose, there can be no argument that the pharmacists and Walgreens did anything wrong by deciding to dispense it,” he said.

New Mexico became the eighth state to sue opioid manufacturers and distributors in September 2017. The suit alleged that “the sheer volume of prescription opioids distributed to (New Mexico) pharmacies is excessive for the medical need of the community.”

New Mexico subsequently reached settlements with a number of opioid manufacturers and distributors in a deal that Attorney General Hector Balderas’ office estimate will bring $190 million to the state.

New Mexico continues to seek settlements with four large manufacturers that have filed for bankruptcy, including Purdue Pharma, maker of OxyContin, Balderas has said.

In March 2023, the state expects to begin a trial in Santa Fe against pharmaceutical manufacturers Teva, Allergan and KVK-Tech.

Olivier Uyttebrouck, Albuquerque Journal