Texas Attorney General Ken Paxton announced he is launching an investigation to determine whether Walmart improperly filled prescriptions and failed to report suspicious orders when selling opioid drugs.

Paxton issued a civil investigative demand (CID) to the retail giant for “potential violations of the Texas Deceptive Trade Practices Act (DTPA) relating to the promotion, sale, dispensing, and distribution of prescription opioids,” a June 28 press release from the AG’s office states. 

“I have fought for Texans who have been tragically impacted by the illegal marketing and sale of opioids, which have caused addiction and the untimely deaths of thousands of people each year,” Paxton said in the release. “I am committed to holding pharmacies accountable if they played a role in this devastating epidemic.”

The investigation will focus on Walmart’s compliance with a requirement to submit documentation related to opioid orders dating back to January 2006 to the U.S. Drug Enforcement Administration and all Texas state agencies, Paxton said.

In a statement, Walmart said it would answer the Texas Attorney General’s questions and stated it has “never manufactured, marketed or promoted opioids, and pharmacists aren’t doctors and don’t write opioid prescriptions.”

“We are confident in our record helping fight the opioid crisis, and we are proud of our pharmacists, who help patients understand the risks about opioid prescriptions and have refused to fill hundreds of thousands of opioid prescriptions they thought could be problematic,” Walmart spokesman Randy Hargrove said.

“As a result of Walmart’s refusal to fill opioid prescriptions, many health regulators (including the Texas Medical Board), medical groups, doctors, and patients say that Walmart is going too far in refusing to fill opioid prescriptions, and even say we are improperly interfering in the doctor-patient relationship,” the Walmart statement continued. 

“Walmart and our pharmacists are torn between the demands on pharmacists imposed by opioids plaintiffs on one side and health agencies and regulators on the other, and patients are caught in the middle,” Hargrove added. 

Opioids, both prescribed and illicit, have caused over 564,000 fatalities from 1999 to 2020, according to the Centers for Disease Control and Prevention. In 2020 alone, nearly 75% of the country’s 91,799 drug overdoses involved an opioid.

More recently, fatalities caused by the powerful synthetic opioid fentanyl have more than doubled in 30 states over the last two years, according to Families Against Fentanyl.

The Justice Department separately sued Walmart in 2020 over its role in fueling the opioid crisis. The lawsuit claimed that Walmart sought to boost profits by understaffing its pharmacies and pressuring employees to fill prescriptions quickly. 

That resulted in pharmacists failing to reject invalid prescriptions, thus enabling widespread drug abuse nationwide, the suit claims. Many examples used in the federal government’s lawsuit involved Texas prescriptions.

At the time the lawsuit was filed, Walmart said that the Department of Justice’s investigation was “tainted by historical ethics violations” and that the lawsuit “invents a legal theory that unlawfully forces pharmacists to come between patients and their doctors, and is riddled with factual inaccuracies and cherry-picked documents taken out of context.”

The lawsuit was put on hold late last year as the Supreme Court considered a separate case involving two doctors who had been convicted of misusing their medical licenses to fill thousands of invalid prescriptions for addictive pain medications.

The Supreme Court decided that case on Monday, ruling unanimously in favor of the two doctors. The doctors had argued that their trials were unfair because the jury that convicted them was not advised to consider whether they had “good faith” reasons to believe the prescriptions they filled were medically valid.

The federal government’s lawsuit against Walmart is scheduled to resume on July 11.

Walmart, CVS, and Walgreens were also found liable in a November civil court case for fueling the opioid epidemic in two Ohio counties. The judge in that case held a second trial to determine the amount Walmart and the other defendants must pay to the two counties but has not yet made a final ruling.