A Walnut Creek pharmacy with a troubled past is once again being scrutinized by authorities for dispensing large quantities of powerful prescription opioid painkillers under suspicious circumstances, according to an Administrative Inspection Warrant affidavit obtained by NBC Bay Area’s Investigative Unit.
According to the warrant affidavit, DEA Diversion Investigators found the pharmacy and its owner, Gerald Tung, had dispensed more than 3,300 pills containing the opioid drugs Oxycodone and Oxymorphone to one patient over a six-month period, amounting to about 18 pills per day.
During a review of the pharmacy’s records, investigators identified additional red flags potentially indicative of the illegal distribution of opioid drugs.
“The database also indicates that Advanced Medical Pharmacy often dispenses multiple narcotic controlled substances to patients that reside at the same address, which is suspicious because this tends to be an indicator that the narcotics prescriptions may not be legitimate, and it is rare for individuals residing in the same household to have identical medical conditions requiring the same or a similar combination of powerful narcotic cocktails,” a DEA Diversion Investigator wrote.
According to the returned search warrant, investigators took 11 boxes of prescription drugs and medical records for 60 patients from the pharmacy.
A DEA spokesperson declined to discuss the specifics of the case, but said the pharmacy no longer possesses a valid DEA registration. Without that, the pharmacy isn’t permitted to dispense most prescription drugs, including opioid painkillers.
Pharmacist Gerald Tung declined to be interviewed on-camera for the story, but spoke to NBC Bay Area in April from inside his pharmacy. He conceded that he filled a substantial number of prescriptions for opioids, but said many of his customers are chronic pain patients, and the powerful painkillers are their only source of relief. Tung also said doctors were responsible for writing his customers’ prescriptions, and he sometimes called those doctors to check a prescription’s validity if he noticed any red flags.
Several weeks after speaking with NBC Bay Area inside his pharmacy, Tung emailed a statement, saying, in part:
“Education to the public about [staying] away from illegal drugs, and strictly [following] prescribers’ orders to take the prescribed medicine, the danger of not following the order, and [following] up closely with their providers to assess treatment alternatives, are the keys to control the current opioid epidemic. Closing down medical offices and pharmacies, and leaving chronic pain patients without proper pain treatment, are never solutions to the active drug seeking behavior individuals.”
Although Advanced Medical Pharmacy recently lost its DEA registration, Tung still has an active pharmacist license and currently faces no disciplinary action by the Pharmacy Board.
But former California Pharmacy Board Member Ramon Castellblanch, an associate professor of public health at San Francisco State University, said the accusations warrant a Board investigation.
“If that pharmacy was dispensing along those lines, they could be putting patients at grave risk,” Castellblanch said. “I, as one [former] board member, would have a serious problem with this pharmacist continuing to practice because of these kinds of patterns. It’s not just that they are breaking the rules, but they could be killing people.”
Castellblanch, pointing to an opioid overdose death rate that continues to climb, said pharmacists are the last line of defense in the fight to rein in opioid abuse. He recently developed a continuing education course for pharmacists to highlight what their responsibilities are when it comes to dispensing drugs.
“You have a corresponding responsibility with the prescriber for the safety of the patient,” Castellblanch said. “When you dispense opioids, if you see a red flag, you need to check it out.”
This is not the first time the Walnut Creek pharmacy has been under a microscope. Just two years ago, the previous owner of the pharmacy, James Yuen, voluntarily surrendered his license after the California State Board of Pharmacy accused him of 14 separate code violations, including “excessive furnishing of a controlled substance.”
In its 2016 accusation against Yuen, the Pharmacy Board wrote, in part:
“For certain patients, Respondent [Advanced Medical Pharmacy] dispensed excessive, and in some cases potentially lethal, doses and/or amounts of controlled substances, including oxycodone, acetaminophen containing controlled substances, methadone, fentanyl, zolpidem, and zaleplon.”
Yuen did not respond to several calls for comment from NBC Bay Area. Tung said he barely knew the previous owner and was not familiar with the allegations against him.
Castellblanch said pharmacists, along with doctors, drug companies and everyone else in the supply chain, must address their respective roles in an opioid epidemic he says shows no signs of slowing down.
“We’re still at probably triple or quadruple the number of opioids prescribed per capita than 20 years ago,” he said. “So we have a long way to go.”