The average pharmacy is not in any danger here at all, and unless a specific pharmacist is personally involved in illegal dispensing, they’re not in any danger here either, as far as I know. So if you know of specific pharmacists or non-franchise pharmacies caught up in this, you would have to look at the specifics of their individual infractions, or what the feds claim there is.

The problem is the huge chains, and to a much smaller extent their pharmacists. What the various DEA investigations found out is that in the states where the opioid crisis was/is the worst, the corruption went all the way up the supply chain. The actual prescription is just the first stop, but after that you have chains like CVS that were receiving literally truckloads of nothing but opioids at their regional supply houses, fully aware of their part in the whole thing but they were making MASSIVE coin, so why stop the gravy train? You’re right, individual pharmacists have to fill a script they are given unless they have cause to believe it’s fraudulent in some way, but again, the problem wasn’t truly at the pharmacist level, it was from the top down. So any pharmacist who recognized that 20 scripts a day from the same pain doc, day after day, was out of the norm and reported it to management was simply told to keep filling it regardless. And this went on regardless of how extreme the problem became, to the point that some individual pharmacies were distributing almost no prescriptions other than opioids.

Incidentally, this is how McKesson (a drug maker) ended up afoul of the feds: they knew exactly how much oxy and hydro they were shipping, to whom, and were all too well aware that the majority of that had to be to fill scripts that were less than legitimately gotten. By the time it got to state lawsuits the states had everything they needed to prove that it had been going on for years with McKesson’s full knowledge and blessing. Same for the other defendant who settled: they would have been gutted, and the proof by that point was legally indefensible.

WaPo did a huge series on this whole thing two or three years ago that is well worth the read, if you’re interested. Let me know and I’ll dig up the links (I have spare gift links, don’t worry about the paywall).