On the twenty-sixth day of a bench trial in Seattle, an expert witness for Albertsons testified that the pharmacy chain's policies for reviewing suspicious opioid prescriptions "met or exceeded" the standard of care at the time. The state of Washington, which is suing the company, has spent the previous weeks arguing the opposite: that Albertsons dispensed more than 641 million opioid pills across its Washington pharmacies between 2006 and 2022, including millions of prescriptions carrying warning signs of misuse, and that its policies were window dressing over a machine built to fill. Judge Janet Helson of King County Superior Court will decide, probably in September, which account is right.
The oddity of the trial is that both sides are arguing about a standard that, by the testimony of the state's own regulators, was never written down anywhere. The case is nominally about pills. It is about a question the law left open for decades: when a pharmacist faces a prescription that looks wrong, what exactly did the rules require, and who was responsible when the system filled it anyway?
The two versions of the record
The state's case, brought by Attorney General Nick Brown, follows the pattern of opioid litigation across the country. Albertsons, through its Safeway and Haggen pharmacies, operates more than 200 pharmacies in Washington. The state alleges that for years the chain filled opioid prescriptions riddled with red flags, prescriptions for extreme quantities, for cash, from distant prescribers, with little documented review, and that it failed to report suspicious orders to federal regulators as required. It accuses the company of violating the state's Consumer Protection Act and seeks penalties that could reach hundreds of millions of dollars. One state expert put the cost of addressing the harm from prescription opioid abuse at nearly $44.4 billion. Another testified that the causal link between excess prescriptions and later heroin and fentanyl use is undeniable. The allegations are contested, and nothing has been adjudicated yet.
Albertsons' defense is that the pharmacy is the wrong defendant, and perhaps that there is no right one. Doctors "hold the only key," its lawyers argue: a pharmacy fills what a physician writes, and the company has seen no evidence that its pharmacists dispensed medication they should not have. Standards around opioid prescribing changed over the years, the company says, and its policies changed with them. Its lawyers have also pointed at the state's own regulators, arguing they knew about problematic prescribers long before they told pharmacies or patients. The red-flag vocabulary itself, the company contends, was coined by federal enforcement agencies without the force of law, a phrase that means nothing outside a courtroom.
The standard was never a list
That last argument has a factual foundation, and it is the most uncomfortable part of the case for the state. Washington's own pharmacy regulator, the Pharmacy Quality Assurance Commission, has testified in this trial that there is no exhaustive list of red flags and no law or rule that states what the standard of care is in every situation. The standard, the regulator said, is what a reasonably prudent pharmacist would do, which is a principle, not a checklist. The state cannot point to a single regulation that Albertsons violated by filling a particular prescription, because the regulation was never written. What it can do, and is doing, is argue that the principle was clear enough and that the scale of the filling shows the principle was ignored.
The national litigation has circled the same void. Across the country, pharmacies were described in the opioid lawsuits as the "last line of defense" against diversion, a duty derived from a federal doctrine called corresponding responsibility that has existed in some form since the 1970s. But what the duty required in practice, how a pharmacist should investigate, what should be documented, what should be refused, was left to professional judgment. When a federal judge in Ohio ruled after trial that pharmacies must now document every refusal to fill, share those refusals across stores, and consider colleagues' rejections, commentators in the pharmacy profession called it a duty the judge had invented. The industry is, in effect, being asked in courtrooms to have complied, twenty years ago, with a standard that no one wrote down until the lawsuits arrived.
What the paper says and what the floor saw
The trial has therefore become an argument about documents. The defense expert's testimony was that the policies themselves were strong, at or above the standard as it existed. The state's witnesses have spent weeks arguing the policies did not govern what happened at the counter: red-flag prescriptions filled with blank documentation fields, review procedures that left no trace, quantities that should have stopped any pharmacist who looked. The gap between a policy manual and a filled prescription is the whole battlefield, because in a case without a written standard, the paper trail is the only evidence either side can offer for what the standard was.
The pattern is not unique to Albertsons. In the federal litigation, expert analyses found that roughly nine in ten sampled red-flag prescriptions across the major chains lacked documentation that anyone had resolved the flag. Internal documents from other companies showed compensation systems that rewarded speed and volume, refusal systems that did not share information between stores, and employees warning that safeguards were inadequate. Each chain settled rather than litigate, paying billions in the national framework. Washington's case against Albertsons is what the argument looks like when a defendant declines to settle and instead asks a judge to rule on whether the policies were enough.
Judging the past by the present
Underneath the documents is a temporal problem the trial cannot escape. The conduct at issue runs from 2006 to 2022, the period when the medical establishment's view of opioids collapsed from "safe and effective for chronic pain" to "public health catastrophe." A pharmacist in 2009 filling a high-dose oxycodone prescription was working inside a different consensus than a pharmacist in 2019, and the trial is asking whether the law should hold the earlier pharmacist to the later standard. The company's answer is no, the standards evolved and it evolved with them. The state's answer is that the core duties, to look, to question, to refuse, were never novel, and that the evolution is precisely what the chain's own data shows it resisted.
The deaths that hover over the courtroom complicate any clean answer. Washington lost roughly 2,276 people to drug poisoning in 2024, the first annual decline since 2013, with fentanyl now involved in more than 90 percent of opioid deaths. The epidemic the trial examines is no longer driven by prescriptions; the illicit fentanyl wave arrived years after the filling patterns at issue. Both sides claim that fact. The state says the prescription era created the demand the street supply now serves; the company says the fentanyl wave is a different catastrophe, caused by drugs its pharmacies never touched. The judge will have to decide how much of 2026's overdose map was drawn by what happened at the pharmacy counter a decade earlier.
The verdict will write the standard
The case matters beyond the parties because it may be the first full adjudication, rather than a settlement, of what a pharmacy chain owed during the prescription era. Washington recovered more than $1.3 billion from opioid defendants overall: Kroger settled its Washington case for $47.5 million, Walgreens agreed to $120.3 million as part of a larger package, CVS to $110.6 million, and Rite Aid resolved its claims separately. The state opted out of Albertsons' $774 million national settlement to try this case, which means the judge's findings will become the state's benchmark for whether that decision was worth it. A former state attorney general has predicted the case could still settle before a verdict, and settlement remains the industry's preferred ending precisely because a ruling would put words to the standard everyone else bought their way out of defining.
Whatever Judge Helson decides, the trial has already performed a public service the settlements never did: it has shown, day by day, how thin the written rules were during the years that mattered. The policies are now in evidence. The fill counts are now in evidence. The question left for the judge is whether a duty that was never written down can be enforced against the companies that had every reason not to read it into existence, and if the answer is yes, what the duty was. That is the standard of care on trial in Seattle, and by September, someone will finally have to say what it was. However the ruling lands, the families behind the state's numbers will not get the era back, and no verdict will tell them why a system with so many policies produced so many pills. It will only say whether the policies were ever enough.
Primary sources
- The Law360 report by Ben Adlin for the day-twenty-six testimony, the expert's characterization, and the trial posture.
- The Seattle Times and Tacoma Daily Index for the trial's start, the 641 million pill figure, the red-flag allegations, the defense arguments, the settlement history, and the bench-trial details.
- Courthouse News for the regulator's testimony that no exhaustive red-flag list exists, MyNorthwest for the former attorney general's prediction, the University of Washington's Addictions, Drug & Alcohol Institute for the state's overdose death data, and Washington Attorney General records for the settlement history and the 2022 filing against the chains.