Trump’s White House Pharmacy Had a Bit of a Pill Problem

A lengthy new report from the Department of Defense found that during Trump’s administration, the White House Medical Unit was mishandling dangerous prescription drugs.

The 80-page document released on January 8 detailed inappropriate mishandling of pharmaceuticals and their respective prescribing practices. The investigation into this matter began in 2018 after the Inspector General of the Department of Defense received complaints which included shoddy record keeping, overuse of brand name medications instead of cheaper generic alternatives, mishandling of medications such as one person picking up a prescription for another and so on. 

“Without oversight from qualified pharmacy staff, the White House Medical Unit’s pharmaceutical management practices may have been subject to prescribing errors and inadequate medication management, increasing the risk to the health and safety of patients treated within the unit. Additionally, the White House Medical Unit’s pharmaceutical management practices ineffectively used DoD funds by obtaining brand‑name medications instead of generic equivalents and increased the risk for the diversion of controlled substances,” the report said.

Over 120 officials were interviewed during the course of the investigation. Several witnesses gave testimony to the Department of Defense in the course of this investigation, almost all of whom described a very laissez faire environment compared to most pharmacies, or most fast food restaurants for that matter, which have all been under immense pressure from the DEA to crack down on mishandling of controlled substance. Most anyone who has tried to fill a prescription for opioid painkillers or stimulants like Adderall in the last five years can attest to this. 

“Anything that took place at the White House Clinic was never written down, never recorded. [However,] the only record that you ever had that a patient came in and got any sort of medication would have been if it was a controlled substance that we were required to document for the pharmacy. But if you came in and got any other prescription medication that wasn’t classified as a controlled substance there would be no record that you came in and did anything,” one witness told the Department of Defense, while another said that it was common practice to make “go-bags” of drugs like Ambien and Provigil for White House staffers before overseas trips.

In addition to mishandling of medications, the investigation found that taxpayers have been footing the bill for egregious overuse of brand name medications in lieu of their generic alternatives. Between 2017 and 2019, for instance, the White House spent $46,500 for Ambien and $98,000 for Provigil, which are 174 and 55 times more expensive, respectively, than their generic alternatives. Medical services including prescribing of controlled substances were also found to have been administered to ineligible White House staffers, on an average of six to 20 times a week according to the report. 

“We found that the White House Medical Unit provided a wide range of health care and pharmaceutical services to ineligible White House staff in violation of Federal law and regulation and DoD policy. Additionally, the White House Medical Unit dispensed prescription medications, including controlled substances, to ineligible White House staff,” the report said. “We concluded that all phases of the White House Medical Unit’s pharmacy operations had severe and systemic problems due to the unit’s reliance on ineffective internal controls to ensure compliance with pharmacy safety standards,” the report said.

The Department of Defense report concluded that more stringent and robust policies to prevent such issues in the future, which included establishing stricter controls for how controlled substances are prescribed and distributed as well as establishing stricter controls for who is eligible for White House medical care and who is not.

“We recommend that the Director of the Defense Health Agency, in coordination with the White House Medical Unit Director, develop policy and procedures to manage controlled and non‑controlled medications, including, at a minimum, procurement, storage and inventory, prescribing and dispensing, and disposal,” the report said. “We recommend that the Director of the Defense Health Agency, in coordination with the White House Medical Unit Director, establish controls for White House patient eligibility within the Military Health System.”

The complete report from the Inspector General can be found here.