Chronic Pain Patients Class Action Lawsuit: CVS, Walgreens, Costco

The two national class action lawsuits that chronic pain patients filed against major pharmacy chains in August 2020 both ended without a class ever being certified. The case against Walgreens and Costco was dismissed by the district court and affirmed by the Ninth Circuit in January 2024. The case against CVS survived an early motion to dismiss on three legal theories, moved into discovery, and was terminated in December 2025 with no class certification ruling on the docket. A handful of related lawsuits and a unanimous Supreme Court decision moved parts of the issue, but the sweeping class relief the plaintiffs sought never arrived.

The Two Lawsuits and Who Filed Them

Both complaints were filed on August 10, 2020.

Fuog v. CVS Pharmacy, Inc. (Case No. 20-cv-00337) was brought in the U.S. District Court for the District of Rhode Island by Edith Fuog, a 48-year-old Florida woman. Fuog alleged that CVS Pharmacy and its affiliate CVS Caremark refused to fill prescriptions tied to her stage-1 breast cancer diagnosis and the medical complications that followed.¹

Smith v. Walgreens Boots Alliance, Inc. (Case No. 20-cv-05451) was filed in the U.S. District Court for the Northern District of California by Susan Smith, a 43-year-old from Castro Valley who lives with chronic pain syndrome. Smith named both Walgreens and Costco as defendants and alleged that pharmacy staff harassed her, laughed at her, and made derogatory comments. She said one Walgreens pharmacist suggested she seek rehabilitation rather than fill a prescription for pain relief right after surgery.²

What the Lawsuits Claimed

Both complaints alleged that CVS, Walgreens, and Costco had implemented company-wide policies amounting to “total or near total bans” on filling opioid prescriptions, regardless of whether a licensed physician had issued them for a legitimate medical purpose.³ The plaintiffs argued that the policies treated chronic pain patients with valid prescriptions as drug abusers and punished them for their underlying disabilities.

The claims rested on three federal statutes:

Title III of the Americans with Disabilities Act, which prohibits disability-based discrimination by places of public accommodation, including pharmacies.
Section 504 of the Rehabilitation Act of 1973, which bars disability discrimination by entities receiving federal financial assistance.
Section 1557 of the Affordable Care Act, which extends anti-discrimination protections into health care settings.

The Fuog complaint focused on CVS’s internal dosage and duration limits, medical record demands made of patients, and the use of internal databases that the plaintiffs said effectively blacklisted people seeking opioid prescriptions. According to the complaint, CVS treated the CDC’s 2016 recommendation of 90 morphine milligram equivalents and a 7-day duration as “hard and fast limits,” refusing anything above either threshold.⁴

Lead counsel Scott Hirsch argued that pharmacies were “blanketly applying” guidelines meant for acute pain patients to deny medication to people with severe chronic conditions.² The plaintiffs pointed to a June 2020 American Medical Association letter to the CDC that called CVS and Walgreens policies “inappropriate” and said they “have resulted in specific harm to patients.”¹

How the Walgreens and Costco Case Ended

The Smith case was knocked out at the pleadings stage. On February 3, 2021, the district court granted the defendants’ motion to dismiss, finding that Smith had not pleaded enough facts to support an intentional discrimination claim. The court suggested that disparate impact or failure-to-accommodate theories might still be viable and allowed her to amend. She filed an amended complaint the following month.³

The district court dismissed the amended complaint too. Smith appealed. On January 2, 2024, the Ninth Circuit affirmed, holding that she had failed to state a claim under any of her theories — facial discrimination, disparate impact, or failure to provide reasonable accommodations. No class was certified.⁵

How the CVS Case Ended

The Fuog case lasted longer and got further. CVS moved to dismiss in October 2020, arguing that Fuog had not adequately alleged the policies were applied to her specifically and that its “bona fide healthcare judgment” could not be challenged through disability discrimination claims. The court heard argument in February 2021.³

On May 10, 2022, Judge William E. Smith granted the motion in part and denied it in part. CVS Caremark was dismissed, but the claims against CVS Pharmacy survived on three theories: disparate treatment, disparate impact, and failure to make reasonable accommodations.⁴ CVS answered in June 2022, and the case entered discovery. A Rule 16 scheduling conference followed in early 2023, and by October 2023 the parties had agreed to extend their informal discovery schedule by 90 days.⁶

The docket shows the case was terminated on December 5, 2025. The entry does not specify whether termination came through settlement, voluntary dismissal, or another mechanism, and no class certification ruling was recorded.⁶

Related Cases That Moved Parts of the Issue

Although the two headline class actions did not produce class relief, other litigation covering the same ground reached chronic pain patients in narrower ways.

In Goldsmith v. CVS Pharmacy, filed in the Central District of California, a court denied CVS’s motion to dismiss in July 2020, finding the plaintiff had adequately alleged ADA and state civil rights violations. That case was dismissed in April 2021 following a settlement.³

In Hansen et al v. CVS Pharmacy, filed in the Eastern District of Kentucky in August 2021, interventional pain physician Dr. Kendall Hansen sued after CVS told him its northern Kentucky pharmacists would stop filling his prescriptions. He reported more than 250 patients who relied on CVS locations. On August 11, 2021, Judge William Bertelsman granted a temporary restraining order requiring CVS to resume filling the prescriptions, finding Dr. Hansen “likely to succeed in his lawsuit” because CVS had failed to show he had broken any law.⁷

On the prescriber side, the Supreme Court decided Ruan v. United States unanimously in June 2022. To convict a physician of unlawfully distributing controlled substances under the Controlled Substances Act, the government must now prove the doctor “knowingly or intentionally acted in an unauthorized manner.” The Court rejected the government’s position that liability could turn on whether a hypothetical “reasonable” doctor would have prescribed the medication, saying that would amount to a negligence standard. The opinion acknowledged the risk of “over-deterrence” when physicians act in good faith near ambiguous regulatory lines.⁸ Advocates have said access problems have continued despite the ruling, driven by continuing regulatory pressure and institutional caution.⁹

In April 2022, the Department of Justice issued guidance stating that the ADA protects individuals with opioid use disorder from discrimination by public accommodations, including pharmacies and medical facilities. The guidance said blanket denial policies for patients receiving legally prescribed medication for substance use disorders constitute disability discrimination, and it outlined the complaint process available through the DOJ and the Department of Health and Human Services.¹⁰ That guidance addresses patients with a diagnosed substance use disorder specifically; it is not the same as a court ruling that chronic pain patients are protected when pharmacies refuse their prescriptions.

Where Pain Patients Stand Now

The agency whose 2016 recommendations the lawsuits said pharmacies had weaponized eventually walked back the way those recommendations had been used. In its updated 2022 guideline, the CDC stated that policies derived from the earlier document had been “misapplied” in ways “inconsistent” with its original intent. The agency documented that these misapplications led to “untreated and undertreated pain, serious withdrawal symptoms, worsening pain outcomes, psychological distress, overdose, and suicidal ideation and behavior.” The revised guideline described its dosage figures as “voluntary” and “not intended to be implemented as absolute limits for policy or practice across populations.”¹¹

State legislatures have moved too. Colorado’s S.B. 23-144, signed in 2023, bars employers from imposing specific prescribing limits on physicians and lets doctors use clinical judgment on opioid dosages at whatever morphine milligram equivalent level they find medically appropriate for a particular patient.¹² Illinois House Bill 5373, sponsored by State Senator Laura Fine, passed the Illinois Senate in November 2024; it authorizes physicians to prescribe controlled substances in line with updated CDC guidelines without rigid dosage limitations, as long as they comply with federal law.¹³

For an individual patient refused a legitimate prescription, the practical takeaway from this stretch of litigation is narrow. The two national class actions did not produce class-wide relief; one plaintiff settled individually; one physician obtained a temporary restraining order on his own facts; the Supreme Court tightened the standard for prosecuting doctors; and the federal government has said in guidance, though not in a binding court ruling for chronic pain patients, that blanket denial policies can violate the ADA. The courthouse door is still open to disability discrimination claims — the Fuog ruling confirmed that disparate treatment, disparate impact, and failure-to-accommodate theories can at least survive dismissal — but no decision from these cases has forced the major pharmacy chains to change their policies at a national level.

1
PR Newswire. Seeking Justice for Pain Patients: Class Action Lawsuits Filed Against CVS, Walgreens, and Costco
2
San Francisco Examiner. Pharmacy Chains Sued for Refusing Legal Prescription for Opioid Medication
3
Center for U.S. Policy. Patient Access to Opioids Litigation Tracker
4
GovInfo. Fuog v. CVS Pharmacy, Inc., C.A. No. 20-337 WES
5
United States Courts for the Ninth Circuit. Smith v. Walgreens Boots Alliance, Inc., No. 22-16468
6
CourtListener. Fuog v. CVS Pharmacy, Inc. Docket
7
Becker’s ASC Review. Judge Sides With Pain Physician, Orders CVS to Resume Filling His Scripts
8
Supreme Court of the United States. Ruan v. United States, No. 20-1410
9
KFF Health News. CDC New Opioid Guidelines and Chronic Pain Patients
10
U.S. Department of Justice. The Americans with Disabilities Act and the Opioid Crisis
11
CDC. CDC Clinical Practice Guideline for Prescribing Opioids for Pain
12
Northern Colorado Medical Society. S.B. 23-144: Addressing Prescription Drugs for Chronic Pain Patients
13
Senator Fine. Senate Passes Fine Bill to Facilitate Chronic Pain Treatment