The pharmacy at the White House repeatedly gave controlled drugs to ineligible staffers, according to an inspector general.
The probe involved interviewing more than 120 officials and reviewing over 200 documents.
Witnesses testified to rampant issues.
“Anything that took place at the White House Clinic was never written down, never recorded,” one witness told investigators. “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.”
The clinic failed to properly account for opioids and other controlled substances, wrote prescriptions without required information, and dispensed prescriptions without checking the recipient’s identity, the probe found.
The clinic’s actions violated both federal law and Department of Defense (DoD) policy, such as a law that requires medical providers keep track of drugs, the inspector general said.
The White House did not respond to a request for comment.
The clinic is run by the White House Medical Unit, a military unit that was established in 1945 and includes both military and civilian DoD employees. Staff members include doctors, nurses, and psychologists.
The unit was composed of 60 staff members as of 2019, triple the number from 2005.
In interviews with investigators, White House Medical Unit staffers said that the clinic does not constitute a true pharmacy because of the relatively low volume of drugs it handles.
“We did not find DoD guidance that outlines the volume of pharmaceutical services that would require a full time pharmacist. However, we concluded that while the White House Medical Unit may be performing a smaller number of pharmaceutical tasks, those tasks entail the full universe of pharmaceutical operations,” the watchdog report states.
“During our site visits, we observed White House Medical Unit staff performing tasks customarily associated with those of a pharmacy, such as ordering and storing a variety of prescription and non‑prescription medications and dispensing medications to patients in conventional, amber‑colored pill bottles that were marked ‘White House Medical Unit.’ Additionally, at the WHCA clinic, we observed a sign that read ‘Pharmacy.’”
The investigation requested records from 2014 through 2020, but records were only provided from 2017 to 2020. President Barack Obama was president until January 2017, while President Donald Trump was president until January 2021.
Pre-Pack Drugs
Some witnesses said that their work at the pharmacy involved pre-packing drugs.“So we would normally make these packets of Ambien and Provigil, and a lot of times they’d be in like five tablets in a zip‑lock bag,” one said. “And so traditionally, too, we would hand these out. ... But a lot of times the senior staff would come by or their staff representatives ... would come by the residence clinic to pick it up. And it was very much a, hey, I’m here to pick this up for Ms. X.; And the expectation was we just go ahead and pass it out.”
Ambien is a sedative while Provigil is a stimulant. Both are controlled substances that require prescriptions.
According to another witness, a doctor asked if he or she could dole out the stimulant as a “parting gift for leaving the White House.
“And at the time, the corpsmen and the medics, the enlisted corpsmen and the medics, [said] it was okay for us to dispense Provigil and Ambien without having a provider present,“ the witness said, adding: ”I’m not sure if it was okay as far as, like, what’s medically allowed. But in the unit, it was authorized for us to do that kind of stuff.”
Investigators also reviewed financial records and discovered that the medical unit frequently used Ambien and Provigil despite the generic versions, which are cheaper, generally being required by federal regulations. The unit spent $46,500 over three years for Ambien, which is 174 times more expensive than the generic version, and $98,000 for Provigil, despite it being 55 times more expensive than the generic equivalent.
Investigators recommended the DoD develop an oversight plan for the pharmacy and revamp its outpatient medical services, including establishing procedures to verify whether people are eligible to receive drugs through the Military Health System. The DoD agreed with the recommendations and said they have started to act on them. The inspector general said it would work to verify later that the recommendations are adopted.
