When you think of Florida and the Drug Enforcement Administration, your head might be filled with images of cocaine-packed speedboats or propeller planes sneaking in pallets of marijuana. But in recent years, the DEA has also been focused on major drugstore chains that looked the other way as stores filled massive numbers of questionable painkiller prescriptions. Nearly three years after shutting down a pair of CVS pharmacies in the Orlando area, the company has agreed to pay $22 million to put the matter behind them.

The two CVS stores, both located in Sanford, FL, had their DEA registrations revoked in 2012 after investigators found that pharmacists there were filling painkiller prescriptions far in excess of the average pharmacy. It marked the first time the DEA had accused a major pharmacy chain of operating a pill mill.

For example, in 2011 the average drugstore in the U.S. placed orders for 69,000 oxycodone dosage units for the entire year. The two Sanford CVS stores, located around 5 miles from each other, combined to order more than 3 million dosage units. The DEA and other authorities maintained that CVS had to filling prescriptions were not based on legitimate medical needs.

The DEA says that Florida became the “nation’s epicenter for the illegal distribution of prescription drugs,” due to the combination of doctors willing to prescribe pain medication without regard to medical need and pharmacies willing to cash in by filling prescriptions that should have been red-flagged.

CVS is not alone in having painkiller problems in Florida. In 2013, Walgreens agreed to pay $80 million for its alleged negligence in allowing prescription painkillers to hit the black market in the state.

Subsequent revelations about that investigation showed the extent to which Walgreens management ignored signs of a growing pill problem and may have even encouraged it.

In 2010, a Walgreens pharmacy in Oviedo, FL, not far from Sanford (or from my high school in Winter Park — go Wildcats!) was chastised by the corporate office for not selling enough pain pills.

“We need to make sure we aren’t turning legitimate scripts away,” the company wrote in a letter to the store. “Please reinforce.”

At the same time, Walgreens paid bonuses based on the number of prescriptions filled, which may have encouraged pharmacies to fill orders even when the pharmacists knew the drugs were not being used for legitimate medicinal purposes.

In one year, that Oviedo store went from purchasing the average amount of oxycodone to nearly three times the national average.

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