DEA Revokes Registration of Texas Pharmacy Over Opioid Red Flags

The Drug Enforcement Administration has revoked the federal controlled-substance registration of St. Michael’s Pharmacy of Rosenberg, Texas, in a Decision and Order published in the Federal Register on October 2, 2026, after the pharmacy defaulted on allegations that it repeatedly filled Schedule II opioid prescriptions without resolving red flags of abuse and diversion and failed to account for large quantities of controlled substances.

The order, published at 91 FR 62754 as FR Doc. 2026-20227, revokes DEA Certificate of Registration No. FS0483951 and denies any pending application of St. Michael’s Pharmacy to renew or modify that registration, as well as any pending application for additional registration in Texas. It is effective November 2, 2026, and was signed September 25, 2026, by DEA Administrator Terrance C. Cole.

On September 10, 2025, DEA issued an Order to Show Cause and Immediate Suspension of Registration, immediately suspending the registration under 21 U.S.C. 824(d) on the ground that continued registration constituted “an imminent danger to the public health or safety,” and proposing revocation as inconsistent with the public interest. According to a DEA Diversion Investigator declaration cited in the order, the OSC/ISO was personally served on the registrant at its registered address on September 12, 2025, and a representative signed a Form DEA-12 acknowledging receipt. The pharmacy never requested a hearing. On October 20, 2025, the Government submitted a Request for Final Agency Action seeking a default order, and the Agency found the registrant in default under 21 CFR 1301.43, which deems the factual allegations of the OSC/ISO admitted.

Red-Flag Dispensing Findings

The OSC/ISO alleged that from at least March 2023 through February 2025, the pharmacy continuously filled Schedule II controlled substance prescriptions despite obvious red flags of abuse and/or diversion and without addressing or resolving them. The alleged red flags included pattern prescribing, prescriptions for controlled substances commonly known to be abused, prescriptions at the highest strength and/or in large quantities, the same patient obtaining similar drugs from multiple practitioners, and shared patient addresses. Because of the default, the Agency found the registrant deemed to have admitted that from at least January 2023 through at least February 2025 it repeatedly filled controlled substance prescriptions containing multiple red flags without resolving them, in violation of federal law and binding minimal standards governing pharmacy practice in Texas.

According to the order, six practitioners (Drs. C.I., D.C., A.P., C.H., L.B., and M.Q.) prescribed 65 percent of all oxycodone 30 mg prescriptions the pharmacy dispensed, 786 prescriptions out of 1,213 total. Eight practitioners prescribed 53 percent of its hydrocodone 10/325 mg prescriptions, 442 out of 830, and eight practitioners prescribed 62 percent of its oxycodone/acetaminophen 10/325 mg prescriptions, 105 out of 170.

The order details individual fills, including five prescriptions for oxycodone 30 mg, each for 100 to 105 tablets, issued by Dr. C.H. for patient D.S. and filled between June 16, 2023, and January 3, 2024. The Agency found substantial record evidence that the pharmacy dispensed over 1,000 tablets of oxycodone 30 mg over a two-year period without first resolving the red flags.

The order also describes prescriptions filled for patients who presented similar drugs from multiple doctors and pharmacies without the pharmacy resolving the red flag: M.V., who received hydrocodone-acetaminophen 10/325 mg prescriptions from three doctors and filled them at five pharmacies; M.W., who received oxycodone 30 mg and hydrocodone-acetaminophen 10/325 mg prescriptions from five doctors and filled them at seven pharmacies; C.G., who received prescriptions from six doctors and filled them at five pharmacies; and J.J., who received oxycodone 30 mg prescriptions from five doctors and filled them at three pharmacies. A DEA-retained independent pharmacy expert concluded, and the registrant is deemed to admit, that the pharmacy repeatedly filled prescriptions without properly resolving red flags of drug abuse or diversion.

Recordkeeping Failures and Loss of State Authority

On March 25, 2025, DEA investigators conducted an on-site administrative inspection at the pharmacy’s registered address and observed that it did not possess the expected physical stock of controlled substances relative to its ordering practices. Comparing dispensing data to distributor ordering data between May 1, 2023, and March 5, 2025, the order states, the pharmacy could not account for at least 43,003.5 dosage units of hydrocodone 10/325 mg tablets, a 123.63 percent variance of calculated inventory; 25,960 units of oxycodone 30 mg, a 39.91 percent variance; 2,975 units of oxycodone 10/325 mg, 39.67 percent; 187 units of methadone 10 mg, 6.93 percent; 100 units of dextroamphetamine 20 mg, 25 percent; 1,005 units of acetaminophen/codeine 300/30 mg, 191.43 percent; and 116 units of tramadol 50 mg, 13.83 percent. In total, the Agency found, the pharmacy could not account for over 73,000 dosage units of controlled substances.

The registrant is also deemed to have admitted failing to provide complete and accurate records, failing to meet general inventory requirements, and failing to retain, link, and maintain original signed electronic DEA 222 order forms on a central server. The OSC/ISO alleged violations of 21 CFR 1304.04(a), 1304.11(a)–(c), 1304.21(a), and 1306.04(a), along with provisions of the Texas Health and Safety Code and Texas Administrative Code.

On March 11, 2026, the Texas State Board of Pharmacy revoked the registrant’s state pharmacy license, Texas pharmacy license 33705. The Government filed a Notice of Change of Registrant’s State Authority on June 8, 2026, and the Agency served a Notice of Allegation and Briefing Order by email on July 28, 2026, giving the pharmacy fifteen days to contest the allegation; the Agency received no response. Taking official notice of Texas online records, the Agency found the registrant is not licensed to operate as a pharmacy in Texas and held that the loss of state authority provides an independent basis for revocation under 21 U.S.C. 824(a)(3), because a pharmacy must be licensed as a practitioner to dispense controlled substances in the state where it is registered with DEA. The registrant may dispute that official-notice finding by filing a properly supported motion for reconsideration of findings of fact within fifteen calendar days of the date of the order.

Under the five-factor public interest test of 21 U.S.C. 823(g)(1), the Agency found that Factor B, experience in dispensing controlled substances, and Factor D, compliance with applicable laws, weigh in favor of revocation, and that the registrant offered no mitigating evidence, having never requested a hearing. The order states that the Government’s evidence showed the pharmacy filled well over a thousand controlled substance prescriptions outside the usual course of professional practice in Texas, failed to maintain effective controls against diversion, and failed to comply with its recordkeeping obligations, leading the Agency to conclude that the registrant cannot be entrusted with a registration.