White House pharmacy under Trump was fast and loose with drugs, report finds

The White House pharmacy under the Trump administration flouted federal regulations by doling out prescription pills, including stimulants and sedatives, to ineligible staffers without keeping adequate records, according to a scathing government report released this month.

“Severe and systemic problems” were found in “all phases of the White House Medical Unit’s pharmacy operations,” the Department of Defense’s Office of the Inspector General found.

“Anything that took place at the White House Clinic was never written down, never recorded,” one witness interviewed for the DOD’s 80-page report said. “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 even when dealing with controlled substances – drugs with potential for abuse and physical dependence – the White House Medical Unit wrote prescriptions that “often lacked the medical provider and patient information mandated by [Drug Enforcement Agency] policy.” 

“The White House Medical Unit dispensed non‑emergency controlled medications, such as Ambien and Provigil, without verifying the patient’s identity,” the report notes, referring to the sedative used to treat insomnia and the stimulant prescribed for narcolepsy and sleep apnea, respectively. 

A requisition form included in the inspector general’s report shows the White House pharmacy ordered these medications by the thousands, and routinely requested brand name drugs despite regulations requiring pharmacies to stock cheaper generic equivalents. 

Between 2017 and 2019, the White House Medical Unit spent an estimated $46,500 for brand name Ambien, which is 174 times more expensive than the generic equivalent.

Over the same three-year period, the unit also spent an estimated $98,000 for brand name Provigil, which is 55 times more expensive than the generic equivalent. 

The watchdog agency concluded that White House pharmacy staffers had little to no oversight, and that their prescribing practices put the health and safety of patients at risk.

One witness explained to investigators that part of their duties in “the President’s clinic” would be to pre-pack controlled drugs in zip-lock baggies ahead of overseas trips, which would routinely be picked up by aides to senior officials in violation of military guidance.   

“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,” the witness 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.” 

Another witness described one instance in which drugs were given to a White House official as a “parting gift.” 

“Dr. [X] asked if I could hook up this person with some Provigil as a parting gift for leaving the White House,” they said. “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.”

“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,” the witness added. 

The investigation found that the White House Medical Unit provided “free medical care to ineligible” White House Staff by instituting a “health care by proxy” practice, which included dispensing controlled drugs to ineligible staffers “in violation of Federal law and regulation and DoD policy.”

About 6,000 White House employees, contractors and government employees received “health care by proxy” at the White House clinics, according to the report. 

By comparison, only about 60 patients were enrolled at the White House Medical Unit – which the report notes is intended to “cater to the needs” of only the “highest of Presidential appointees.”