Patients around the country, especially in rural areas with fewer healthcare options, may face trouble refilling their prescriptions and receiving other medical services as the troubled Rite Aid chain reportedly prepares to close between 400 and 500 stores. 

Other pharmacies, including Walgreens and, to a lesser extent, CVS, face troubles of their own — as employees take steps toward a national walkout at the end of October to protest work conditions. 

Rite Aid, which has been closing stores for years, is buckling under its more than $3 billion in debt and the legal costs of more than a thousand lawsuits against the company related to its alleged contribution to the opioid crisis.

As more of its 2,100 locations shut down, the bankruptcy will have major ramifications for the chain’s some 50,000 employees and 1.6 million daily customers. The company announced Sunday that it has named Jeffrey Stein as its chief executive.

Because many family-owned pharmacies were put out of business by chains, Rite Aid closures are sparking fears that rural areas, small towns, and low-income areas will be left with “pharmacy deserts.” The bankruptcy will mean not only are there fewer places to get prescription drugs, but there will be less access to other healthcare options, a Cato Institute senior fellow, Jeffrey Singer, tells The New York Sun.

“Pharmacists nowadays don’t just dispense medications,” Mr. Singer says, as some states allow them to administer vaccinations, prescribe birth control pills, or even diagnose and treat routine infections such as strep throat and urinary tract infections. 

“Everyone knows we have an acute shortage of primary care clinicians, be they physicians or nurse practitioners or even physician assistants,” he adds. “That seems to be worsening, particularly as the population is aging, and pharmacists can play a very important role in getting routine kinds of preventative treatments and measures to patients besides dispensing meds.”

The bankruptcy will pause pending legal complaints against Rite Aid, one of which came from the Department of Justice earlier this year. Its allegations — which Rite Aid has denied — claim that the pharmacies filled prescriptions that didn’t meet legal requirements and “deleted internal notes about suspicious prescribers.”

“The Justice Department is using every tool at our disposal to confront the opioid epidemic that is killing Americans and shattering communities across the country,” the attorney general, Merrick Garland, said. “That includes holding corporations, like Rite Aid, accountable for knowingly filling unlawful prescriptions for controlled substances.” 

Pharmacists are “an easy boogeyman” for politicians and the press to attack, Mr. Singer says. 

“Because of these efforts to reduce prescribing prescription pain pills — the prescription rate peaked in 2012 and is down 60% since then — what’s happened to the overdose rate since then? It’s skyrocketed,” he says, adding that overdose deaths that include prescription pain pills have dropped. 

“This bankruptcy of Rite Aid is like a trophy on the wall of the prosecutors, and all the other pharmaceutical teams are looking at that, and that’s kind of sending them a message that’s going to make them even less inclined to want to even get involved with filling pain prescriptions,” Mr. Singer says. 

As a surgeon, Mr. Singer says his profession requires inflicting pain, and he therefore continues to prescribe pain pills, but he knows doctors in other fields who won’t prescribe pain treatment and tell patients to take Tylenol or Advil instead.

If patients aren’t satisfied, doctors will often refer them to pain specialists to avoid liability, he adds. 

“The pain specialist offices are overwhelmed with people being referred to them, so a lot of patients can’t even get in to see them for weeks, and they’re in pain waiting,” Mr. Singer says, adding that there are reports of patients who turn to the black market to get relief and then accidentally take something laced with fentanyl. 

A representative of Rite Aid declined to comment beyond its press release.