As the opioid addiction epidemic continues to take thousands of lives across America each year, more states and local jurisdictions are taking legal action against the companies that they say are largely causing the crisis: pharmaceutical companies.

These multi-million dollar lawsuits typically argue that drug companies are intentionally misleading the public about the dangers of opioid prescription drugs, as they try to sell more of the drugs to make profits for themselves and their shareholders.

The CDC reports that opioid overdose was responsible for 33,000 deaths in the US in 2015, and the death rate continues to rise every year. There also were nearly 180,000 overdose deaths between 2000-2015, which is three times the number of Americans who were killed in the Vietnam War. The opioid crisis has also led to many thousands more deaths from heroin and fentanyl. The latter two drugs are becoming easier and less expensive to get than some prescription opioids.

The Washington Post reports that in the last year, at least 25 cities, states and counties have filed civil lawsuits against drug manufacturers, distributors and major drugstore chains that constitute a large chunk of the $13 billion per year opioid industry.

The legal strategy bears similarity, some argue, with the effort that was made against major tobacco firms in the 1990s. The rise of these lawsuits is born of the same type of frustration as with tobacco over the soaring death rates and the high costs of dealing with the growing public health crisis.

Below are some of the pending lawsuits that are ongoing in the US against pharmaceutical and prescription drug companies that sell opioid drugs.

Mingo County, West Virginia Weighing to Join Big Pharma Lawsuit

It was not a surprise that pharmaceutical company representatives showed up for the Mingo County, West Virginia Commission meeting in May 2017. On the agenda that evening was whether the 26,000 person county that is in West Virginia coal country should participate in a lawsuit against the top drug distributors in the United States for their part in the area’s opioid epidemic.

Collectively, the three companies – Cardinal Health, Purdue Pharma LLP and Teva Pharmaceuticals – distributed 423 million opioid pills in the state over the last five years. One of those firms, Cardinal Health, had three representatives at the meeting. One of them had come all the way from Washington DC to talk to the county commission about the opioid lawsuits that were occurring in counties in the area.

The fact that Fortune 15 companies would send a representative to a remote county commission meeting gives an indication of the huge stakes involved in the litigation that is going after companies that manufacture and distribute opioid drugs in the US. In the last few years, the legal and financial stakes of these lawsuits have only grown. Companies including Purdue, Cardinal Health and Teva have been accused of negligence and overly aggressive sales tactics, and lawsuits against them and other drug companies have only grown in recent years.

The lawsuits are becoming more common because all levels of government are feeling the financial pinch as the opioid epidemic affects federal, state and local budgets. Thus, many municipalities across the US have been filing lawsuits against pharmaceutical companies. Mingo County in West Virginia is only one considering action. Others that have taken legal action include Nassau County in New York; Orange County in California; Chicago, Illinois; Kermit, West Virginia; and the entire states of Ohio, Mississippi and New Mexico.

There also is an investigation involving several states into several opioid manufacturers that a coalition of 35 state attorney generals started in June 2017. There also are congressional and Senate investigations of the matter underway.

Is This Pharma’s ‘Big Tobacco Moment’?

The growing number of lawsuits has made many stakeholders on both sides of the crisis wonder if this is going to give Big Pharma its Big Tobacco moment? This refers to 1998, when cigarette manufacturers agreed to a $248 billion civil settlement. This was the biggest ever, and it was done to come to an agreement over legal action pending in 46 states against cigarette manufacturers.

However, attorney Ken Feinberg, who is the attorney who oversaw legal claims after 9/11, the Boston Marathon bombing and the BP oil spill, says that the analogy is not accurate. He noted recently that there are a few factors that make it challenging to specifically assign blame in the opioid crisis. First, pain medications are legal drugs, and they have been approved and are regulated by the US government. There also are a lot of middlemen in the process of distributing the drugs. He argues that the litigation is being brought against companies that seem to be in compliance with the law.

Feinberg thinks that the opioid lawsuits could fail much in the same way that lawsuits against gun manufacturers failed in the early 2000s. Since then gun manufacturers have lobbied for protection from most civil liability lawsuits. They argue that guns are a legal product and the manufacturers are producing them in accordance with federal law. If the firearms are used illegally by certain parties, that cannot be held against the companies that produced a legal product. A similar line of argument might derail the pharmaceutical lawsuits.

However, Feinberg concedes that a lot is up in the air and he does not know if the lawsuits will find juries that are sympathetic or not. He does wonder however, what would be done with the money if some of the litigation was successful. Giving the money to surviving family may not be appropriate as some of them are addicted themselves. He also does not think the money should go to pay for the bill for the national opioid crisis, as he thinks that there is not enough money to cover the huge bill.

New Mexico Sues Opioid Pharma Manufacturers and Distributors

The state of New Mexico in September 2017 filed a lawsuit targeting eight opioid manufacturers and wholesale distributors. This made New Mexico one of the latest state or local governments to file a civil lawsuit that attempts to hold major drug companies accountable for the national opioid crisis.

New Mexico Attorney General Hector Balderas accused Purdue Pharma LP, Johnson & Johnson, Allergan Plc, Endo International Plc and Teva Pharmaceuticals Industries Ltd of selling highly addictive drugs through aggressive and deceptive marketing.

The civil lawsuit also accuses McKesson, Cardinal Health and AmerisourceBergen of breaching their legal obligation to detect, monitor and report any suspicious orders of opioids.

Balderas stated that the state of New Mexico is dealing with catastrophic effects of the opioid epidemic, and major international companies are making billions in profits while families suffer.

This lawsuit is one of a wave of suits against drugmakers that have been filed by OK, MS, OH, MO, NH and SC. The drug makers also are facing litigation in several counties in West Virginia, where the effects of the opioid epidemic have been especially dire.

The New Mexico lawsuit, which was filed in the First Judicial District Court, argues that the drug manufacturers are downplaying risks of drug addiction with prescription opioids and are falsely touting the benefits of continuing to use the drugs for the long term. It also is accusing wholesale drug distributors of violating their legal duties by selling high quantities of the drugs that are then diverted to be sold illegally. This, the lawsuit argues, is contributing to the opioid crisis.

The civil lawsuit against drug manufacturers and distributors is seeking damages, which includes the costs that New Mexico is incurring for responding to the opioid crisis.

In similar lawsuits, the companies have denied that they have done anything wrong. The drugmakers are arguing that they are acting in a responsible manner in how the drugs are marketed. All of the drugs have been approved by FDA and carry warning labels that detail the risks of taking the drugs.

Purdue, the maker of OxyContin, stated that it denies the allegations made in the New Mexico lawsuit, but that it shares the concerns of public officials about the opioid epidemic. It noted that it is committed to working with major stakeholders to find solutions to the problem.

The drug company and others say that stopping the opioid epidemic will require a strong, coordinated effort from doctors, the pharmaceutical industry, and federal and local government partners.

Cuyahoga County OH Files Racketeering Lawsuit Against Drug Companies

Cuyahoga County, Ohio officials last week filed a lawsuit against several prescription drug companies, stating that they had purposely misled the public about the many dangers of taking opioids. They claim that the companies were trying to sell as many prescription painkillers as possible to rake in what they called ‘blockbuster profits.’

The 270-page complaint was filed in Cuyahoga County Common Pleas Court. It claims that drug manufacturers, distributors and several physicians have enriched themselves improperly as they behaved like a criminal enterprise, and tried to break several state laws that protect Ohio consumers. The suit also claims that the conspiracy has led to a large number of opioid overdoses in Ohio that has damaged thousands of families.

The lawsuit names some of the biggest companies in the pharmaceutical industry, such as Purdue Pharma LP, Teva Pharmaceuticals, Cephalon, Janssen Pharmaceuticals, McKesson Corporation, Cardinal Health and AmerisourceBergen Corp. The lawsuit also names and accuses four doctors of downplaying risks of opioid medications in lectures and papers that were paid for by the pharmaceutical companies.

The lawsuit asks an Ohio jury to force the pharmaceutical companies to pay Cuyahoga County for the costs that are related to the opioid epidemic, and to force punishment on the drug companies for creating a serious public nuisance that created thousands of drug-addicted Ohioans.

Cuyahoga County is one of many entities to sue prescription drug companies over their part in the epidemic that has swept the United States in the last decade. Several West Virginia Counties also have filed such lawsuits against the same drug companies. Also, Ohio Attorney General Mike DeWine filed the same type of lawsuit against some of the same drug companies that were named in Cuyahoga County’s lawsuit.

Lawsuits Won’t Fix Opioid Crisis, Some Say

Some stakeholders in the pharmaceutical industry argue that lawsuits are not going to fix the opioid crisis.

According to John Hammergren, CEO of McKesson Corp., lawsuits from various parties against pharma companies is not going to solve the problem. He said in a conference call recently that what will solve the problem is thinking in a larger context and putting new solutions in place that will prevent opioid overdoses from happening in the first place.

McKesson is the largest drug distributor in the world. The company is facing claims that it has a major role in causing higher opioid addiction rates and a large number of overdoses that is killing thousands of American annually.

Hammergren stated that his corporation has taken a number of steps to address the problem. These include improving its internal substance abuse monitoring program. His comments on the conference call came on the same day that the president stated that it was declaring the drug crisis a national public health emergency.

The McKesson CEO also blamed other major players in the industry. He noted that better technology will give pharmacists time to think before filling certain drug prescriptions. He added that doctors need to think carefully about the opioid prescriptions that they are writing. Opioids are intended mostly for short term pain problems, such as post-operative pain or for pain after dental surgery. Prescribing opioids for chronic pain, other than for serious conditions such as terminal cancer, is highly dangerous.

Hammergren does not think that the opioid epidemic will cause a ‘tobacco overhang’ for the pharma industry. He seemed to be referring to a legal strategy by some plaintiffs that are filing lawsuits against pharmaceutical companies. He also noted that some sources of the drugs, such as heroin, cannot be controlled by the legal drug supply chain.