After rejecting the $500 million settlement agreement, Washington Attorney General Bob Ferguson tried the state’s case against the three major U.S. drug distributors on Monday, saying that they must be responsible for their role in the U.S. opioid epidemic. Responsible.

The Democrat himself issued a partial opening statement in the King County High Court, saying that this case may be the most important public health lawsuit brought by his institution.

“These companies know what will happen if they fail to perform their duties,” Ferguson told judge Michael Ramsey Scott. “We know that they are aware of the harm their actions bring, because in private communications, company executives ridicule individuals suffering the painful effects of opioid dependence. … They behave towards the communities and people affected by greed. Relentless indifference.”

But Ferguson’s legal strategy is not without risks, as evidenced by the losses suffered in similar cases in three California counties this month and the Oklahoma Supreme Court’s ruling overturning the drug maker Johnson & Johnson’s $465 million judgment.

Orange County High Court Judge Peter Wilson issued a preliminary ruling on November 1, stating that the counties and the City of Oakland have not yet proven that pharmaceutical companies use deceptive marketing to increase unnecessary opioid prescriptions and cause public nuisance. The Oklahoma State’s ruling stated that the lower courts misinterpreted the state’s public nuisance laws.

In an email, Ferguson emphasized that the relevant laws in Washington are different and called these cases “apples and oranges.”

Public nuisance claims are at the core of the approximately 3,000 lawsuits filed by state and local governments against drug manufacturers, distribution companies, and pharmacies. Washington is the first state to bring a trial against a drug distribution company. Ferguson claimed public nuisance and violated state consumer protection laws.

“When a case is heard, there is always uncertainty,” he said. “However, we have full confidence in the strength of our case.”

The Attorney General’s Office sued McKesson Corp., Cardinal Health Inc., and AmerisourceBergen Corp. in 2019, alleging that they shipped a large number of prescription painkillers to the state, even if they knew or should have known that these drugs might benefit from the opioid epidemic Billions of dollars find ways for drug dealers and drug addicts.

Ferguson is seeking tens of billions of dollars in “transformational” spending from these companies to help eliminate the damage to Washington State from the epidemic, including more than 8,000 deaths between 2006 and 2017 and incalculable damage to families. The state hopes to pay $38 billion in 15 years to pay for treatment services, criminal justice costs, public education activities, and other projects, as well as billions of dollars in additional losses.

The trial is expected to last about three months.

In July, Ferguson rejected an 18-year settlement proposal of $527.5 million on the grounds of “serious shortcomings”. This transaction will provide approximately $30 million in funding for Washington and its 320 cities and counties each year. Ferguson said that considering the inflation during the 18-year payment period, the real value of the settlement is only $303 million.

The pharmaceutical companies stated that they cannot be blamed for the outbreak; they only provide opioids prescribed by doctors. They argued in a trial briefing filed this month that their duty is not to re-guess prescriptions or interfere with the doctor-patient relationship.

In addition, they believe that Washington State itself played an important role in the epidemic. In the 1990s, fearing that chronic pain patients were not adequately treated, legislators passed the Intractable Pain Act, which made it easier to prescribe opioids.

The two companies wrote: “With the support of the state’s good faith efforts to protect residents from suffering, well-meaning doctors increased the prescription of opioids, which led to an increase in the distribution of opioids.” “The defendant did not play a role in changing the standard of care. As a result, wholesale distributors also have no professional knowledge, obligation or ability to make second guesses about the good faith medical decisions made by doctors to prescribe opioids.”

Despite this, the state argued that these companies are responsible for maintaining control of drug transfers. Instead, they shipped so much to Washington that it was obvious that it fueled addiction: between 1997 and 2011, opioid sales in Washington increased by more than 500%.

The attorney general said that in 2011, the state distributed more than 112 million doses of all prescription opioids every day, enough to meet the 16-day supply of each resident. In 2015, 8 of the 39 counties in Washington had more prescriptions than residents.

The prescription drug epidemic has subsided with further attention and control, and the number of deaths from prescription opioids has fallen by half since 2010. But since then, heroin and fentanyl deaths have soared: from 2010 to 2018, heroin-related death rates in Washington increased more than five-fold, and from 2016 to 2018, fentanyl-related death rates More than doubled.

The state wrote in its trial briefing: “This is a predictable result of user addiction, especially for those who can no longer obtain or can afford prescription opioids.” “Thus, these deaths and other heroin and phenanthrene drugs. The hazards associated with tanyl are an integral and tragic part of the opioid epidemic and public nuisance.”

The federal government says that since 2001, nearly half a million Americans have died from opioid abuse.

Other opioid trials rooted in public nuisance laws are being conducted before juries in federal courts in Cleveland and New York State courts. The trial is expected soon before a judge in West Virginia.

Johnson & Johnson also faces another lawsuit from Washington State, which is scheduled for trial next year.

The negotiations between Johnson & Johnson and the three distribution companies on a $26 billion settlement agreement involving thousands of government lawsuits are in the final stages, but it may take several months to obtain final approval.