This Wednesday, the state of Ohio took action against the opioid epidemic in the form of a lawsuit against five major drug companies stating that they “helped unleash a healthcare crisis that has had far-reaching financial, social, and deadly consequences in the State of Ohio.”

The lawsuit, filed by Ohio Attorney General Mike DeWine, names Purdue Pharma, Teva Pharmaceuticals, Allergan, Endo Health Solutions and Johnson & Johnson’s Janssen charging that they engaged in fraudulent marketing regarding the risks and benefits of prescription opioids which fueled Ohio's opioid epidemic.

"These drug manufacturers led prescribers to believe that opioids were not addictive, that addiction was an easy thing to overcome, or that addiction could actually be treated by taking even more opioids," DeWine said in a statement.

In addition, the suit alleges the drug companies violated the Ohio Consumer Sales Practices Act, committed Medicaid fraud, and created a public nuisance by disseminating false and misleading statements. It seeks to halt deceptive practices, a declaration the companies acted illegally and caused unspecified damages to the state and consumers.

Opioid drugs, including prescription painkillers and heroin, killed more than 33,000 people in the United States in 2015, more than any year on record, according to the U.S. Centers for Disease Control and Prevention. The rate of overdoses has quadrupled since 1999.

The drug’s use (and subsequent) misuse has soared since the 1990s, which DeWine chronicled in the lawsuit to illustrate how the companies “trivialize the risks of opioids while overstating the benefits of using them for chronic pain.”

“Historically, because they were considered too addictive and debilitating for the treatment of chronic pain (like back pain, migraines and arthritis), opioids were used only to treat short-term acute pain or for palliative (end-of-life) care,” he stated in the suit. “However, by the late 1990s, and continuing today, each Defendant began a marketing scheme designed to persuade doctors and patients that opioids can and should be used for chronic pain, a far broader group of patients much more likely to become addicted and suffer other adverse effects from the long-term use of opioids.”

The “marketing scheme” is purported to include use of compensating key opinion leaders, or KOLs, as well as medical industry and patient advocacy groups to sway a general practitioner’s knowledge on the safety of the drug.

DeWine presents how these efforts resulted in Ohio becoming the epicenter of the crisis.

“In 2012, the total number of opioid doses prescribed to Ohio patients soared to 793 million – enough to supply every man, woman and child in the state with 68 pills each. In 2016 alone, 2.3 million Ohio patients – roughly 20% of the state’s population – were prescribed an opioid drug.”

A Janssen spokeswoman said the lawsuit's allegations are "legally and factually unfounded,” in an email to the Cleveland Plain Dealer.

"Janssen has acted appropriately, responsibly and in the best interests of patients regarding our opioid pain medications, which are FDA-approved and carry FDA-mandated warnings about the known risks of the medications on every product label," spokeswoman Jessica Castles Smith said in the email.  

Purdue Pharma, maker of OxyContin, said it shared DeWine's concerns about the opioid crisis and is committed to working collaboratively to find solutions. 

"OxyContin accounts for less than 2 percent of the opioid analgesic prescription market nationally, but we are an industry leader in the development of abuse-deterrent technology, advocating for the use of prescription drug monitoring programs and supporting access to Naloxone--all important components for combating the opioid crisis," the company said in a statement.

Ohio joins the state of Mississippi, two California counties, four New York counties and the city of Chicago in opioid marketing suits. Several counties in West Virginia have also filed lawsuits against drug wholesalers who they say failed to report suspicious orders of opioids.