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AKRON, Ohio — Citing a spike in overdose deaths, rising calls for for drug therapy and a strained finances, officers right here in Summit County filed a lawsuit late Wednesday in opposition to firms that make or distribute prescription opioids. On Monday, Smith County in Tennessee did the identical. And on Tuesday, 9 cities and counties in Michigan introduced comparable fits.

Cities, counties and states throughout the nation are turning to the courts within the spiraling opioid disaster. What started a number of years in the past with a handful of lawsuits has grown right into a flood of claims that drug firms improperly marketed opioids or didn’t report suspiciously giant orders. Near 200 civil circumstances have been filed by native governments within the federal courts; dozens of different fits are enjoying out in state courts; and attorneys normal from 41 states have banded collectively to discover authorized choices.

“There’s a brand new case being filed nearly each day, and I don’t see any finish in sight,” mentioned Paul J. Hanly Jr., a lawyer who represents a few of the native governments.

Scores of plaintiffs’ attorneys met in Cleveland this week, the place a choose has been assigned to supervise at the very least 189 of the federal circumstances — a sign, some attorneys say, that the authorized combat may begin to transfer extra shortly and that its disparate strands is likely to be labored out in a single place. Some attorneys liken the state of affairs to the state litigation in opposition to the tobacco trade within the 1990s, which ended with a worldwide settlement, and concerned a few of the identical attorneys.

“This litigation is sort of a large hammer — it’s like a instrument the place you’re hitting any person upside the pinnacle to get their consideration,” mentioned Mike Moore, who as Mississippi legal professional normal filed the primary state case in opposition to the tobacco trade within the 1990s and who now represents some authorities entities. “We have now a public well being emergency. It’s time to stop speaking about it and, if persons are critical about fixing it, let’s sit down and resolve it.”

Representatives for a few of the drug makers and distributors deny the claims within the lawsuits and say they intend to vigorously defend their firms. In written statements, a number of firms pointed to efforts that they and trade teams have taken to stem opioid abuses and famous the function of the federal authorities, together with the Meals and Drug Administration, in overseeing their merchandise. Additionally they rejected comparisons to tobacco.

“Not like the previous tobacco litigation, our medicines are authorised by F.D.A., prescribed by medical doctors, and allotted by pharmacists, as therapies for sufferers affected by extreme ache,” Robert Josephson, a spokesman for Purdue Pharma, which developed OxyContin, mentioned in a written response to questions.

Inmates left a drug courtroom in Akron, Ohio, overseen by Choose Pleasure Malek Oldfield.Credit scoreTy Wright for The New York Occasions

Right here in Akron, officers mentioned legally prescribed painkillers have been usually a precursor to habit, overdose and drug abuse. Nanette Kelly, an Akron resident, mentioned she turned hooked on prescription ache drugs after a again damage years in the past and finally turned to heroin.

“It’s onerous to remain straight and be good,” mentioned Ms. Kelly, who’s present process therapy, “as a result of there’s simply heroin all over the place.”

Matthew J. Maletta, government vp and chief authorized officer on the drug firm Endo, mentioned a complete resolution “should not solely take into account the product provide chain, but in addition particular person affected person threat elements and the function of prescribing well being care suppliers.” Felony trafficking of the medication, together with unlawful web gross sales and importation, additionally should be addressed, he mentioned.

The authorized battle is enjoying out because the sale of prescription opioids, which embrace oxycodone and hydrocodone, have quadrupled since 1999, as have overdose deaths. Greater than 183,000 individuals died from overdoses tied to prescription opioids within the 15 years main as much as 2015. And the bigger drug disaster, together with heroin and fentanyl obtained illicitly, is swamping the assets of native governments and draining their budgets, officers say.

Summit County officers say they spent $66 million coping with the disaster between 2012 and final yr. The county’s baby protecting company spent greater than $21 million in that interval relocating youngsters from properties the place a relative was utilizing opioids. Akron firefighters common round 100 overdose responses every month. And a cell morgue was introduced in when the medical expert ran out of room.

“We’ve had sufficient right here,” mentioned Ilene Shapiro, the county government, who has declared a public well being emergency. She mentioned she hoped the courts may drive modifications in the best way the medication are marketed and, maybe, impose a hefty monetary settlement or judgment.

In Barberton, a small metropolis in Summit County that can also be suing, rookie law enforcement officials should shortly grasp the right way to make dying notifications, the right way to refer addicts to therapy and the right way to administer Narcan, the overdose antidote. The police chief, Vince Morber, mentioned the pharmaceutical firms “owe us an apology.”

Peeking by the window of a courtroom door the place Choose Oldfield, left heart, was seen listening to a defendant speak about his drug case.Credit scoreTy Wright for The New York Occasions

“They completely knew what they have been doing: Their enterprise practices, the best way they did it, the best way they marketed it,” mentioned Chief Morber.

However authorized specialists mentioned the lawsuits in opposition to the drug makers and distributors are something however easy. The circumstances fluctuate in the case of the businesses they title as defendants and are sophisticated by all kinds of components — together with the roles of others in what has occurred, from medical medical doctors to heroin sellers to the F.D.A., which regulates prescription drugs.

“My guess is that no one needs to actually attempt these circumstances,” mentioned Richard C. Ausness, a professor on the College of Kentucky School of Legislation.

Critics say the litigation is a sideshow within the opioid debate — an opportunity for attorneys to become profitable and politicians to make headlines — somewhat than a long-lasting resolution within the overwhelming disaster, which the president’s Council of Financial Advisers final month estimated as having price $504 billion in 2015.

“Certainly, by permitting them to take credit score for doing one thing about the issue, the lawsuits could take the stress off of public officers” to make actual modifications, Lars Noah, a professor on the College of Florida School of Legislation, mentioned.

However attorneys for some counties, cities and states say the litigation may drive actual modifications, reminiscent of far wider availability of overdose antidotes, ample cash to get all addicts into therapy, and the event of a sturdy prevention and schooling program. The consolidation of the federal circumstances in a so-called multidistrict litigation may additionally pace the method, the attorneys mentioned.

“It’s a serious alternative to have a big influence on this well being epidemic now and never 5 years from now,” mentioned Joseph F. Rice, whose agency, Motley Rice, represents a few of the circumstances, and who performed a central function in negotiating the tobacco settlement. “Will the events take benefit? Will the courtroom take benefit? That’s but to be seen.”

A nurse stuffed bottles with small quantities of liquid methadone for take-home prescriptions at a clinic in Akron.Credit scoreTy Wright for The New York Occasions

In Summit County, the variety of deadly drug overdoses has subsided barely since a peak of 298 final yr, however paramedics, politicians and regulation enforcement officers nonetheless view opioids as an uncontained epidemic with no straightforward fixes.

Firefighters say they often revive the identical particular person many times, and the medical expert has gotten used to notifying households of drug deaths of a number of family. One lady misplaced two siblings and two nephews to overdoses in lower than a yr. Charlene Maxen and her husband, Jim, misplaced their two sons to opioid overdoses in the identical month in 2015.

“I used to have a look at those that by no means had a household and say, ‘What do they do after they get outdated?’” mentioned Mr. Maxen, a retired accountant. “We’re going to seek out out.”

Dan Horrigan, the mayor of Akron, mentioned the disaster had turn out to be “a intestine punch to the neighborhood, and we want to have the ability to get a deal with on it.” He mentioned a variety of ground-level efforts to assist addicts right here confirmed promise, however “there’s a fireplace happening and it wants extra water to place it out.”

Among the many indicators for hope: A well being clinic that opens earlier than daybreak and supplies methadone for individuals in search of to finish their opioid addictions; dwelling visits by metropolis staff providing assist to individuals who not too long ago overdosed; and Choose Pleasure Malek Oldfield’s drug courtroom, the place a stream of younger defendants approached the bench on Monday to obtain reward, scoldings and even applause.

“If you get sober, it’s not simply rainbows and unicorns,” the choose advised one. “Nevertheless it’s a greater life, don’t you assume?”

Choose Oldfield mentioned about 90 % of individuals in drug courtroom have been hooked on opiates, which she known as “far more troublesome to handle” than different addictions. One man, shackled and clad in an orange jail jumpsuit, appeared in entrance of her once more on Monday. He had relapsed not way back.

“I’m glad you’re alive,” Choose Oldfield advised him.

Mitch Smith reported from Akron, and Monica Davey from Chicago.

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