MONTGOMERY — Twenty-one Alabama hospitals have filed a civil lawsuit in Conecuh County Circuit Court against the manufacturers, distributors and retailers of opioid-based drugs.

The hospitals are alleging negligence, fraud and civil conspiracy by the defendants, which include Purdue Pharma, Johnson & Johnson, and more than 40 other companies and individuals involved in the production and sale of opioids.

Alabama hospitals allege in the complaint that the opioid companies engaged in a decades-long practice of making false assurances about the addiction risks associated with opioid products and used other deceptive marketing tactics to persuade physicians and health care providers to broaden prescribing patterns.

“The deceptive marketing efforts of the defendants substantially contributed to an explosion in the use of opioids across the country — and the aftereffects are felt in hospitals every single day,” Robert King, an attorney representing the hospitals, said in a press release. “Hospitals have provided heroic levels of care to opioid-addicted patients and saved countless lives. But the financial, operational and emotional expense for hospitals is staggering. The defendants are at the root of this crisis.”

The Alabama hospitals involved in the complaint include Baptist Health medical centers in Montgomery and Prattville, DCH Health Care facilities in Tuscaloosa, Northport and Fayette, three Birmingham hospitals and several rural hospitals.

Representatives from several hospitals this week said they could not comment on ongoing litigation.

Alabama has had the highest number of opioid prescriptions per person in the nation.

In 2017, the state had 836 drug-overdose deaths, and 50% involved opioids, according to the Alabama Department of Public Health.

Total drug overdose and opioid overdose rates had climbed in Alabama in recent years to averages of 17.1 and 8.6 per 100,000 people in 2017. Escambia, Etowah and Jefferson counties had the highest opioid overdose rates in 2017.

Industry analysts estimate the country’s healthcare system incurred more than $215.7 billion in costs related to the opioid crisis from 2001 to 2017, according the the press release from hospitals announcing the lawsuit. The costs were largely attributable to overdose-related emergency department visits.

This also comes amid news that a tentative national settlement may have been reached between Purdue Pharma and multiple states and local governments that sued the company.

The agreement would have Purdue file for a structured bankruptcy and pay as much as $12 billion over time, with about $3 billion coming from the Sackler family, which owns Purdue, the maker of OxyContin, The Associated Press reported.

In addition, the family would have to give up its ownership of the company and contribute another $1.5 billion by selling another of its pharmaceutical companies, Mundipharma.

Several attorneys general said the agreement was a better way to ensure compensation from Purdue and the Sacklers than taking their chances if Purdue files for bankruptcy on its own.

The first federal trial over the opioid epidemic is scheduled to begin in Ohio next month.

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