Delaware has accused drug distributors and pharmacies of facilitating the abuse of prescription painkillers in a lawsuit that targets the entire opioid supply chain.

U.S. states, counties and cities have repeatedly sued drugmakers for pushing addictive painkillers through deceptive marketing. In its suit filed on Friday, Delaware makes similar allegations against two drug companies — Purdue Pharma and Endo Pharmaceuticals.

The manufacturers “have engaged, and continue to engage, in a massive marketing campaign to misstate and conceal the risks of treating chronic pain with opioids,” the complaint said.

But Delaware Attorney General Matt Denn also accused companies further down the supply chain of violating their legal duties to prevent the “diversion” of opioids for illegitimate use.

Distributors and pharmacies have instead “taken advantage of the massively increased demand for prescription opioids for non-medical uses by profiting heavily from the sale of opioids that they knew, or should have known, were being diverted from the legitimate supply chain to illegitimate channels of distribution,” according to the suit.

The distributor defendants include McKesson, Cardinal Health, and AmerisourceBergen, while the retailers are CVS Health and Walgreens Boots Alliance.

Of the 860,000 opioid prescriptions issued in Delaware each year, studies suggest that as many as 110,000 of those are diverted to non-medical uses. According to the Substance Abuse and Mental Health Services Administration, more than 32,000 Delaware residents use prescription opioids for non-medical purposes.

The AG’s lawsuit specifically alleges the distributors have supplied opioids “with the actual or constructive knowledge” that they were ultimately being consumed for illegitimate purposes. They also allegedly contributed to diversion by linking employee compensation to the volume of opioid sales to pharmacies.

As for CVS and Walgreens, the suit said they have “regularly filled opioid prescriptions that would have been deemed questionable or suspicious by a reasonably-prudent pharmacies.”

The state says the opioid epidemic drains at least $100 million a year from its healthcare, criminal justice, social services and welfare, and education systems. The suit seeks, among other things, compensation for those costs.

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