Purdue Pharma and its founding family took a quarter-of-a-billion-dollar hit when it settled with the state of Oklahoma over a lawsuit accusing the company of pushing false and misleading ads for powerful opioid OxyContin. Now, even more states are seeking paydays of their own.

Attorneys general in Iowa, Kansas, Maryland, West Virginia and Wisconsin have filed lawsuits against Purdue and its former president Richard Sackler, accusing the company and billionaire businessman of exacerbating the nation’s opioid addiction crisis through aggressive marketing of its drugs. The new additions bring the count to 44 states that have filed suit against Purdue.

Purdue said it "vigorously denies" the claims in the newest lawsuits and intends to fight them out in court.

"These complaints are part of a continuing effort to try these cases in the court of public opinion rather than the justice system," the company said.

The new lawsuits follow a landmark $270 million settlement in late March between Purdue and Oklahoma prosecutors, the drugmaker’s first hit across the bows among thousands of lawsuits filed against the company.

As part of the settlement, Purdue and members of the Sackler family agreed to donate $200 million for a new National Center for Addiction Studies and Treatment at Oklahoma State University, with an additional $60 million paid to cover the state’s litigation expenses.

In Oklahoma’s suit, Attorney General Mike Hunter said Purdue was one of a group of opioid makers that "manipulated" residents into believing their pain drugs were safe to use for long periods of time. The state also claimed Purdue violated its Medicaid false claims act and its consumer protection act in marketing a product that caused a public nuisance.

Despite that result, there is some precedent showing state litigation against Purdue could face a steep uphill climb in court.

Last week, a North Dakota judge tossed the state’s complaint against Purdue, saying FDA labeling of OxyContin that did not adequately warn consumers of the drug’s effects placed the litigation under federal jurisdiction rather than the state's purview. North Dakota Attorney General Wayne Stenehjem said the state would appeal the judge’s dismissal.

With lawsuits mounting and the pressure for even more settlements increasing, Purdue has eyed bankruptcy to halt litigation and negotiate with plaintiffs in the thousands of state and local lawsuits it faces under the eye of a bankruptcy judge.

Purdue is one of a group of opioid drugmakers that have been targeted for their roles in driving the nation’s opioid epidemic, which contributed to a record 70,237 overdose deaths in 2017, according to the Centers for Disease Control and Prevention.

While individual companies have been knocked for their role in the crisis, only one case has led to an opioid executive being found directly responsible in court. In early May, Insys founder and former CEO John Kapoor was found guilty on federal racketeering charges for his role in driving an elaborate kickback scheme paying doctors to boost scripts of the company’s powerful under-the-tongue opioid spray, Subsys. 

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