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Opioids

An arrangement of Percocet pills is shown last year in New York. 

At a minimum of $206 billion to be paid out, the 1998 settlement between tobacco companies and a majority of states remains the largest civil settlement in American history.

The next great public health crisis, that of opioids, might come with an even steeper price tag — with a lawsuit from northeast Nebraska the first in this state, among dozens nationally, aimed at holding the pharmaceutical companies and distributors responsible for the damages.

Knox County and the Ponca Tribe of Nebraska were later joined by all Native nations in the state, who filed their own lawsuits. Both correctly note municipal governments are burdened with costs of handling treatment and other public safety measures stemming from an opioid epidemic they played no role in creating.

Nebraska Attorney General Doug Peterson expressed concern that the suit could make it harder for the state to settle with the opioid manufacturers. Given the track record of tobacco companies’ legal victories in private suits before the 1998 master settlement championed by state attorneys general, he has a valid point.

However, our hope is that the local lawsuits force the inevitable settlement with Nebraskans to be of enough value to help those devastated by abuse of a dangerous drug prescribed far too frequently for far too long. This scourge of opioid addiction and overdoses has left no state untouched.

And, just as a reminder, Nebraska has been among the luckiest states in dodging this costly crisis.

A March study by the American Enterprise Institute found opioids cost West Virginia, which Nebraska recently passed in terms of its population, $8.8 billion annually — 12 percent of its gross domestic product. That state has six of the top 10 (and 12 of the top 20) counties in the nation shouldering the highest per-capita costs of this epidemic, the Charleston Gazette-Mail reported.

Meanwhile, four states experienced more than 4,000 overdose deaths in 2016, with 17 more tallying quadruple-digit fatalities. Data from Centers for Disease Control and Prevention attribute nearly two-thirds of the 63,632 overdose deaths that year to opioids.

Nebraska’s comparative lack of all drug-overdose deaths — the lowest age-adjusted rate in the country in 2016, according to the CDC — doesn’t mean its residents have skated free. The toll, in the hundreds, means many Nebraskans have felt the pain of chemical dependency and loss.

Addressing the societal and economic costs, even outside the epicenters in Appalachia and the Great Lakes regions, will take untold amounts of cash.

The tobacco settlements have been undermined in several states as a way to pay other bills, even though the money was originally designated to help recoup Medicaid costs.

As such, local governments must be aggressive in pursuing the best course of action to serve their residents. Litigation is certainly a reasonable means to that end.

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