The suit, filed last week in Crittenden County Circuit Court, brings together 215 Arkansas cities and all 75 counties in the state and accuses opioid manufacturers of wreaking havoc by aggressively pushing the drugs from the early 2000s to the present, leading to hundreds of overdose deaths while straining law enforcement and public health resources.
Opioid manufacturers, the suit alleges, "falsely touted the benefits of long-term opioid use, including the supposed ability of opioids to improve function and quality of life, even though there was no 'good evidence' to support their claims.
"Each manufacturer defendant knew that its misrepresentations of the risks and benefits of opioids were not supported by, or were directly contrary, to the scientific evidence," says the suit.
The suit names 52 opioid manufacturers, including Purdue Pharma, Endo Pharmaceuticals and Johnson & Johnson, as well as 13 other distributors, physicians, pharmacists and retailers. It seeks to have a jury in Arkansas determine how much money the companies should pay to create mental health clinics, drug courts, opioid abuse treatment clinics and other treatment programs across the state.
The suit differs from others filed against opioid manufacturers by more than a dozen state attorneys general, including Arkansas', across the nation, as well as scores of individual counties and cities that have filed their own lawsuits.
The Arkansas case brings together cities and counties in a single civil case. "Our case is unique in that regard, because it focuses on a remedy that will solve this problem," said Jerome Tapley, an attorney advising the cities and counties in the suit.
Officials in North Carolina, Utah, Mississippi, Iowa and several other states have reached out to learn more about how the case in Arkansas was brought, those involved with the suit told CNN.
The drug companies and other defendants have not filed a response, according to the Crittenden County clerk's office.
Johnson & Johnson took strong issue with the allegations. "Our actions in the marketing and promotion of these medicines were appropriate and responsible," it said in a statement. "The labels for our prescription opioid pain medicines provide information about their risks and benefits, and the allegations made against our company are baseless and unsubstantiated. In fact, our medications have some of the lowest rates of abuse among this class of medications."
Purdue said that it was "deeply troubled by the prescription and illicit opioid abuse crisis" and that it was dedicated to working toward a solution. "We vigorously deny these allegations and look forward to the opportunity to present our defense," it said.
Endo did not respond to CNN's requests for comment. "We are unable to comment on legal matters relating to specific member companies," industry group PhRMA said in a statement.
The Healthcare Distribution Alliance, a national trade association representing wholesale distributors of opioids, including two named in the suit, called the issue a "complex public health challenge that requires a collaborative and systemic response."
"The idea that distributors are responsible for the number of opioid prescriptions written defies common sense and lacks understanding of how the pharmaceutical supply chain actually works and is regulated," Senior Vice President John Parker said in a written statement. "Those bringing lawsuits would be better served addressing the root causes, rather than trying to redirect blame through litigation."
With debate in Washington on how to fix the opioid crisis and advocates pushing for billions in federal funding to create a robust treatment system, those involved in the Arkansas case say their solution is simple: Make the manufacturers pay.
"There's an equity situation as to whether the taxpayers should have to bear the burden of this, as opposed to the folks who created the problem," said Don Zimmerman, executive director of the Arkansas Municipal League, an alliance of cities and towns.
The opioid crisis has become a major priority among the Trump administration, with the president declaring the epidemic a public health emergency. Just last week, Trump rolled out a three-part plan to tackle the opioid epidemic
, including supporting policies to increase access to the opioid overdose antidote naloxone, calling for more medication-assisted treatment programs and highlighting a new high-profile advertising campaign to discourage America's youth from trying drugs.
Trump also said he wanted to go after drug manufacturers in a big way. "Our Department of Justice is looking very seriously into bringing major litigation against some of these drug companies," he said. "Some states are already bringing it, but we are thinking about bringing it at a very high federal level."
Tapley said the administration's strong stance only helps the Arkansas case. He compared the dire situation there to a massive oil spill, with city and county officials trying to return their communities back to the way they were before the disaster. "That's our objective in this lawsuit: to restore Arkansas communities back to where they were before the opioid crisis began," he said.
Drug companies in Arkansas, the suit says, sold enough opioids in the state for every man, woman and child to take 80 pills a year. In 2016 alone, more than 235 million opioid pills were sold across the state, the suit says.
Tapley and Zimmerman said the opioid epidemic has created a strain across the state, with city and county jails overflowing and the state's judicial system clogged. So-called heroin babies -- those born addicted to opioids -- have increased tenfold since 2000. The epidemic has also gripped the state's youth in other ways. Arkansas ranks first in the nation for children ages 12 to 17 misusing painkillers, the lawsuit says.
The state is also overwhelmed by children whose parents get arrested due to opioid use, Tapley said. "How do you process them? How do you end the cycle of addiction? How do you find services to provide emotional and psychological support?" he asked. "Part of the remedy will be to create these services."
Adding to the mounting legal action, Arkansas Gov. Asa Hutchinson and state attorney general Leslie Rutledge on Thursday announced a separate suit against opioid manufacturers Purdue, Johnson & Johnson and Endo, accusing the companies of making billions of dollars while deceiving the public about the potential dangers of opioids.
"Drug companies should never place their desire for profits above the health and well being of their customers or the communities where their customers live," Rutledge said. "In short, these manufacturers lied. ... The marketing schemes and misinformation campaigns utilized by Purdue Pharma, Johnson & Johnson and Endo are irresponsible and downright dangerous.
"I am here today to tell you: I am going to make them pay for what they have done to Arkansas," she said.
The attorney general said Thursday's suit brought by the state deals with potential Medicare fraud and violations of the Arkansas trade practices act, different from what the cities and counties are alleging.
Hutchinson called the legal actions "a significant step in our overall efforts to combat opioid abuse and to look for partners to address the problem."