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A civil case against entities accused of fueling the opioid epidemic in San Francisco kicks off on Monday before Justice Charles R. Breyer in the U.S. District Court for the Northern District of California.

City and County of San Francisco, et al., v. Purdue Pharma L.P., et al.” takes on manufacturers, distributors and pharmacies that engaged in what the city and county allege was an unlawful and harmful “flooding” of San Francisco with opioids. Among the defendants are Walgreens, Allergan Pharmaceutical Company, Teva Pharmaceuticals, Anda Inc. and Endo Pharmaceutical Company.

City Attorney David Chiu claims that by going after manufacturers, distributors and pharmacies — an entire supply chain — this case is the first of its kind to go to trial.

“Walgreens, Allergan, Teva, Anda and Endo (have caused) a widespread public nuisance and public emergency,” said Chiu in a news conference this past Wednesday. “They need to be held accountable.”

Chiu threw out statistics to support his argument: There are roughly 163 million prescription opiates in San Francisco per year, or 22 pills each for every man, woman and child; about 25 percent of all emergency room visits to San Francisco General are opioid-related, overdoses in the county increased by 478 percent from 2015 to 2020, and in 2020, double the number of people died from opioid overdoses than died from COVID-19.

“Walgreens, Allergan, Teva, Anda and Endo (have caused) a widespread public nuisance and public emergency. They need to be held accountable.”

City Attorney David Chiu

Many of the overdose deaths in recent years are due to fentanyl, which is often laced in illegal street drugs. More than twice as many people experiencing homelessness in San Francisco died during the first year of the COVID-19 pandemic compared to previous years, with the leading cause of death being drug overdose, according to a UC San Francisco study that exposed the effects of fentanyl on the community.

On April 6, the Drug Enforcement Administration sent out a letter to federal, state and local law enforcement warning of a nationwide spike in fentanyl-related “mass-overdose” deaths. A mass-overdose is characterized by three or more overdoses occurring close in time in the same location.

Asked about fentanyl’s impact on San Francisco, Chiu responded that the companies in the city’s lawsuit played a “devastating role in the opiate crisis” by “flooding our marketplace” and creating the addiction that has led some people to seek out illegal drugs.

The suit alleges unfair business practices, fraud, making false statements, misleading the public, and violating the Controlled Substance Act, the California Consumers Legal Remedies act.

According to Chiu, Endo already settled with the plaintiffs and has agreed to pay $10 million to San Francisco to combat the crisis, $5 million to be paid immediately and then $5 million more to be paid over 10 years.