IN 2016 a coroner’s office in Ohio had to store corpses in refrigerated lorries for a week because residents were overdosing on opioids faster than their bodies could be processed. This year has been no better: the coroner borrowed space from a local funeral parlour to stow the dead. Largely because of opioids, Ohio has the third-highest drug-overdose death rate in the country. In a recent survey, four out of ten adults there reported knowing someone who has overdosed on prescription painkillers. Ohio blames opioid manufacturers. On May 31st the state government filed a lawsuit against a group of drug companies, accusing them of exaggerating the effectiveness of opioid painkillers while downplaying the risk of addiction.

Until the 1990s, doctors mostly reserved opioids for acute pain or easing suffering at the end of life. Around the middle of that decade, drug companies began a concerted marketing effort to convince doctors that opioid pills were also safe for treating chronic pain. Since then, addiction and deaths associated with prescription opioids have soared. The state of Mississippi, Santa Ana and Orange Counties in California, and the city of Chicago, among others, have recently filed complaints that similarly condemn drug companies for fuelling the opioid epidemic. The suits paint a startling picture of the companies’ marketing strategies.

In 2014, the five defendants in the Ohio case spent $168m promoting their products to doctors—twice what they spent in 2000. This allowed the companies to hire droves of sales representatives, who were deployed, as is usual in America, to hobnob with doctors at conferences and visit them in their offices. They doled out coupons for the drugs, as well as branded gifts. Purdue Pharma, one of the largest opioid manufacturers and maker of the popular OxyContin, was perhaps the most creative. When it introduced OxyContin in 1996, the company handed out soft toys in OxyContin T-shirts, branded fishing hats and a 1950s-music CD entitled “Get in the Swing with OxyContin”. An investigation by STAT, a health-news website, found that to convince a doctor with a sweet tooth to begin prescribing the drug, one salesman delivered a box of doughnuts and snack cakes arranged to spell OxyContin to his office.

In a strategy that the Ohio suit calls “borrowing a page from Big Tobacco’s playbook”, the pharmaceutical companies also recruited “key opinion leaders”—doctors and pain-treatment advocates identified as amenable to increasing the use of opioids for chronic pain. The companies paid these people to serve on advisory boards, give talks and hold continuing medical-education classes for other doctors. A report by the Government Accountability Office found that between 1996 and 2002 Purdue Pharma alone financed 20,000 such education programmes.

Most of the marketing practices detailed in the suits are not new, and opioid prescriptions have dropped off since 2011. The fact that local governments are suing now reflects their desperation, says Juliet Sorensen, of Northwestern University’s Pritzker School of Law. She believes that Ohio, Chicago and the others hope for an outcome similar to that in litigation against the tobacco industry. In the 1990s, 46 state attorneys-general sued the country’s largest tobacco companies over their marketing practices. The companies were forced to change their advertising methods and pay the states billions of dollars.

Opioids are more regulated than tobacco was, which could make cases against their manufacturers harder to win. The Food and Drug Administration approved the painkillers and their marketing; convincing a jury that the companies used “deceptive” advertising to increase sales could be hard. But even if the suits fail in court, they may still achieve other goals, says Timothy Lytton, of Georgia State University College of Law. Whereas the immediate aim of many local governments may be to recoup money spent on treating drug-overdose victims and addicts, Mr Lytton believes the ultimate objective of the suits is to force pharmaceutical companies to change their behaviour.