Arkansas' attorney general on Thursday sued three drug distributors for their alleged role in the opioid crisis, claiming the companies failed to monitor and report suspicious shipments of opioids into the state.

Attorney General Leslie Rutledge filed the lawsuit in Pulaski County Circuit Court against Cardinal Health, McKesson Corporation and AmerisourceBergen. The lawsuit claims the companies' conduct has cost consumers and the state millions of dollars in payments for opioid orders that were illegal, misrepresented, unfair or harmful to consumers.

Arkansas had the second-highest opioid prescribing rate in the country in 2016, with enough delivered to supply every person in the state with 78 doses each, according to the lawsuit.

"Distributors fueled the explosion of opioids in Arkansas and enabled illegitimate avenues to flourish," Rutledge said at a news conference announcing the lawsuit. "Many of these companies have profited substantially from the sale and distribution of opioids within Arkansas, and they should be held accountable."

The lawsuit seeks civil penalties and restitution, but does not specify how much. It also asks the court to enjoin the companies from directly or indirectly failing to comply with state and federal law requiring monitoring and reporting of suspicious opioid distributions to the state.

Representatives of AmerisourceBergen and Cardinal Health did not immediately respond to requests for comment. McKesson did not comment directly on the lawsuit but said it maintains and continually enhances "strong programs designed to detect and prevent opioid diversion within the pharmaceutical supply chain."

The suit is the second Rutledge, a Republican, has filed against companies over opioid abuse. Last year she sued three opioid manufacturers on behalf of the state.

At least 40 states have sued drug companies over the toll of the opioid crisis in the highest profile suits out of some 2,000 filed by government entities. Most of the states' suits have focused on manufacturers — and many of them only Purdue Pharma, the maker of OxyContin. But increasingly the states are doing what local governments are in their most of their opioid suits: going after distributors, too. With the filing in Arkansas, at least 15 states now have suits pending against one or more distributors. Most of those states have sued the same three distributors Arkansas targeted in its suit Thursday.

The lawsuits argue that the companies — which are massive even if they're not household names — shipped orders that they saw as suspicious, helping inundate some communities with powerful painkillers that were diverted to the black market.

"Without defendants' actions, opioid use would not have become so widespread, and the enormous public health hazard of opioid overuse, abuse and addiction that now exists would have been averted," Arkansas' latest lawsuit said.

The national trade group representing distributors, including those targeted by Arkansas' suit, said the idea that distribution companies 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."

"Those bringing lawsuits would be better served addressing the root causes, rather than trying to redirect blame through litigation," John Parker, senior vice president of communications at the Healthcare Distribution Alliance, said in a statement.

Four states — Delaware, Florida, Kentucky and New Mexico — have also sued pharmacies. Rutledge on Thursday didn't rule out additional actions, including against pharmacies, in what she called a "multifaceted" approach. Rutledge said there haven't been any settlement discussions with the manufacturers the state sued last year.

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Associated Press Writer Geoff Mulvihill in New Jersey contributed to this report

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