Cherokee Nation is suing CVS Health, Walgreens, and other drug companies and retailers, alleging the companies didn’t do enough to stop prescription painkillers from flooding the tribal community and creating a crisis of opioid addiction.

The lawsuit, filed in tribal court on Thursday, alleges that the companies failed to properly monitor opioid prescriptions and orders. The tribal government alleges that those patterns should have raised red flags that the companies are legally responsible for reporting to federal officials.

“These drug wholesalers and retailers have profited greatly by allowing the Cherokee Nation to become flooded with prescription opioids,” the lawsuit alleges. “They have habitually turned a blind eye to known or knowable problems in their own supply chains.”

The rate of drug-related deaths among American Indian and Alaska Native people has nearly quadrupled since 1999, according to the Indian Health Service. It’s now double the rate in the US as a whole. Oklahoma — home to most of the 120,000 citizens of Cherokee Nation — leads the country in prescription painkiller abuse.

Cities and counties across the US have filed similar lawsuits against drug companies. West Virginia included several pharmacy chains as well in a case brought against opioid distributors. But this is the first case brought by a tribal nation seeking to hold those dispensing prescriptions responsible for an epidemic of opioid addiction.

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In a statement to STAT, CVS Health said it has “stringent policies, procedures and tools to ensure that our pharmacists properly exercise their corresponding responsibility to determine whether a controlled substance prescription was issued for a legitimate medical purpose before filling it.”

Walgreens declined to speak on pending litigation.

Under the Controlled Substances Act, pharmacies and drug distributors are legally responsible to flag federal officials when they see suspicious orders or prescriptions for controlled substances such as opioids.

Those suspicious orders can take several forms. They could involve patients filling multiple opioid prescriptions from different doctors — known as “doctor shopping” — or an order for opioids that’s disproportionately large for the local population.

“Pharmacists have a duty only to fill scripts that are for a legitimate medical purpose,” said Richard Fields, a D.C.-based lawyer who filed the lawsuit on behalf of the tribe. “If a doctor is engaged in prescribing opioids illegally, that doesn’t relieve the pharmacy of liability.”

In 2015, an estimated 845 million milligrams of opioids were distributed in the 14 counties that span Cherokee Nation, according to the Drug Enforcement Agency. That averages out to between 360 and 720 pills per year for every prescription opioid user in the Cherokee Nation, the lawsuit says.

By 12th grade, nearly 13 percent of American Indian teens have used OxyContin, according to the American Drug and Alcohol Survey. And 2.6 percent of American Indian students in 12th grade have used heroin, nearly double the rate of the general population.

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“As we fight this epidemic in our hospitals, our schools, and our Cherokee homes, we will also use our legal system to make sure the companies, who put profits over people while our society is crippled by this epidemic, are held responsible for their actions,” Cherokee Nation Principal Chief Bill John Baker said in a statement.

There have been a slew of lawsuits filed by local governments accusing drug makers of contributing to the opioid epidemic by downplaying the addictive properties of painkillers and improperly encouraging doctors to prescribe the drugs.

In February, for instance, Erie County, N.Y., sued four companies — Purdue Pharma, Johnson & Johnson’s Janssen unit, Teva Pharmaceuticals, and Endo International — for costing the county government millions of dollars each year to fight the opioid crisis.

“The goal is to get justice for the Cherokee Nation and to recover the extraordinary losses they’ve suffered as a result of the opioid epidemic,” said Fields.

This article is reproduced with permission from STAT. It was first published on April 20, 2017. Find the original story here.