Minnesota Attorney General Keith Ellison says the owners of the pharmaceutical company at the root of the opioid crisis were “motivated not by human dignity or the value of human life, but by unlimited greed.”

That’s the argument at the heart of an updated lawsuit Minnesota has brought against Purdue Pharma and the Sackler family. Forty-eight states and the District of Columbia are suing the pharmaceutical company and its owners for allegedly lying about the addictive nature of powerful painkillers that caused a national addiction epidemic.

Ellison says the Sacklers made $4 billion nationally from opioids including “tens of millions” in profits in Minnesota. The family knew opioids like Oxycontin were potent and highly addictive, but downplayed the risk and then called addicts “culprits,” “reckless criminals,” and “scum of the earth.”

Between 2000 and 2017, Minnesota lost 3,628 residents to opioid-related drug overdoses. In 2017, 422 people died and deaths declined to 331 in 2018, according to preliminary data.

“The Sackler defendants knew they were distorting facts, deceiving people, and destroying lives, and they kept going for the sake of greed. They didn’t see addiction, epidemic, and death as reasons to change course — they saw them as opportunities for profit,” Ellison said in a statement.

The company has denied the allegations, stating on its website: “Purdue will continue to defend itself vigorously against any misleading and inflammatory claims. The responsibility for this crisis cannot, as a matter of law, be tied to one company that manufactures a small fraction of the prescription opioids in the United States.”

Many opioids are now manufactured by generic drug makers and other companies, but Ellison and other attorneys general suing Purdue say the company led a campaign to get doctors to prescribe the drugs by making misleading claims.

Four out of five opioid addictions are believed to have started with prescription pills. In 2017, nearly 3.2 million opioid prescriptions were dispensed.

Minnesota first filed suit against Purdue in July 2018 under then Attorney General Lori Swanson. Ellison decided to add eight members of the Sackler family as defendants in May.

Ellison’s office released the updated lawsuit Monday and highlighted allegations the Sackler family long knew about the risks of marketing opioids, but ignored them. The state’s allegations include:

The Sacklers were personally behind deceptions that opioids were safe and not addictive.

Purdue’s owners learned as early as 1999 opioids were being misused and blamed individuals for it.

After denying Oxycontin was addictive the Sacklers moved to profit from drugs used to treat opioid addiction.

The defendants tried to influence Minnesota’s pain management standards.

In May, the state Legislature approved a new licensing fee for opioid makers and distributors. The fee is expected to raise $20 million annually for addiction prevention and treatment.

The state has also set new guidelines for prescribing opioids. Physicians who prescribe too many opioids risk losing the ability to serve Medicaid and MinnesotaCare patients.