Opening statements for a trial against pharmaceutical giant Johnson & Johnson began in an Oklahoma courtroom on Tuesday in a civil action designed by state officials to hold the drugmaker accountable for its role in the opioid crisis. The suit alleges that Johnson & Johnson, along with Purdue Pharma, the manufacturer of Oxycontin, and Teva Pharmaceutical, used deceptive marketing practices to sell highly addictive opioid painkillers in Oklahoma.

State Attorney General Mike Hunter said that Johnson & Johnson was the “kingpin behind this public health emergency,” growing and importing raw materials that it and other companies used to manufacture opioids that led to the death of thousands of Oklahomans.

“We believe our evidence is persuasive and compelling with regard to their legal responsibility for thousands of deaths and hundreds of thousands of addictions in the state,” Hunter said.

Oklahoma state officials settled the claim with Purdue in March for $270 million and came to an agreement worth $85 million with Teva on Sunday. That left Johnson & Johnson as the sole defendant in the case that began Tuesday morning in Norman, Oklahoma. The nonjury trial will be heard and decided by Cleveland County District Judge Thad Balkman.

Opening Statements Begin

Johnson & Johnson markets the opioid painkillers Duragesic and Nucynta. In opening statements, Hunter said that between 2007 and 2017, 4,653 people died of unintentional opioid overdoses in Oklahoma.

“To put it bluntly, this crisis is devastating Oklahoma,” Hunter said.

“The pain, anguish, and heartbreak… is almost impossible to comprehend,” he added. “How did this happen? At the end of the day, your honor, I have a short one-word answer – greed.”

Brian Beckworth, an attorney working for the State of Oklahoma on the case, told the court that 135 opioid pills were available for every adult in Cleveland County, Oklahoma, where the trial is being held, during the opioid crisis. Drug company representatives made nearly 150,000 sales visits to doctors in Oklahoma between 1999 and 2005, Beckworth told the judge.

Wrapping up the opening statement, Michael Burrage, another lawyer for the state, said that the drug manufacturer should be held accountable for its actions.

“Johnson & Johnson helped create this public nuisance in Oklahoma, and here is what they did your honor. Both falsely and deceptively, through multiple methods and with others, promoted opioids for the treatment of chronic, non-malignant pain,” he said.

Company Denies Responsibility

Johnson & Johnson has denied the claims against the company, saying that it cannot be held responsible for the crisis, which also bears responsibility from doctors, patients, and retailers.

“Our actions in the marketing and promotion of these important prescription pain medications were appropriate and responsible. The FDA-approved labels for these prescription pain medications provide clear information about their risks and benefits. The allegations made against our company are baseless and unsubstantiated,” the company said in a statement.

“We acted responsibly in providing FDA-approved pain medications, and we are ready for trial,” the company said before the trial began.

The suit against Johnson & Johnson is the first of nearly 2,000 similar actions that have been filed against drugmakers nationwide. The plaintiffs in those cases are closely following the events in Oklahoma, according to attorneys familiar with the suits.