While the U.S. is still struggling to get a grip on the opioid crisis, a drug epidemic that's killed more than 200,000 people since the ’90s, we're slowly getting a clearer picture of the role that drug companies played in the wave of addictions. Last Friday, attorneys in Summit and Cuyahoga counties in Ohio filed suit against some of the biggest players in the drug industry—including drug manufacturers McKesson and Purdue, and national pharmacy chains like CVS, Walgreens, and Walmart—claiming that they fueled the crisis. Specifically, they assert that both pharmaceutical companies and distributors failed to flag unusually large and frequent orders for highly addictive pain pills that were often a gateway to heroin use.

As the plaintiffs wrote in a motion outlining their argument, "Their failure to identify suspicious orders was their business model."

A judge in Cleveland has unsealed court documents that, as The Washington Post reports, show astoundingly huge orders for painkillers that pharmaceutical executives and distributors approved without a second glance. One order in 2009 to Purdue Pharma for 115,200 oxycodone pills—double the distributor's average for the previous three months—was approved in less than a minute, according to e-mail time stamps.

For their part, the pharmaceutical companies argue that the fault lies with the Drug Enforcement Administration, which had all the necessary information to stop the pain pills from reaching the black market. And they seem right, at least on that last part. One of the more shocking examples comes from Kermit, West Virginia, a town of 400 people, where over two years a single pharmacy received more than five million pain pills from the drug company McKesson. In an April 2019 deposition, a lawyer representing the plaintiffs asked a senior DEA official how, exactly, the agency failed to flag such astoundingly large orders of opioids. Per the Post:

"Is there any basis that you can make up in reality or otherwise where a town of 400 people have a medical need for five million pills of opium in a span of 24 months?" attorney Paul T. Farrell Jr. asked.

"There isn’t," said Thomas Prevoznik, the acting section chief of pharmaceutical investigations for the DEA’s Diversion Control Division. "There isn’t."

Farrell asked Prevoznik why the federal government did not charge McKesson with a crime.

"Based on my attorney’s advice, I’m not going to answer that," Prevoznik said.

In short, the drug companies blame law enforcement, while law enforcement is unwilling or unable to explain why they failed to act. The repercussions have been massive. Approximately every 15 minutes, a baby is born with neonatal opioid withdrawal syndrome, a medical epidemic that has cost the U.S. more than $2 billion since 2004. In Ohio, where the lawsuit is based, there were 4,293 reported deaths from overdoses in 2017. That's a death rate of 39.2 for every 100,000 people, almost three times the national average. In West Virginia, the death toll is as high as 33,091 in just one year. Meanwhile, the owners of drug manufacturing companies, like the Sackler family of Purdue Pharma, some of the most prolific philanthropists in the country, have made billions of dollars.

The profit-driven opioid epidemic is reminiscent of the 2008 financial crisis, when a housing bubble burst after banks knowingly sold millions of people mortgages that they couldn't afford, all the while assuring them that they could. A single banker went to jail, while the industry as a whole got off the hook for a global economic disaster that they directly caused. In fact, the federal government gave those same banks $188 billion just to stay afloat.

The biggest difference, though, is that the banks' business model cost people across the country their homes and livelihoods. The drug companies' cost people their lives.