The Ponca Tribe of Nebraska and Knox County this week sued more than two dozen drug manufacturers and distributors of opioid painkillers.

The Omaha attorney who filed them, Dave Domina, said he would be stunned if more such cases aren’t filed by other counties or cities in Nebraska seeking to recover their expenses as they grapple with the nationwide opioid epidemic.

“The United States faces a public health crisis arising from the profligate manufacturing, distribution, permissive and knowing diversion, and abuse of opioids and opioid medications. An opioid addiction epidemic has resulted,” Domina said.

The Nebraska lawsuits, filed Wednesday in U.S. District Court in Omaha, are the latest across the country filed over the opioid crisis. But, where most are against about a dozen companies, these target 25, alleging each used false, deceptive, or unfair marketing practices that helped lead to the problem.

Domina said Walgreens, CVS, McKesson Corp., Purdue Pharma Inc. and others misled medical professionals and misrepresented the dangers and addictive risks of their drugs while 183,000 people died of overdoses between 1999 and 2015. He described it as the worst public health epidemic in U.S. history.

In a phone interview Thursday, he said it’s probably the biggest public health crisis since the plague.

“And this one is the product of greed,” Domina said, and has to be stopped by human behavior changing, not an anecdote.

Drug makers and pharmacies made huge profits, spent billions influencing key opinion leaders and paid civil fines for wrongdoing as if it were just a cost of doing business, he said.

In many cases, drug companies already have admitted wrongdoing, like McKesson, which last year agreed to pay a $150 million civil penalty to the DEA for failing to identify and report suspicious orders at 12 of its facilities, including one in La Vista.

The companies haven’t yet filed a response in the case. But, John Parker, senior vice president at Healthcare Distribution Alliance, a national trade association that represents distributors including AmerisourceBergen, Cardinal Health and McKesson, said the misuse and abuse of prescription opioids is a “complex public health challenge that requires a collaborative and systemic response that engages all stakeholders.”

“Given our role, the idea that distributors 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,” he said in an email Friday.

Two months ago, U.S. Attorney General Jeff Sessions said the Justice Department would file a statement of interest in the multidistrict action regarding hundreds of lawsuits like the Nebraska cases seeking to recover the costs associated with providing treatment and public safety measures to combat the opioid epidemic.

“It has cost this nation hundreds of thousands of precious lives,” Sessions said in a statement Feb. 27. “It has strained our public health and law enforcement resources and bankrupted countless families across this country.”

Sessions said the Justice Department would use every lawful tool at its disposal to turn the tide and “seek to hold accountable those whose illegality has cost us billions of taxpayer dollars.”

Domina said the two Nebraska cases likely will be transferred into that action for discovery but return here for trial.

He said it became clear to him that cities and counties in Nebraska could be left out of a larger settlement because the mortality rate is not yet as high here as in some other parts of the country.

But, he said, the problem is escalating here, and costs associated with addictions have dramatically increased the costs of government operations for the Ponca Tribe and Knox County; and their budgetary, human and physical resources are inadequate to deal with the rapidly growing crisis.

Domina said:

* In 2016, deaths due to opioids increased 24 percent over the prior year in Nebraska and even higher in Indian Country.

* More than 500,000 prescriptions for Oxycontin alone were written in Nebraska between 2013 and 2016. And in 2015, 1.4 million opioid prescriptions were written in the state.

* More than 95 percent of the people booked into the Knox County Jail test positive for drugs, with the number with opioids in their system increasing. Chemical and opioid dependency and withdrawal are major aspects of the law enforcement budget, public health and emergency services budgets.

Domina said the state’s political subdivisions need to think carefully through what happened in the tobacco litigation, which resulted in a $206 billion settlement in 1998 between the four largest tobacco companies and states seeking to recover tobacco-related health-care costs.

The state got to decide where its share of the money went.

But now, Domina said, cities and counties largely are bearing the brunt of the costs.

They’ll all be in competition for the same money.