(Reuters) – San Francisco will square off on Monday against Walgreens Boots Alliance (WBA.O) and three other companies accused of fueling an opioid crisis in the city, the first trial to target manufacturers, distributors and pharmacies over the addictive pain medicines.

San Francisco has alleged that pharmacy chain Walgreens, drugmakers Teva Pharmaceutical Industries Ltd (TEVA.TA) and AbbVie Inc’s (ABBV.N) Allergan unit, and drug distributor Anda Inc, which is owned by Teva, created a “public nuisance” by flooding the city with prescription opioids and failing to prevent the drugs from being diverted for illegal use.

The companies have denied the allegations, saying that they sold opioid medications that were prescribed by doctors.

Opening arguments before Judge Charles Breyer in San Francisco are scheduled for 9:30am PT (4:30pm GMT) on Monday.

People walk by a Walgreens, owned by the Walgreens Boots Alliance, Inc., in Manhattan, New York City, U.S., November 26, 2021. REUTERS/Andrew Kelly

San Francisco has been hard hit by the opioid crisis, which has caused more than 500,000 overdose deaths nationwide in the past two decades, according to the U.S. Centers for Disease Control and Prevention.

Opioid-related health issues now account for 25% of emergency room visits at the city’s largest public hospital, according to the lawsuit.

San Francisco’s lawsuit, filed in 2018, initially included claims against drugmakers Purdue Pharma LP, Johnson & Johnson (JNJ.N) and Endo International Plc (ENDP.O) and the three largest U.S. drug distributors – McKesson Corp (MCK.N), Cardinal Health Inc (CAH.N) and AmerisourceBergen Corp (ABC.N) – but the city previously settled with those defendants.

City Attorney David Chiu said at a Wednesday news conference that the upcoming trial would be the first to test claims against “each part of the opioid supply chain.”

The San Francisco case comes amid a wave of opioid settlements. J&J earlier this month agreed to pay $99 million to settle claims over its part in West Virginia’s opioid crisis..

Alabama reached $276 million in settlements with J&J, McKesson and Endo after that state opted out of a nationwide $26 billion settlement of opioid litigation.

The San Francisco trial comes five months after a state judge held that Los Angeles, Santa Clara, and Orange counties, as well as the city of Oakland, failed to prove that Endo, Johnson & Johnson, Teva and Allergan created a public nuisance through the sale and promotion of opioids pain medicines.

Reporting by Dietrich Knauth; Editing by Noeleen Walder and Bill Berkrot

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