The Cherokee Nation of Oklahoma has launched a lawsuit against three national retail pharmacy chains and two of the largest national drug distributors in the country. The complaint charges that they knowingly flooded the tribal community with prescription opioids, fueling a deadly drug epidemic that has taken hundreds of lives and cost hundreds of millions of dollars.

The landmark lawsuit, filed on April 20, 2017, contends that retailers Walmart, CVS and Walgreens, and wholesalers AmerisourceBergen, McKesson, and Cardinal Health, “allowed massive amounts of opioid pills to be diverted from legitimate channels of distribution into the illicit black market in quantities that have fueled the opioid epidemic in the Cherokee Nation.

 The suit alleges the defendants ignored red flags and “turned a blind eye” to known problems in their supply chains. Todd Hembree, the Cherokee Nation Attorney General, said the drug companies failed to keep their opioids from being diverted and did nothing to prevent rampant over-prescribing.

The rate of drug-related deaths among American Indian and Alaska Native people has quadrupled since 1999 and is double the rate of the country as a whole. The diversion of millions of opioid pills over the past 18 years has contributed to nearly 400 deaths among the Cherokee Nation – double the death rate of the country at large – and 10,000 hospital visits.

 Actions like the Cherokee suit can be expensive—especially if you lose and have to cover the legal expenses.

Despite this, considering the social destruction that prescription opioids have caused the American Indian and Alaska Native populations, it’s possible we will see other tribal nations follow with their own lawsuits.

The reason: there’s strength in numbers.

Similar lawsuits have snowballed among cities, counties and states, where opioid addiction has cost taxpayers and citizens billions of dollars. From coast to coast, they’ve come to the same conclusion: Drug companies are complicit in the opioid epidemic, and they need to be held accountable.

The combined pressure is starting to have an effect. Recent federal cases against drug companies show that lobbyists and armies of lawyers are getting companies off rather lightly.

“They pay fines as a cost of doing business in an industry which generates billions of dollars in revenue,” the Cherokee suit says.

Light fines and no jail time helps fuel the problem. The industry has to start paying for its lack of responsibility.

I support the Nation’s suit, but much more legal pressure is needed.

 Almost every day we see new state, county and city laws and statutes that increase funding for local treatment and law enforcement.

At the federal level, the new 21^st Century Cures Act has allocated the first half of a $1-billion grant to the states and territories for drug treatment, law enforcement and prevention programs.

Another important piece of federal legislation is the Drug Supply Chain Security Act (DSCSA). Enacted in 2013 and set for completion in 2024, the DSCSA helps ensure prescription drugs get to where they are supposed to go.

Right now, drug companies are scrambling to be in compliance by November, when on-pack label serialization and tamper-evident packaging must be in use to prevent theft and counterfeiting. These new requirements are going to make a difference.

 All of this is helping. But for communities like the opioid-devastated Cherokee Nation, it’s mostly too little too late.

In the tribal communities, which are at high risk for substance use disorders, local governments need to expand education, treatment and prevention programs now.

We need insurance regulations that add to, not take away from, coverage for treatment of substance use disorders. And we need more access to medically supervised detox programs that help ease the pain and discomfort of prescription opioid withdrawal. These encourage people to attempt recovery, not avoid it. With more effective drug detox, rehab and support programs, we can greatly reduce relapse rates and enjoy successful long-term recovery.

I urge healthcare leaders and lawmakers everywhere to strengthen and more rigorously enforce all regulations that pertain to drug diversion. We must hold manufacturers, distributors and pharmacies responsible for the failures in the supply chain that lead to illicit diversion.

I heartily applaud the Cherokee Nation for its preemptive actions to deter diversion. They have implemented their own prescription monitoring program, and eliminated some of the most widely abused opioids from their own formulary.

 As an executive deeply involved in the world of drug and alcohol recovery, I have been outraged many times over the past 10 or so years as drug company after drug company has been charged with breaches of the law, brought to court, found guilty and paid enormous fines—from hundreds of millions to even billions of dollars—only to return to the same pattern of behavior as before

No one of consequence is ever jailed.

We deal with the results of the opioid epidemic on a daily basis. We see and hear first-hand how these situations of dependence and addiction can develop, regardless of age or station in life, and so often from a single pill or two or three, usually borrowed or innocently gifted.

Every day we hear how opioids—meant to relieve pain—can ruin lives.

It is critical that we take immediate action to prevent further loss of life, deteriorating health issues and increased economic consequences.

Bryn Wesch is Chief Financial Officer at Novus Medical Detox Center, a Joint Commission Accredited inpatient medical detox facility that is also licensed by the Florida Department of Children and Families and known for minimizing the discomfort of withdrawal from prescription medication, drugs or alcohol. She welcomes comments from readers.

It is a well known fact that Native Americans and Alaska Native people have a high incident of excessive alcohol consumption.  The questions has to be asked is why haven’t these tribes sued all the alcohol companies for fueling the known alcoholic epidemic ?

Could it be that since a number of other entities are initiating similar law suits and they are just trying to “pile on” and ride on the “coat tails” of these other lawsuits ?

And why has it taken them 18 years to take this action… where they asleep at the switch or just not paying attention ?