When Suffolk County filed one of the nation’s earliest lawsuits against distributors of opioid painkillers five years ago, Rob Calarco, then-deputy presiding officer of the county legislature, said Suffolk saw 337 heroin-related deaths between 2009 and 2013, adding, “That’s 337 deaths too many.”

But it was only the beginning. As the case wound through the courts and the opioid addiction epidemic worsened, fatalities exploded.

From 2013 to 2017, annual opioid overdose mortalities on Long Island increased by 77%, from 348 to 617. Most deaths were from either fentanyl or heroin. But many of the deadly addictions that ended with street drugs once the pills ran out, began with prescriptions written by licensed doctors for drugs produced by legal manufacturers and sold by neighborhood drugstores.

The Suffolk suit, later joined by Nassau and New York State, argued that distributors and manufacturers should have flagged drug shipments to pharmacies so large they indicated that opioid abuse and illegal transactions, not pain treatment, drove the sales. On Tuesday, the state reached an agreement with four of the largest distributors of those drugs, which will net the plaintiffs $1.1 billion over 18 years, including $87 million for Nassau and $87 million to $106 million for Suffolk, to be set aside in a “lockbox” to address addiction.

Turning a blind eye to huge orders of deadly opioids is just one of the wrongs of which the companies are rightly accused, though they made no admission of guilt. They played down addiction risks by relying on biased research, aggressively marketed the drugs as safe, launched massive sales and payment campaigns to get doctors to prescribe more and stronger narcotics, and claimed addicted patients were suffering from “pseudo-addiction” and needed even more opioids to overcome it. It was corporate greed in one of its most deadly and disgusting manifestations.

The Food and Drug Administration, along with manufacturers, distributors, pharmacy chains and many doctors, share the blame. Now the pandemic and its accompanying stresses have reinvigorated an epidemic of addiction and death that had lost steam.

New York and Long Island need a plan on how to spend their share of the settlement dollars. The goals — reductions in overdoses and deaths, increases in the number and effectiveness of treatment beds and outpatient programs, and prevention of new addictions — must be firmly set, with clear metrics for success. Affected families, the children of addicts in particular, need services. And harm reduction, by which active addicts can be kept safer and healthier even if they cannot quit right now, is needed and often overlooked.

Addiction is a deadly disease. The dramatic and incriminating evidence made public as a result of multiple lawsuits proved conclusively that our drug regulatory and medical oversight structures failed us.

The money will help address this tragedy. Systemic reforms are needed to prevent the next one.

MEMBERS OF THE EDITORIAL BOARD are experienced journalists who offer reasoned opinions, based on facts, to encourage informed debate about the issues facing our community.

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