Within about 20 years, more than 76 billion opioid pills or painkillers were sold in just six years in the U.S., manufacturers and distributors made billions of dollars – and at least 400,000 people died from overdosing.

The nearest comparable crisis is the havoc wreaked by tobacco. And, just as cigarette manufacturers lied about the health risks of their products while aggressively marketing them, so too opioids makers are accused of spreading misleading information about their drugs. Tobacco companies agreed to a $246 billion settlement and opioids manufacturers are paying out hundreds of millions of dollars – to begin with – to settle lawsuits Young white men are typical victims but so too are “minorities.” The Centers for Disease Control and Prevention (CDC)

said opioid deaths are increasing faster among African Americans and Latino Americans than among whites. Amber Robins, a board-certified family medicine doctor, said in the Huffington Post that there is “a major health crisis that greatly affects black Americans.” Indigenous Peoples are also victims, with the CDC saying they had the second-highest rate of opioid overdose in 2017.

The smallest among us are also victims. Scott Bickford, an attorney, said more than 150,000 babies were born with opioid withdrawal from 2012 through 2016 and the number is growing, the Associated Press reported. Initial hospital stays for such babies can cost $200,000 to $250,000 more than infants born without complications, Bickford said.

Opioids are drugs which influence the part of the brain where pain, as well as pleasure, is experienced, the “opioid receptors.” The drugs, ranging from morphine and heroin to more powerful versions, provide not only relief but also a feeling of euphoria and are potentially fatally addictive. One version, fentanyl, made mostly in China, is up to 100 times more powerful than heroin.

A 2017 University of Arkansas study found that a patient given an initial prescription for a one-day supply has about a six percent chance of being addicted a year or longer; a five-day supply, about 10 percent; a 10-day prescription, about 20 percent; a 30-day supply, through several prescriptions or refills, about 30-percent; a 30-day supply all at once, 45 percent.

Addicts do anything to satisfy the craving as they spiral down a path in which only the next pill matters and which often ends in death. A now 22-year-old Australian man prescribed an opioid after his wisdom tooth was extracted overdosed 60 times in 12 months. At one time, he was drinking 110 pills a day. “You become the drug,” his mother said. At the time AP filed the story on Sept. 7, he was still alive, because his mother wouldn’t let him die.

Several companies have been accused of capitalizing on this dependency. The Washington Post said in an editorial on Sept. 2, “Gatekeepers in both the public and private sectors bought into the idea, promoted by industry and by many doctors, that pain was vastly undertreated and that new, extended-release opioid formulations would not be addictive.

Starting in the late 1990s, they abandoned medicine’s traditional reluctance to use opioids for non-cancer pain, and the rate of death from overdose, previously minuscule, began its upward march.”

The Sackler family, owners of Purdue Pharma, which created OxyContin, have become the ugly face of the crisis. But the companies had a lot of help. The Tampa Bay Times reported that more than 5.5 billion opioids were distributed from Florida alone, including by “pill mills” run by doctors, starting in the 1990s. “The clinics’

doctors did no diagnostic work. They just signed prescriptions and shuffled the ‘patients’ to the clinics’ onsite pharmacies to buy… narcotics at $10 a pill, cash only,”

the AP reported. “Some pill-mill tourists would visit a dozen or more clinics before returning home with thousands of pills, which would be sold to their neighbors for up to $100 each. Within a few days, many headed south to buy more.”

It took Florida officials years before they began cracking down on the scandal and critics blame the delay on campaign donations. The Tampa Bay Times reported that 15 corporations and executives have donated more than $22 million since 1993.

Between 2006 and 2015, opioids makers donated almost $4 million, according to a joint 2016 investigation by the AP and the Center for Public Integrity. Republicans, who run the state, got almost $3 million.

Meanwhile, calls for a reckoning beyond financial settlements are increasing.

Steve Williams, mayor of the West Virginia city of Huntington, often described as “ground zero” for the crisis, has called for criminal prosecution of the “drug dealers in Armani suits,” the Guardian reported.

And if there was hope that lawsuits would bring relief, it was dashed when, just on Aug. 30, CBS News reported that Virginia police seized enough fentanyl to kill 14 million people.

As for the Sacklers, they exemplify the fact that wealth can have its own extrastrength narcotic effect. They even proposed making a pill to counter the overdosing their drugs have been causing. And at one stage they offered to give up their company and pay billions in compensation, so long as they could sell opioids overseas. They are hooked on money but it is others who die from that addiction.