Local leaders across Washington have launched legal campaigns against companies that make and distribute opioid painkillers, saying false advertising is partially to blame for widespread addiction.
But for one of the counties hit hardest by the crisis, the decision to sue is a matter of debate and a question of resources.
Cowlitz County is home to cities like Longview and Kalama that skirt the Columbia River in Southwest Washington.
It also has the state's third-highest opioid overdose death rate, just behind Clallam and Mason counties, according to the state Department of Health.
The crisis is stressing jails, hospitals, and other institutions in a county where resources are already strained by a struggling economy, said County Commissioner Dennis Weber.
“I don’t know about the other counties in the Puget Sound area, but the property values in Cowlitz County are just now reaching 2008 levels," Weber said. "The recession hit us very hard, and so we’re scrambling for every revenue dollar.”
He advocates suing drug companies to recoup some of those costs.
"It's not going to solve things, but it will provide us with some resources," he said. "And, like I said, we're kind of in desperation trying to balance the budget every year."
He believes a struggling economy is also the reason more county residents are resorting to drugs.
Cowlitz County's unemployment rate is 6.8 percent, well above the statewide rate of 4.7 percent. Weber said automation has replaced many jobs in the logging industry and paper mills.
Meanwhile, a rise in overdoses as well as suicides, particularly of adult men, are a factor in the county's decision to build a larger morgue this year, expected to cost $6-7 million, he said.
“People are losing hope," Weber said. "When adult men commit suicide, it’s because it’s out of desperation. They’re not able to take care of their families. They can’t get jobs. And they lose hope.”
But Weber has to convince other elected officials that a lawsuit is the right response.
County commissioners can recommend a course of action, but Cowlitz County Prosecuting Attorney Ryan Jurvakainen has the final say.
Jurvakainen said taking drug companies to court could be a costly and time-intensive process. He said the county would have to find a way to measure damage from the opioid crisis in dollars.
“I could foresee it being a large task, trying to monetize or come up with damages," he said. "A much bigger county with more resources, I don't know if they have the ability to expend that time."
But, he added, employees in his office are strapped for time and resources.
He said he'd like to have more conversations with county commissioners and other officials before making a decision.
If Cowlitz County officials decide to sue drug companies over the opioid crisis, they'd be joining a statewide trend.
King County filed a lawsuit against three of the nation's largest opioid manufacturers in January.
Skagit County and three of the cities within it followed with a similar lawsuit later that month.
Pierce County filed its own lawsuit in February.
Washington State and the cities of Seattle, Tacoma, and Everett have also filed lawsuits against drug companies in recent months.
Thurston and Clark counties filed two of the most recent lawsuits last week.
“We know that people from all walks of life are struggling with addiction, and that needs to be addressed not just on the streets, but at the source," Schelli Slaughter, Thurston County's director of public health and social services, said in a news release.
In Clark County, the sheriff's department estimates it has spent more than $5.5 million responding to the addiction crisis over the past three years.
“It’s time to hold these drug companies accountable and take steps to reverse this disturbing trend," Clark County Council Chairman Marc Boldt said in a separate news release.