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A U.S. judge on Tuesday rejected efforts by major drug-makers, pharmacies and distributors to dismiss claims that they caused the country’s opioid crisis, clearing the way for a scheduled landmark trial even as he pushes for a nationwide settlement.

U.S. District Justice Dan Polster, who oversees roughly 2,000 opioid lawsuits by states, counties and cities, said the plaintiffs can try to prove that drug-makers’ deceptive marketing of the painkillers caused a harmful, massive increase in supply that pharmacies and distributors did not do enough to stop.

“A fact-finder could reasonably infer that these failures were a substantial factor in producing the alleged harm suffered by plaintiffs,” the Cleveland-based judge wrote.

The ruling was among seven decisions and orders totalling 80 pages from Justice Polster ahead of a scheduled Oct. 21 trial by two Ohio counties against Purdue Pharma, the OxyContin maker accused of fuelling the epidemic, and several other defendants.

Justice Polster also refused to dismiss civil conspiracy claims against drug-makers, pharmacies and distributors, and said federal law did not pre-empt much of the plaintiffs’ case.

Other defendants included the drug-makers Endo International and Johnson & Johnson; pharmacy operators CVS Health, Rite Aid, Walgreens Alliance and Walmart; and distributors AmerisourceBergen, Cardinal Health and McKesson.

Justice Polster also refused to dismiss a variety of claims against generic drug-makers Allergan, Mallinckrodt Pharmaceuticals and Teva Pharmaceutical Industries.

Opioid addiction claimed roughly 400,000 lives in the United States from 1999 to 2017, according to the U.S. Centers for Disease Control and Prevention.

Critics of the industry said opioid makers hid the addiction and abuse risks of prolonged use from consumers.

Rite Aid’s lawyers declined to comment. Lawyers for other major defendants did not immediately respond to requests for comment.

Paul Hanly, a lawyer for the plaintiffs, said his clients were pleased that Polster “almost uniformly” agreed with their positions on the dismissal requests and whether to admit various testimony.

Johnson & Johnson has said it will appeal an Oklahoma judge’s Aug. 26 order that it pay US$572.1-million to that state for the company’s role in the opioid epidemic.

Purdue and its owners, the Sackler family, have been in talks on a possible US$10-billion to US$12-billion nationwide settlement of opioid claims, two people familiar with the matter said last week.

That accord could include a bankruptcy filing for the Stamford, Connecticut-based company. Purdue and the Sacklers have denied the allegations.

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