Fulton officials on Monday filed suit against more than two dozen drug manufacturers, distributors and doctors, accusing them of causing an ongoing opioid crisis that has killed hundreds of people in that county alone.

It’s the first such lawsuit in Georgia, though more than 100 others have been filed by cities, counties and state governments nationwide. The United States is in the grip of what the federal government described as an epidemic, with 91 Americans dying every day from an opioid overdose in 2015, according to the Centers for Disease Control and Prevention.

Fulton County has had more opioid deaths than any other county in the state. So far this year, 61 people have died. There were 154 deaths last year, and 104 in 2015. District Attorney Paul Howard said Narcan, a drug that can reverse the effects of an overdose, has been administered 340 times in the last 12 months.

Paul Napoli, an attorney representing the county, said the suit took on manufacturers, distributors and doctors so no one could pass the blame. The breadth of the suit, he said, gives the county a better chance of success.

“It’s like whack-a-mole,” he said. “You really have to hit it at all angles.”

The lawsuit is reminiscent of the tack local governments took against tobacco companies. The county accuses the drug manufacturers, distributors and others of being a public nuisance, as in the tobacco cases. The suit also accused them of fraud for marketing opioids as solutions to chronic pain, and of negligence in not reporting suspicious orders. Since 2007, no distributor refused to ship opioids to any Fulton County pharmacy, even as there was “an alarming and suspicious rise in the ordering of opioid pain medications by retailers throughout Fulton County.”

Dick Anderson, the Fulton County manager, said the suit would help with the “mounting pressure” needed to get drug companies to curtail their practices. If the county does get money from the case, it can use it to help residents through recovery, he said.

“We want to be responsive to this,” Anderson said.

Napoli Shkolnik, the New York firm representing Fulton, has filed suits in 40 other cities and counties, and is working on other suits in metro Atlanta.

The lawsuit does not specify a dollar amount, but asks that Fulton County be reimbursed for expenses related to the crisis. The county asserts that it "has been forced to expend exorbitant amounts of money" because of corporate greed.

"Fulton County has experienced economic costs directly related to the opioid epidemic, including Medicaid costs, law enforcement, judicial, foster care, Narcan costs, loss of productivity and various other costs directly caused by the actions of the defendants," the suit said. The county has spent "millions of dollars each year in its efforts to combat the public nuisance created by Defendants' deceptive marketing campaign."

Napoli said the CDC estimated opioids cost Georgia $450 million in 2007. Since then, that number has only grown.

“The only way you can affect change is their wallet,” said Shayna Sacks, an attorney with Napoli Shkolnik.

The county will not spend any money on the case. Bob Ellis, the vice chairman of the county commission, said he thinks the county’s case is strong and it is time industry officials are “held accountable for their actions.”

“I don’t think we’re going to lose this lawsuit,” he said.

Ellis and County Commissioner Liz Hausmann said the lawsuit is necessary in order for something to change.

“We want people to stop dying,” Hausmann said.

There are 31 parties named in the suit, including drug manufacturers like Purdue, which makes OxyContin, and distributors like McKesson. When parent companies and subsidiaries are taken into account, the county has effectively sued 20 different groups it says are responsible for creating the opioid crisis.

The drug manufacturers, distributors and others knew that opioids were addictive and subject to abuse, especially when prescribed for chronic pain, but set out to convince doctors they were not, and to encourage an increase in prescriptions, the suit said.

In 2012, the suit said, the drugs generated $8 billion in revenue as health care workers wrote 259 million prescriptions for opioid painkillers.

Roderick Edmond, a doctor and an attorney on the case, said people who received painkiller prescriptions after getting their wisdom teeth pulled were ending up shooting heroin in the Bluff, a notorious area where residents often go for drugs.

“We’re at a tipping point with this epidemic,” Ellis said, saying police, jails, morgues and medical examiners’ offices have been taxed nationwide.

Filing in Fulton County State Court, Napoli and Edmond said, will allow them to have locally elected judges and jurors who live in the area decide the case. Edmond said the process would take years.

“We don’t control when they say uncle, but we’re in it 100 percent to the end,” he said.

Fulton County has sued a number of companies and individuals they say are responsible for creating the opioid crisis. They are:

Purdue Pharma

Teva Pharmaceuticals

Cephalon

Johnson & Johnson

Janssen Pharmaceuticals

Endo Pharmaceuticals

Allergan

Actavis

Watson Laboratories

Insys Therapeutics

McKesson Corporation

Cardinal Health

AmerisourceBergen Corporation

Russell Portenoy

Perry Fine

Scott Fishman

Lynn Webster

Medicine Center Pharmacy

Amrac Medical Clinic

J.M. Smith Corporation

Vaxserve

PSS World Medical

Attain Med

Bloodworth Wholesale Drugs