As counties, municipalities, Native American tribes, now even the White House, pile on with lawsuits filed against the producers of opioids, Madison County continues to debate whether to get involved.
No decision has yet been made by the county judiciary committee over whether it too will allege a direct line between the marketing and sale of opioids from the 1990s to the crisis gripping the country today, a pipeline from the legal to the illicit, and the estimated 40,000 opioid-related deaths last year.
Some of the members still have some questions before being comfortable and saying yes or no to joining a suit, Mike Walters, the chair of the Madison County Board judiciary committee, told the Madison Record.
While Walters did not want to speak to what the exact questions are, there is some concern over whether the county will land in a suit that expands beyond those pharmaceutical companies that sold opioids.
There is talk, he said, of the suits entangling doctors, pharmacists, hospitals, and those pharma companies that did not even sell the opioids.
"We are fearful it could be expanded," Walters said, adding there is no timeline on when a decision will be made as he suspects that when answers are received to questions, there will be more.
But he is in touch with State's Attorney Tom Gibbons, who is not indicating yet that he wants this either wrapped up or moved forward. Gibbons has the power to use is office to join a suit independent of the board.
"There are also people concerned that this will be the new mesothelioma," said Walters, that attorneys may be attracted to Madison County as a venue for suits, which he definitely does not want to see happen.
"People say it brings people into the county, but business is not coming," said Walters. "The mesothelemia (asbestos) cases have had a negative impact on the county."
But such a scenario becomes ever less likely the longer the county takes to make a decision to join a suit. Large scale multi-district suits have been filed elsewhere.
"I don't know what the likelihood there would be for that to happen as there are counties that are far ahead of us," Gibbons told the judiciary committee earlier this year. "I suspect because we have taken a more cautious approach that that train may have already left the station."
According to preliminary figures released by the Centers for Disease Control, more than 70,000 people died of drug overdoses last year. Of those, 30,000 were linked to fentanyl, a staggering rise from close to none in 2011.
While both legal opioid prescriptions and overdose deaths have dipped considerably in recent years, the argument is that pharma companies are responsible for pumping so many out in previous years that it led directly to people getting hooked, including young people plundering medicine cabinets.
And the next step was on to cheaper street drugs, much of which contained more and more lethal illicitly manufactured fentanyl.
Walters said of this particular argument: "I am not going to point fingers at anybody, we have to just wait and see where we go from here."
A number of Illinois counties, cities and villages have filed suit, including most recently in May one taken by 11 in the Chicago suburbs. Among those being named in the suit are three three doctors, all with revoked licenses.
President Trump told his Attorney General Jeff Sessions at a cabinet meeting Thursday to file a federal lawsuit against un-named pharmaceutical companies, though the Justice Department has already joined various state-based suits.
Madison County has been mulling joining a suit since last November when the judiciary committee hosted local lawyers involved in actions elsewhere in the country. And a judiciary committee hearing was held in January to further discuss the issue.
But hundreds of cities and counties have filed suit, and collectively claim to have spent billions on tackling the crisis, according to a Bloomberg report in July.
Bloomberg also published an analysis of court records and lawsuit filings, and found that more than 900 actions have been filed or have been brought on behalf of states, local government, tribes, and others.