With language reminiscent of the government’s legal attack against the tobacco industry beginning in 1999, officials from Orange and Santa Clara counties in California filed suit against five of the world’s largest narcotics manufacturers last month. Both counties have been hit hard by overdose deaths, emergency room visits, and rising medical costs associated with prescription narcotics.

The lawsuit names Actavis, Endo Health Solutions Inc., Johnson & Johnson’s Janssen Pharmaceuticals, Purdue Pharma, and Teva Pharmaceutical Industries’ Cephalon Inc. and alleges that the companies essentially caused the nation’s prescription drug epidemic through false advertising, deceptive business practices, and by creating a public nuisance to manipulate doctors and reap huge profits.

According to court documents, the companies are accused of encouraging patients to ask their doctors for painkillers such as OxyContin to treat relatively common conditions such as headaches, arthritis, and back pain. The drug manufacturers promoted these narcotic painkillers as safer than they actually and promised unproven benefits like improved sleep and quality of life, the suit says.

The drug manufacturers’ marketing campaigns, carried out over the past 20 years, have encouraged doctors to turn to narcotic prescriptions as a first resort rather than the last for all types of pain, and many patients stay on the drugs indefinitely.

Twenty years ago, the narcotics industry was selling to a relatively small market because of the long-held fear of addiction that stopped doctors from prescribing the powerful painkillers for anything but cancer and end-of-life pain. The lawsuit claims that to expand their market, drug companies engaged in a dishonest campaign to reeducate doctors and revolutionized the treatment of pain associated with a wider array of ailments.

According to the suit, it was the marketing and not any medical breakthrough that heightened the prescribing of narcotics for chronic pain and increased the potential for use and abuse. Painkillers are reportedly involved in over 16,000 fatalities in the U.S. each year, beating out traffic accidents as a leading cause of death.

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