A county in New York state has sued Purdue Pharma LP, Johnson & Johnson and other drugmakers, accusing them of engaging in fraudulent marketing that played down the risks of prescription opioid painkillers, leading to a drug epidemic. The lawsuit, which also named units of Teva Pharmaceutical Industries Ltd and Endo International Plc as defendants, was announced by Orange County, New York, which is located in the southeastern part of the state.

Reuters reports that the case, filed in a New York state court is the latest lawsuit by local and state governments seeking to hold drugmakers accountable for a national opioid epidemic. The lawsuit claims the drugmakers through deceptive marketing misrepresented the dangers of long-term opioid use to doctors, pharmacists and patients. Those misrepresentations about drugs like Purdue’s OxyContin and Endo’s Opana ER led Orange County New York to incur health care, criminal justice and other costs related to addiction, the lawsuit said.

Drugmakers also face lawsuits by Santa Clara and Orange counties in California, the city of Chicago and Mississippi over their marketing practices.

Santa Clara and Orange (California) counties filed a case in 2015 in Orange County Superior Court. They alleged that Purdue Pharma, Cephalon, Janssen Pharmaceuticals, Endo Health Solutions and Actavis violated California’s false advertising and unfair competition laws and created a public nuisance. The case was placed on hold in 2015 pending the outcome of FDA investigations that were underway at the time.

Chicago sued Teva Pharmaceuticals, Purdue Pharma Inc. and other drugmakers in 2014, saying they misled doctors and the public about the addictive nature of opiates and pushed prescriptions despite known dangers of addiction. A defense request for a stay order pending FDA investigations was denied in September 2016, and the Chicago case is still active.

Some state attorneys general have started similar investigations. J&J this month said New Jersey’s attorney general had issued a subpoena related to opioid marketing.

Orange County New York, which has a population of about 379,000, said it recorded 943 opioid-related emergency department admissions in 2014 and 44 deaths from overdoses involving opioid pain relievers in 2015.

Orange County New York Executive Steven Neuhaus said in a statement the county has been working with non-profits and doctors to increase awareness to opioid-related problems. “At the same time, we want those responsible to compensate the taxpayers for the public funds the county has had to pay to address opioid addiction,” he said.

The lawsuit also named four physicians as defendants.

J&J in a statement called the allegations “unfounded” and noted its drugs carry U.S. Food and Drug Administration-mandated warnings.

Purdue said it shares officials’ concerns about the opioid crisis and is “committed to working collaboratively to find solutions.”

Endo did not respond to a request for comment. Teva declined to comment.

Opioid drugs, including prescription painkillers and heroin, killed over 33,000 people in the United States in 2015, more than any year on record, the U.S. Centers for Disease Control and Prevention said.

Orange County’s lawsuit is the fourth since August by a New York county seeking to recover costs related to opioid addiction. Several other counties are also considering suing.