US pharmaceutical operators Walgreens Boots Alliance, Walmart Inc and Kroger Co faced the state of New Mexico on Tuesday in the latest lawsuit over their alleged role in the US opioid epidemic, following recent high-profile losses by pharmacies in other trials.

New Mexico Attorney General Hector Balderas argued in his opening remarks that pharmacies should act as a “dam” against the flood of illegitimate opioid prescriptions by refusing to fill prescriptions that would set off alarm bells indicating abuse.

“I believe that the defendants had a legal obligation to contain the avalanche and protect New Mexicans from harm,” Judge Francis Matthew, who is presiding over the non-jury trial in the First Judicial Circuit of New Mexico in Santa Fe, told Judge Francis Matthew.

Dan Alberstone, another attorney for the state, said the three companies had dispensed more than 550 million opioid pills in New Mexico from 2006 to 2019, more than 263 for every person in the state.

John Majors, a Walmart attorney who issued an opening statement defending the three companies, argued that pharmacists should exercise “professional judgment” rather than rely on the “mechanical application of red flags.”

He said the state could not prove that pharmacists knowingly dispensed illegitimate prescriptions.

The opioid epidemic in the United States has caused more than 500,000 overdose deaths in two decades, according to government data. More than 3,300 lawsuits have been filed, mostly by local governments, accusing drugmakers, distributors and pharmacy chains of fueling the crisis.

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