Jackson Smith of Fresno died at the age of 22 from an opioid overdose. The toll of these incidents has prompted local public agencies to file a lawsuit against the opioid industry.

For two months, Fresno resident Jackson Smith seemed to be getting better as he was treated for an addiction to alcohol and opioids. In June of 2016, however, his mother Pamela said that he was showing signs that he was using again.

Then, at 2:42 a.m. July 3, 2016, Pamela Smith received the call that would change her life. At 22, Jackson had overdosed and wasn’t breathing. She would see him for the last time at Saint Agnes Medical Center a half-hour later.

“Within minutes of us walking into that room, the doctor called it,” Smith said. “Something that you never forget — the time of death — 3:18.”

Autopsy reports would later reveal Jackson was killed by OxyContin laced with fentanyl, a powerful opioid that can kill users even in small amounts. The pills came from a street dealer.

More than 30 counties in California have filed lawsuits against those companies deemed responsible for the manufacture and distribution of opioid-type pain medications. Likely companies to face litigation include OxyContin manufacturer Purdue Pharma and Janssen Pharmaceuticals — a subsidiary of Johnson & Johnson — the manufacturer of the fentanyl drug Duragesic.

Last month, the Madera County Board of Supervisors announced that the county would also join the lawsuit. Meanwhile, Tammie Adkins of the Tulare County Health and Human Services Agency confirmed that Tulare County is also in. The counties to formally confirm involvement in the lawsuit represent some 10.5 million residents in the state.

At the Fresno Healthcare Coalition’s Strategic Forum on May 16 — Dawan Utecht, the director of Fresno County Behavioral Health — was asked if Fresno County was joining the lawsuit, to which she replied that they were considering the option.

On announcement of the lawsuit, Madera County Counsel Regina Garza stated that the litigation sought to recover taxpayer money used to respond to the crisis, which was the result of companies whose “irresponsible actions placed profit over public safety.”

Along with human suffering and the costs to communities in the form of law enforcement, treatment and other expenses, Fresno attorney Dan Gordon pointed out a loss of revenue in taxes paid to the municipality/county involved. Gordon — Smith’s boss and someone who knew Jackson from age 5—said that money is invested in their education. When they are killed, the community takes a financial hit overlooked by the personal loss.

“The way that they get it back is after they’re out of school, they’re productive and they pay taxes, and that supports the generation of children,” Gordon said. “That’s a huge cost to society that I don’t think a lot of people think about.”

Smith said that she fully supports Fresno County in taking part in the lawsuit, along with Parents and Addicts in Need (P.A.I.N.) founder Flindt Andersen.

“My big question is why wouldn’t the county want to join in this lawsuit?” Andersen said. “This is a national epidemic and this has effected every county everywhere in the United States.”

A former opioid user, Andersen now runs P.A.I.N. in order to help people with substance abuse issues achieve sobriety. He is also heavily involved in public speaking about the dangers of opioids and the effects they’ve had in public schools — especially in Clovis. According to Andersen, approximately 80 percent of P.A.I.N.’s clientele come from Clovis schools. Andersen added that the opioid crisis has hit schools the hardest where parents are able to afford prescriptions.

Critics of the pharmaceutical companies claim they were irresponsible in the marketing and distribution of the pills. This allegedly included the idea of pain as a “fifth vital sign” by the Joint Commission and the Center for Medicare Services (CMS).

“That was pretty much codified through this influence,” said Dr. Michael Habibe of Saint Agnes Medical Center in an interview last November. “The state medical boards were influenced also by industry to mandate that doctors as a condition for maintaining their licenses to start learning to prescribe these medicines.”

The reported result of this was the overprescription of painkillers for minor injuries and surgeries. Smith said this was how her son was introduced to opioids — a prescription to Norco following a skateboarding accident.

“It just makes me really angry because all these lives and all they did, they lied about this stuff, so they could load their pockets, and with no regard for human life,” Smith said. “They have no idea what it feels like to lose a child.”

The plan of the litigating counties is to file each suit in a federal court, after which they will be transferred to multi-district litigation that is being held in Ohio, along with more than 500 public entities that have filed similar suits.