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ST. PETERSBURG, Fla. — A trial opened Monday in Florida’s opioid epidemic lawsuit against the Walgreens pharmacy chain, which state officials accuse of prioritizing profits over health by improperly dispensing millions of powerful painkillers that caused tens of thousands of deaths.

The trial, in Pasco County north of Tampa, comes after other defendants in the Florida lawsuit including the CVS drug store chain settled for an estimated $870 million. The state could seek similar massive damages from Walgreens in the jury trial expected to last a few weeks.

OxyContin maker Purdue Pharma has a tentative nationwide deal that includes $6 billion in cash from members of the Sackler family who own the company. In all, settlements, civil and criminal penalties around the country since 2007 have totaled over $45 billion, according to an Associated Press tally.

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In Florida, the state’s case hinges on accusations that as Walgreens dispensed more than 4.3 billion total opioid pills in Florida from May 2006 to June 2021, more than half contained one or more easily recognized red flags for abuse, fraud and addiction that the company should have noticed and acted upon.

The evidence will show Walgreens knowingly profited from the opioid crisis, said attorney Jim Webster for the state in an opening statement, which was attended by Florida Attorney General Ashley Moody. Walgreens wasn’t just greedy. It was fueling the opioid crisis that was killing people.

Walgreens is based in Deerfield, Illinois, and operates more than 9,000 stores in all 50 states, according to the company website. About 820 of those locations are in Florida.

Walgreens attorney Steve Derringer told jurors they should focus on how manufacturers such as Purdue Pharma misled pharmacies on opioid addictive properties. He also noted that Florida did little as the opioid epidemic arose, particularly the predatory pill mills that proliferated in the state before a crackdown finally ended them.

Walgreens had nothing to do with any of that, Derringer said in his opening statement. They (drug makers) caused this epidemic by misrepresenting the risks and benefits to pharmacies.

The opioid epidemic has been linked to more than 500,000 deaths in the U.S. over the past two decades, counting those from prescription painkillers such as OxyContin and generic oxycodone as well as illicit drugs such as heroin and illegally produced fentanyl.

In Florida, Webster said, more than 39,000 Floridians died from opioid abuse or related problems between 1999 and 2020. Walgreens, he said, sold about one of every four opioids in the state over a similar time span often under questionable circumstances, such as a shady doctor, fake prescriptions or huge amounts of drugs obviously far in excess of what was necessary for a given patient.

Walgreens was the last line of defense, Webster said. Walgreens failed its duty to investigate suspicious prescriptions.”

Florida has spent some $14 billion over the last 20 years for multiple opioid-related costs, ranging from criminal justice to drug rehabilitation for addicts to treatment for opioid-addicted infants, Webster said. The state will seek billions of dollars in damages in the Walgreens case.

In the same case, Moody said CVS Health Corp. and CVS Pharmacy Inc. will pay the state $484 million. Teva Pharmaceuticals Industries Ltd. agreed to pay $195 million and Allergan PLC more than $134 million.

Florida has previously obtained millions of dollars in opioid settlements involving McKesson Corp., Cardinal Health Inc., Johnson & Johnson Inc. and AmerisourceBergen Corp.