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Cheshire County plans to join New Hampshire in a $21 billion national opioid settlement with three major drug companies after the state announced its own intention to join Tuesday night and invited dozens of municipalities to follow suit.

Keene is mulling the matter over, according to the city attorney.

“This settlement agreement is the result of years of hard work and dedication by attorneys at the N.H. Department of Justice and throughout the nation,” N.H. Attorney General John Formella said in a news release announcing the state’s plans to join the settlement.

Nationally, drug makers and distributors have faced litigation accusing them of using deceptive marketing practices to push prescription opioid use for chronic pain, despite knowing the medications are highly addictive.

The resulting increase in opioid availability, followed by the use of heroin by those who first became addicted to prescription drugs, led directly to the nationwide spike in drug-overdose deaths.

New Hampshire has been one of the hardest hit states during the opioid epidemic, with more than 3,600 drug-related deaths reported by officials since 2011.

Three drug companies — McKesson Corp., Cardinal Health and Amerisource Bergen — are involved in the pending settlement, according to the news release Tuesday night.

The settlement would require the distributors to pay up to $21 billion over 18 years, with about $115 million over that time frame dedicated to New Hampshire. Most of the funds would be used for the remediation and abatement of the opioid epidemic’s impact, according to the release.

Additionally, the distributors would be required to provide oversight of opioid marketing, sale and distribution, and also implement additional safeguards to prevent prescription opioid abuse.

Formella sent letters to the 28 Granite State counties and communities that had filed their own opioid lawsuits, including Keene and Cheshire County, to see if they want to join the settlement. They have until January to decide, according to the letter.

Cheshire County had not yet received the letter as of Wednesday afternoon but is prepared to join once it does, according to County Administrator Chris Coates.

“We’ve already submitted everything we’re supposed to submit,” he said.

Keene City Attorney Thomas Mullins said the city has not yet reviewed the settlement’s details, which is why it hasn’t yet decided whether to join.

In April 2018, Keene sued about a dozen pharmaceutical manufacturers and distributors. City officials estimated in Keene’s initial filing in U.S. District Court in Concord that the opioid crisis costs the city hundreds of thousands of dollars per year in municipal services.

This litigation was almost immediately consolidated into a national multi-tort lawsuit, according to Mullins, which allows one group of attorneys to represent all those affected.

All New Hampshire counties, including Cheshire, joined in on the national lawsuit that same year, Coates said.

If the national settlement is finalized, the release says it would resolve all other opioid litigation against the three companies that would be part of the agreement.

And if more communities join in on the national settlement, it will “maximize the amount paid to the State,” according to the release.

Sentinel staff writer Caleb Symons contributed to this report.

Olivia Belanger can be reached at 352-1234, extension 1439, or obelanger@keenesentinel.com. Follow her on Twitter @OBelangerKS.