Five more state attorneys general announced legal filings Thursday seeking to hold the company that makes OxyContin responsible for an opioid addiction crisis that has become the biggest cause of accidental deaths across the country and in many states.

The company, Connecticut-based Purdue Pharma, blasted the claims. “The states cannot link the conduct alleged to the harm described, and so they have invented stunningly overbroad legal theories, which if adopted by courts, will undermine the bedrock legal principle of causation,” Purdue said in a statement.

The new filings in Iowa, Kansas, Maryland, West Virginia and Wisconsin mean 45 states have now taken legal action in recent years against Purdue. Michigan announced last week that it’s looking for law firms to help it sue the industry, too.

All the new filings but the one in Kansas also named Richard Sackler, a former company president and a member of the family that owns the Connecticut-based firm, as a defendant. Maryland named other members of the Sackler family in its administrative action.

Some states have also sued other drugmakers or distributors as the fallout from the crisis moves increasingly to courthouses.

“There’s far too much senseless death in West Virginia and many ruined lives,” that state’s Attorney General Patrick Morrisey said Thursday. “We cannot and will not tolerate companies that allegedly use false and misleading information to deceive medical personnel and patients.”

States’ suits are among the highest-profile claims in flood of litigation over the crisis. Opioids, including prescription painkillers and related drugs such as heroin and fentanyl, were involved in nearly 48,000 deaths in the U.S. in 2017 — more than AIDS killed at the peak of that epidemic and more than auto accidents kill annually. The death toll since 2000 is 391,000.

The states and about 2,000 local and tribal governments that have sued assert that Purdue and other companies downplayed the addiction dangers of the drugs and used sales representatives to encourage doctors to prescribe even more of them.

But the legal cases are complicated. Purdue points out that the majority of the recent deaths are linked to heroin or fentanyl — not prescription drugs. States say most users, though, start with prescription pills, whether they’re prescribed to them or diverted.

A judge in North Dakota last week dismissed all of that state’s claims against Purdue, perhaps the company’s biggest court win in a round of litigation. In a written ruling that the state says it will appeal, Judge James Hill questioned the idea of blaming a company that makes a legal product for the deaths. “Purdue cannot control how doctors prescribe its products and it certainly cannot control how individual patients use and respond to its products,” the judge wrote, “regardless of any warning or instruction Purdue may give.”

Mark Cheffo, a lawyer for Purdue, said he’s hoping other judges will reach similar conclusions as they delve into the cases.

All the cases filed by state governments except one are working their way through state courts. Alabama’s case is among about 1,500 in federal court and being overseen by one federal judge based in Cleveland. He has rejected arguments to dismiss the suits and has scheduled an initial trial in October for the claims of two Ohio counties.

The looming trial could put pressure on Purdue and other companies to settle the cases — something the judge has said he wants to see.

In March, Purdue and the Sackler family, which owns the company, settled with Oklahoma for $270 million. Purdue also settled with Kentucky in 2015 for $24 million. A handful of other companies have entered deals with states in the last few years, including drug distribution firms that have agreed to pay West Virginia a total of $84 million.

Pennsylvania Attorney General Josh Shapiro, one of the leaders of a multistate investigation of the opioid crisis, announced a lawsuit earlier this week against Purdue, saying the company was not working in good faith on a settlement. Iowa Attorney General Tom Miller also said lack of progress in talks was a factor in filing a lawsuit now. “There was a hope that the negotiations would yield a settlement for all the states,” he said. “And may still.”

Cheffo, the Purdue lawyer, disputed that in a phone interview Thursday. “While we recognize the complication of a resolution process involving so many different parties and interests and certainly cannot get into the details of them, we remain optimistic and believe that both sides are participating in good faith in an effort to try to reach some resolution that is in the best interests of the parties and the public health.”

A lawyer representing members of the Sackler family has said the family would also like to settle.

For some states, there’s a political element in deciding to join the litigation now.

For instance, Wisconsin didn’t sue earlier because Republican Attorney General Brad Schimel opted to join a multistate investigation instead. Schimel argued that it would be a faster way to hold them accountable. But Schimel was defeated in November by Democrat Josh Kaul, who campaigned on a platform that included filing opioid lawsuits.