York County Solicitor Glenn Smith knows the county coroner's phone number by heart. He calls often to get the most recent number of drug overdose deaths, a number that increases almost every day.
"As of today?" said York County Coroner Pam Gay. "Twenty-two confirmed, another 25 suspected... We just had two this morning."
York County has been hit hard by the opioid crisis, with 176 overdose deaths last year. It is one of 17 Pennsylvania counties to sue Purdue Pharmaceuticals and other companies that make prescription opioids.
Smith said the costs of drug addiction have blown the county's budgets. The coroner's office has had to run an unprecedented number of drug tests. The district attorney's office prosecutes drug-related cases. The public defender program provides counsel for those drug users. And the children and youth program helps the children left behind when a parent dies of an overdose.
"The seams are bursting, and the only option is to reduce the budget in other services provided by the county or increase taxes."
Smith said it's gotten so bad the county's drug and alcohol court has had to turn away people who are addicted to substances other than opioids.
"They happen to be addicted to some other drug," Smith said. "We have had to make a hard decision to say we have to treat the opioids first because these are the people that are dying."
With the lawsuit, Smith hopes to get money to expand the drug court and other programs. "The amount needed is significant. It is less about reimbursing the county and more about giving the county the assets it needs to fight this," he said.
Dauphin County is also suing Purdue and many of the same other companies, including Teva Pharmaceuticals and several doctors "considered to be instrumental in the proliferation of prescription drugs."
Like in neighboring York County, Dauphin County Coroner Graham Hetrick has seen unprecedented drug overdoses in recent years To Hetrick, he doesn't have any doubt drug companies share some of the blame for what's happening in communities across the state.
"To me, I can see gross negligence in both the regulatory bodies and the companies themselves," Hetrick said. "Because you can't look at the figures and not know we had a crisis a long time ago. And it is true, I think, the etiology of this crisis is the introduction of opioids."
Hetrick said his costs have also gone up. The office is spending more money on autopsies. As more versions of illicit fentanyl end up on the street, he has to order more special blood tests. He's also hired two new employees this year, and funds from a lawsuit would help to cover those costs.
York law firm Napoli Shkolnik has taken on more than 100 communities as clients, including both York and Cumberland counties. Attorney Joe Ciaccio said pharmaceutical companies misled doctors and the public about the addictiveness of OxyContin and similar drugs.
Every community has been affected a bit differently, he said, and by rolling out lawsuits on a county level, that increases the odds that counties will actually see that money and be able to use it in the ways they need it.
"Each community may have a couple of problems that are the most pressing for them," Ciaccio said. "That's why it's important that they decide where that money can go."
Still, any recovery from the lawsuits won't ease the financial burdens for many others affected by the financial costs of the crisis. At Susquehanna Township Emergency Medical Services, Director Matt Bailey said he doesn't expect his team will get any help if counties prevail in court.
Like many EMS stations, they're self-funded and they don't receive money from local or state tax dollars. Baily said costs have increased as more heroin laced with fentanyl has flooded the streets. They need more naloxone to revive people who have overdosed.
In York, Solicitor Smith knows the lawsuits aren't going to solve everything. He said the suit will likely take years, and he doesn't know how much his county would get if it were to win. York County's case is being consolidated with other Pennsylvania county lawsuits and will be heard in Delaware County Court. Proceedings will begin later this year.
Still, he said it's worth it to try to help people in need. "Whether it was a factor worker at Harley that hurt his back lifting something, or an athlete who blew out their knee, or even when you got your wisdom teeth taken out, they were handing these prescriptions out like candy."
In a written statement, Purdue Pharmaceuticals said it is "deeply troubled" by opioid abuse and is "dedicated to being part of the solution." The company "vigorously denies" allegations that it is complicit in the crisis and says it looks forward to presenting its defense.
Counties that have filed suit against Purdue and other opioid makers:
WESA's Bridges to Health covers the well-being of Pennsylvanians and is funded by the Jewish Healthcare Foundation.