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As lawyers exchange mountains of paper and dicker over the details of a settlement with OxyContin maker Purdue Pharma, Americans are dying from opioids by the tens of thousands in an epidemic that grinds on in state after state, community after community,

» Purdue Pharma bankruptcy filing is just an early step toward the multibillion-dollar settlement,

Human toll

In July, the coroner serving the Columbus, Ohio, area reported nine overdose deaths in just 48 hours. Police in Norwalk, Connecticut, responded to eight overdoses — five fatal — over a six-day period in August and September. In Pennsylvania’s hard-hit York County, the coroner investigated eight suspected overdose deaths in a single week of August, and four in 24 hours.

“This is a battle that’s not going to end easily, and it will be

something we are fighting for a while,” York Coroner Pam Gay said. “It’s going to take a while to see a significant decline.”

York resident Ed Bojarsky got an oxycodone prescription to manage pain from his kidney disease and became addicted, taking “an ungodly amount” of the powerful drug as his illness progressed, his stepmother said.

“You don’t need all that medication,” Tina Bojarski would tell him. But he “didn’t want to hear it,” she said. “Because once you have it, you need it.”

And when he couldn’t get it,

Tina Bojarski said, he turned to the streets. Last month, the 36-year-old died of a suspected overdose. “These doctors do this to people. This medication does this to people. And then what are they supposed to do?” his stepmother said.

Working against addiction

In Wilson, North Carolina, where Purdue has a manufacturing plant, Jonathan Cannon took opioids before moving on to heroin. He died of an overdose at 26. At Cannon’s 2015 funeral, his father, Mike Cannon, warned Jonathan’s friends — who were also using — to go to rehab or risk meeting the same fate.

After their son’s death, Cannon and his wife launched a nonprofit group aimed at helping addicted people, but he said Purdue has never stepped up.

“Where I really struggle more than anything is they realize they’re a major contributor to the problem, but they’re not rolling up their shirt sleeves and saying, ‘Hey, let me get in here and help,’” Cannon said.

State and local governments aren’t waiting on potential Purdue settlement money before taking action, promoting “warm handoff ” policies that connect overdose survivors to immediate drug treatment, dramatically expanding distribution of the life-saving overdose-reversal drug naloxone and keeping better tabs on opioid prescribing.

In the wake of at least 16 fatal overdoses, Elk Grove Village, a community of 32,000 outside Chicago, launched a program in which addicted people can ask police officers and other municipal workers for help without fear of arrest, even if they have illegal drugs or paraphernalia. Drug treatment is offered regardless of ability to pay, and local employers commit to hiring graduates of the program.