CHARLESTON — West Virginia Attorney General Darrell McGraw announced lawsuits Tuesday against 14 pharmaceutical drug distributors, alleging their negligent practices have helped fuel the state’s pain pill abuse epidemic.

The complaints in Boone County Circuit Court seek to ensure the companies halt all shipments to West Virginia state that aren’t for legitimate medical purposes. They also ask a judge to require that they flag suspicious drug orders to the state Board of Pharmacy.

The lawsuits also request a court-ordered program to monitor the health of prescription drug users, alleging the negligence has exposed these people to addiction and misuse. Alleging various consumer protection and antitrust violations as well, the filings seek damage awards to compensate West Virginia for costs to its health and public safety systems from prescription drug abuse, overdoses and related crimes.

West Virginia suffers the nation’s highest drug overdose death rate, with most of those cases involving prescription drugs, the lawsuits note. Fatal prescription drug-related overdoses quadrupled between 2001 and 2008 in West Virginia to 21.5 deaths per 100,000 residents, the filings said. Ongoing federal probes centered on southern West Virginia have shut down suspected “pill mills” that unlawfully provide pain drugs or prescriptions, and have led to the criminal convictions of physicians, pharmacists and their staffers.

“Prescription drug abuse costs West Virginians over $430 million a year, devastates families, and hangs enormous burdens on our hospitals, courts, law enforcement, and communities,” McGraw said in a Tuesday statement. “With today’s filing, we are seeking to make major drug distributors that have substantially (benefited) from prescription drug abuse accept responsibility and pay for their illicit actions.”

A spokesman for the parent company of one defendant, Anda Inc. of Florida, said it does not comment on pending lawsuits but that it seeks to avoid the sort of practices alleged by McGraw.

The official, Charlie Mayr of Watson Pharmaceuticals, said the company’s safeguards include sophisticated monitoring that allows the company to halt and investigate suspicious ordering patterns. The company also doesn’t ship directly to physician offices or to clinics or other places labeled “pill mills” by authorities.

Mayr also noted statistics suggesting that more than 70 percent of young pain pill abusers obtain their drugs through friends and relatives, at least sometimes through theft. Both state and federal officials in West Virginia sponsor events to allow people to hand in unused prescription drugs so they can be safely destroyed.

“We do recognize this and we do everything in our power to avoid the diversion of these products,” Mayr said, adding that the industry takes a similar position.

The other defendant companies did not respond to requests for comment Tuesday. At least two were recently targeted by the U.S. Drug Enforcement Administration for their distribution practices.

A Florida facility of defendant Cardinal Health Inc. of Ohio cannot ship controlled substances for two years as part of a settlement reached last month after the DEA alleged it distributed amounts of the powerful pain drug oxycodone far in excess of legitimate medical needs.

The company earlier paid $34 million after DEA cited that same Lakeland, Fla., facility for allegedly failing to flag suspicious orders for hydrocodone, the main ingredient in painkillers like Vicodin. Cardinal Health is the sole defendant in one of McGraw’s lawsuits.

The DEA also barred defendant Harvard Drug Group of Michigan from distributing oxycodone  in 2010, alleging the company should have known that some Florida customers in were trafficking in painkillers. The federal agency relented on a proposed ban of less-potent painkillers such as hydrocodone supplied by that company.

McGraw’s lawsuits allege the 14 companies have contributed to an abuse epidemic that has Charleston Area Medical Center reporting that narcotic abuse plays a role in the injuries of 20 percent of its hospital trauma patients. The filings also cited how the Mingo County town of Kermit, with 300 residents, has a pharmacy that received 3.1 million dosage units of hydrocodone in 2006.

“The Defendants have willfully turned a blind eye towards the actual facts by regularly distributing large quantities of controlled substances to customers who are serving a customer base comprised of individuals who are themselves abusing prescription medications, many of whom are addicted and all of whom can reasonably be expected to become addicted.

The other defendants are: Alabama’s Associated Pharmacies; Delaware-incorporated companies Amerisourcebergen Drug and H.D. Smith Wholesale Drug Co.; Kentucky companies Quest Pharmaceuticals and Richie Pharmacal Co.; Auburn Pharmaceutical Co. of Michigan; Ohio companies Keysource Medical, Masters Pharmaceuticals and Miami-Luken Inc.; J.M. Smith Corp., of South Carolina; and Top Rx Inc. of Tennessee.