On Tuesday, a court filing from Attorney General Maura Healey accuses the Sackler family of directly misleading doctors and patients about the risks of OxyContin, the painkiller owned and distributed by the family’s company, Purdue Pharmaceuticals.

Since OxyContin entered the consumer market in 1996, there have been more than 200,000 overdose deaths involving prescription opioids in the United States. The Centers for Disease Control estimate an average of 130 Americans die each day from opioid overdose. As deaths from opioids expanded across the country, and particularly impacted New England, journalists and government prosecutors began to investigate the origins of the crisis and found substantial evidence that Purdue Pharmaceutical used aggressive marketing and sales tactics to mislead and encourage doctors to prescribe the drug to patients, with full knowledge of the drug’s addictive properties.

Years of government investigation resulted in a series of indictments that led to the departure of Purdue’s CEO Michael Friedman, Chief Medical Officer Paul Goldenheim and General Counsel Howard Udell, along with $634.5 million in fines for the company. Throughout the lawsuit, the three insisted the Sackler family were unaware of the more nefarious parts of the business, and no charges of wrongdoing were leveled against any member of the family, despite justice department prosecutors in 2007 claiming that members of the Sackler family were kept abreast of issues regarding patients abusing the drug.

“It’s a horror story,” Art Caplan, medical ethicist and director of the Division of Medical Ethics at New York University’s Langone Medical Center told Boston Public Radio on Wednesday. “Some of the brothers who ran the company, and their family members on the board, all endorsed this horrific strategy of marketing an unsafe drug as safe and then blaming the victims.”

In Healey’s 274-page memorandum, she portrays the Sackler family as not just aware of the drug’s dangerous qualities, but as architects of a series of policies that sought to encourage doctors to prescribe more drugs while blaming users for becoming addicted.

“We have to hammer on the abusers in every way possible,” former Purdue president and chairman Richard Sackler wrote in an email in 2001, according to the court filing. “They are the culprits and the problem. They are reckless criminals.”

In her memorandum, Healey also outlines several insidious efforts the company undertook to market the drug to consumers. In one example, the memo describes how the company funded the creation of a website called "In the Face of Pain" that encouraged visitors to “overcome” their “concerns about addiction” while featuring personal testimonials from individuals who claimed to be helped by OxyContin. Those individuals were later revealed to be consultants paid tens of thousands of dollars by Purdue.

In another instance, the company funded the creation of the book "Exit Wounds" that was marketed as the story of a wounded veteran, but was intended to encourage opioid usage among veterans who the company knew relied on government-sponsored healthcare and were more likely to be able to afford long-term use of the drug.

Purdue Pharmaceuticals said in a statement that Healey was trying to vilify the firm and has over exaggerated the company’s role in the opioid crisis. No member of the Sackler family has made any public statements about the memo.