North Carolina state government lawyers are suing a pharmaceutical company whose former leaders already face criminal charges elsewhere related to an alleged nationwide bribery scheme involving a powerful opioid.

Attorney General Josh Stein announced an unfair trade lawsuit Thursday he filed in Wake County Superior Court against Arizona-based Insys Therapeutics for an unlawful marketing campaign he says rewarded doctors who prescribed the drug Subsys.

Subsys, a mouth spray, contains fentanyl and is approved only for cancer patients dealing with extreme bouts of pain. It’s 50 times stronger than heroin and 100 times stronger than morphine, according to the lawsuit.

Insys officials gave financial inducements to physicians who prescribed Subsys to noncancer patients and sponsored presentations in Chapel Hill and Winston-Salem to expand use, the lawsuit alleges while seeking civil penalties and forcing the company to give up money generated through its scheme.

The lawsuit also accuses the company of misleading insurers about the drug so they would cover the drug’s use and providing incentives to its sales staff to get physicians to switch the medications of noncancer patients to Subsys.

Stein, who is also involved in a multistate investigation of major opioid manufacturers, said actions like those by Subsys are “unconscionable” and “unacceptable,” particularly in light of the nation’s opioid epidemic. Nearly four people a day in North Carolina die from unintentional drug overdoses, according to officials.

“As millions of Americans were becoming addicted to these prescription pain killers and communities were struggling to respond to the crisis, we allege that Insys unlawfully pushed these powerful pain killers on North Carolina patients just to make more money,” Stein said at a news conference.

Federal prosecutors in Massachusetts indicted company founder John Kapoor in October in connection with the kickback allegations, while former executives — including one based in Charlotte — face trial next year. Kapoor’s lawyer said he’ll fight the charges.

Through a spokesman, Insys declined comment Thursday on Stein’s lawsuit. At the time of Kapoor’s indictment, the company said in a statement that it is now under new management and has taken “necessary and appropriate steps to prevent past mistakes from happening in the future.”

Several former Insys employees and health care providers have pleaded guilty to felony charges around the country. New Jersey’s attorney general also filed a lawsuit in October.

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