Johnson & Johnson and three other companies have agreed to pay $26 billion to U.S. states in order to resolve thousands of lawsuits filed over the opioid epidemic, reported NBC News

States, municipalities, counties, tribal nations and school districts across the nation accused J&J and three of the largest opioid distributors—Cardinal Health, AmerisourceBergen and McKesson—of flooding communities around the country with prescription opioid painkillers. 

According to the Centers for Disease Control and Prevention, over 500,000 people died from opioid drug overdoses from 2009 to 2019. Harvard’s T.H. Chan School of Public Health has gathered initial data that suggests 2020 will be the worst year for opioid overdoses yet.

NBC News reports that under the agreement, the three drug distributors will pay up to $21 billion over the next 18 years. Johnson & Johnson will pay up to $5 billion over nine years, with up to $3.7 billion paid during the first three years.

However, more than 40 states and hundreds of cities and counties still need to agree to the settlement. 

At least one state has indicated that it would reject the settlement. Washington state attorney general, Bob Ferguson, said in a statement, “The settlement is, to be blunt, not nearly good enough for Washington." Ferguson added, "It stretches woefully insufficient funds into small payments over nearly 20 years, to be shared among more than 300 Washington jurisdictions."

Should the settlement agreement move forward, Johnson & Johnson and the three opioid-distributing giants would not have to admit liability in fueling the nation’s opioid crisis, which worsened during the coronavirus pandemic. In 2020, there were 93,000 opioid deaths, which is 21,000 more than were recorded the previous year.

According to FiercePharma.com, the settlement coincides with a $1.1 billion opioid settlement agreement between Cardinal, AmerisourceBergen and McKesson and New York State. Additionally, J&J agreed to pay New York $230 million to escape opioid litigation. 

Similar to the New York state settlement agreement, the nationwide opioid settlement, should it be approved, would ensure that money from the settlement will be allocated toward treating and preventing opioid addiction. Settlement funds would also cover states’ expenses for litigation. Additionally, the three opioid distributors agreed to establish a plan to target suspicious drug orders. 

The $26 billion settlement figure is not set in stone, FiercePharma reports. The final figure will be based upon how many states and municipalities agree to join the settlement in the next coming months. If not enough states and municipalities agree to the offer, FiercePharma reports that J&J and the three drug distributors could back out of the agreement. 

Other defendants named in opioid lawsuits are not included in the $26 billion settlement agreement.