The ruling by an Oklahoma judge that Johnson & Johnson intentionally played down the dangers and oversold the benefits of opioids is an important milestone in the campaign to make drug companies accountable for their role in creating the prescription painkiller epidemic in the United States. Concluding that Johnson & Johnson had conducted "false, misleading and dangerous marketing campaigns" that had caused increasing rates of addication and overdose deaths, the judge ordered the company to pay the state $572 million (€515 million). That sum was far less than the $17 billion the state had argued it needed to deal with the impact of the drug crisis on Oklahoma, and Johnson & Johnson's shares were up yesterday as a result (the company intends to appeal the verdict).
But the significance of the ruling goes far beyond the scale of the award. This was the first time that a drug manufacturer went on trial for the death and destruction caused by the epidemic, which has resulted in 6,000 deaths by overdose in Oklahoma alone and was estimated in 2017 to have cost the US $500 billion (€450 billion). It was therefore seen as a bellwether for other legal cases across the country. Of particular note is that Judge Thad Balkman accepted the state's use of public-nuisance laws to punish predatory drug marketing, in effect endorsing the argument, made by communities across the US, that the epidemic significantly affected public health. That will give a boost to more than 45 other states and 2,000 local governments who plan to bring similar arguments in cases of their own.
Responsibility for the opioid crisis lies with a range of players, from doctors who over-prescribed to the Drug Enforcement Administration, which failed to heed the signs of large-scale inappropriate prescribing. But it was the drug companies themselves who, starting in the early 2000s, flooded the market with addictive painkillers then aggressively marketed them and played down the risks. They made huge profits on drugs that wrought havoc on vulnerable communities. Now, not before time, a reckoning looks likely.