• In a landmark decision, an Oklahoma judge has ordered Johnson & Johnson to pay the state $572 million for the corporation’s role in the opioid epidemic
• This decision likely portends future awards or settlements for state and local governments, including in Michigan
• As a principle of good governance, any money received by Michigan and its local governments in relation to opioid cases should be directed to policies, programs, and services that improve people’s health (in particular, those directly related to opioid use disorders)

Earlier this week, a judge in Oklahoma ruled that Johnson & Johnson and its subsidiaries were culpable in the state’s opioid crisis, and ordered payment of $572 million to the state of Oklahoma. This is more than double the $270 million settlement between the state of Oklahoma and Purdue Pharma in March—marking the beginning of a legal reckoning for the ongoing, disastrous opioid epidemic that has ravaged many parts of the United States.

Numerous counties and cities in Michigan have filed or joined lawsuits against opioid manufacturers and distributors. Additionally, Michigan Attorney General Dana Nessel has indicated her interest in joining the more than 40 other states pursuing opioid lawsuits, but she may be hindered by Michigan Public Act 249 of 1995—the law states “a manufacturer or seller is not liable for a drug that was approved by the [U.S.] Food and Drug Administration.”  

In recent years, opioid prescriptions have been linked to thousands of overdose deaths in Michigan. This has exacted a substantial emotional toll on affected individuals, families, and communities; it has also created substantial economic costs for state and local governments. Ongoing response must seek to make systemic changes to prevent new addictions while also mitigating harm and providing treatment to those already affected. 

Framing the crisis from a public health perspective highlights the kind of complex, multifaceted response that is needed, including improvements in data collection, resource allocation, clinical practice, stigma reduction, criminal justice policies, regulation of controlled substances, and approaches to both treatment and harm mitigation. Michigan is mounting an admirable response to the opioid crisis, but the response was delayed, and substantial harm has already been done.

The possibility of a future opioid-lawsuit windfall might provide optimism that Michigan will get the resources needed to continue its response. Parallels to the 1998 tobacco Master Settlement Agreement are nonetheless cause for skepticism that these funds would be used to mitigate addiction and improve health in communities affected by opioids. 

Tobacco settlement dollars have been spent on an assortment of state programs and activities, from economic development, tourism, and education programs to the old standby of plugging various budget holes. Given the huge role tobacco has played in impairing health and shortening life expectancy for Michiganders, comprehensive tobacco prevention and control efforts, as well as general health promotion and improvement, should have been the primary focus of these funds. Over the period that Michigan has been receiving tobacco settlement money, however, the Citizens Research Council highlighted a 15-year disinvestment in public health by the state. Moreover, with the advent of vaping (and Michigan’s slow, half-hearted response to it), youth tobacco use appears to be once again increasing, erasing past progress.

The allocation of tobacco settlement funds is one example, among many, of legislators directing revenues to fill unrelated budget holes rather than addressing long-term needs associated with the source of the revenue. Michigan voters made a similar mistake when approving a ballot proposal that directed marijuana tax revenue to roads and schools rather than substance abuse treatment, health education, and data collection.

Regardless of whether Michigan (or its various local governments) ever receives new revenue from a future opioid settlement, the costs for addressing the crisis are ongoing and must be met. Moreover, it is essential that Michigan place an ever greater focus on population health programs and policies to improve the wellbeing of its people and, hopefully, head off future public health crises before they emerge.