Opioid Lawsuits

Opioid lawsuits are one of the largest types of liability settlements in the United States, with agreements reaching almost $60 billion. These cases reshaped how the country creates opioid regulatory rules and patient protection. If you have questions related to opioid cases, it’s a good idea to contact a healthcare attorney. They can help you understand the intricate laws that govern the opioid crisis.

Understanding the Regulatory Foundation of Opioid Cases

The Controlled Substances Act (CSA) establishes the provisions that regulate controlled substances, including prescribing opioids. It was enacted in 1970 as Title II of the Comprehensive Drug Abuse Prevention and Control Act. This Act serves as the legal foundation for many opioid related enforcement and lawsuits.

Pharmaceutical companies and drug manufacturers violated CSA requirements through their business practices. These practices led to widespread addiction and engendered subsequent legal actions.

The term “opioid” refers to a broad class of drugs. It includes poppy-derived opiates such as morphine and heroin, along with synthetic opiates such as fentanyl, oxycodone, and hydrocodone. Drug makers marketed these substances as safe and not prone to abuse due to protective coatings that allow for time-released dosage. However, many patients remained addicted after their prescriptions ran out. This led to the substance abuse of heroin, fentanyl, or other illicit opioids.

Companies sold these drugs using false claims, prompting the federal government to implement stricter protocols. Under the CSA, pharmaceutical companies manufacturing these drugs must register with the Drug Enforcement Administration (DEA) and comply with strict manufacturing quotas and reporting requirements.

Often, opioid lawsuits concern the companies’ failure to follow CSA requirements. Companies fail to monitor suspicious orders of controlled substances and to report these orders to prevent illegal use and drug abuse.

Opioid Lawsuits: Federal, Tribal, State, and Local

State resources became stressed due to skyrocketing addiction rates and overdoses. As a result, many states filed lawsuits against opioid manufacturers and distributors. There were also suits filed by the Cherokee Nation and other Native American tribes. Patient advocacy groups also supported these efforts to hold companies accountable. 

A growing list of states filed lawsuits. These states include Ohio, Mississippi, Oklahoma, Missouri, New Hampshire, Texas, Florida, Nevada, North Carolina, North Dakota, and Tennessee. Ohio was particularly hard-hit by the epidemic.

These complaints were consolidated into federal Multi-District Litigation proceedings in the Federal District Court in Cleveland, Ohio, in December 2017. Plaintiffs in the suit alleged the following, stating that they contributed to the current opioid epidemic:

• Manufacturers of prescription opioid medications overstated the benefits of their drugs: They also downplayed the risks of using these opioids while aggressively marketing these drugs to physicians, both directly and through medical experts
• Distributors failed to monitor, detect, investigate, refuse, and report suspicious orders of prescription opiates

The Centers for Disease Control and Prevention (CDC) reported troubling statistics for 2024. Drug overdose deaths reached around 87,000 from October 2023 to September 2024. In response, the U.S. Department of Health and Human Services worked with other agencies to address substance use disorders. 

The economic costs also escalated dramatically. According to reports, illicit opioids cost Americans an estimated $2.7 trillion in 2023 alone. This is equal to 9.7 percent of Gross Domestic Product (GDP).

The Legal Implications of an Opioid Lawsuit

The consolidated federal opioid case is In Re: National Prescription Opiate Litigation, MDL 2804. The legal implications of this case extend far beyond financial settlements. It reshaped the controlled substance system in the United States. The law changed how these substances are manufactured, distributed, and prescribed. The two main legal arguments target opioid manufacturers and distributors.

False Advertising and Marketing

The opioid lawsuits are similar to state and federal claims against Big Tobacco in the 1990s. Plaintiffs claim that Purdue Pharma and other manufacturers knew their products were prone to abuse and addiction.

Companies directed materials to both physicians and patients. The materials claimed that opioid addiction is a “myth.” They also argued that opioids were necessary because pain was undertreated. Manufacturers regularly cited a 1980 letter to support their claims. The letter was published in the New England Journal of Medicine. It claimed that addiction is rare in patients treated with narcotics. This wasn’t a peer-reviewed study, but merely a letter that its author now regrets writing.

Research and federal agencies, including the FDA and CDC, later contradicted many of these marketing claims. The complaint notes that the U.S. Food and Drug Administration (FDA) and the CDC confirmed the falsity of the Defendant’s misrepresentation.

Ohio Attorney General Mike DeWine filed a complaint against Purdue Pharma and other opioid manufacturers on May 31, 2017. In the complaint, DeWine claimed that the defendant spent millions of dollars on materials and activities. These materials falsely deny the risks of opioids and overstate their benefits for treating chronic pain.

Failure To Monitor Distribution

Federal and some state laws place requirements on distributors of controlled substances. These distributors must monitor prescription dispensing. The goal is to prevent misuse and abuse of the system. The so-called “diversion theory” argues that distributors should have known something wasn’t quite right. The sheer volume of prescriptions being filled should have alerted them to the issue. Plaintiffs claim that distributors simply looked the other way, blinded by record profits.

Under the CSA, distributors are legally required to maintain effective controls against diversion. They must also design and operate a system to disclose suspicious orders of controlled substances. Failure to follow these requirements can result in both civil and criminal penalties.

An investigation by the Charleston Gazette-Mail discovered that roughly nine million hydrocodone pills flooded into a single pharmacy in just two years. This pharmacy was located in the small town of Kermit, West Virginia, which has a population of only 393. Many of these pharmacies and pain clinics have been described as “pill mills.” They earned this label because of their allegedly loose prescribing of pain medications.

In April 2017, the Cherokee Nation filed the first lawsuit by a tribal government against distributors. The distributors involved in the lawsuit are:

• McKesson Corporation
• Cardinal Health, Inc.
• AmerisourceBergen
• CVS Health
• Walgreens Boots Alliance, Inc., and
• Wal-Mart Stores, Inc.

According to the lawsuit, distributors sent an estimated 845 million milligrams of opioids to the 14-county Cherokee Nation in 2015. This amount of opioids averages out to between 360 and 720 pills per year per prescription opioid user in the Cherokee Nation. According to the reports by the CDC, opioid overdose deaths in the Cherokee Nation doubled between 2003 and 2014.

How Much Is the Total Opioid Settlement?

The opioid settlement represents the largest liability settlement in American history. Nationwide, agreements have almost reached $60 billion in settlements with states and other local governments. Drug manufacturers, distributors, and pharmaceutical companies shouldered these settlement payments.

The most recent development came in June 2025. 55 Attorney Generals signed the $7.4 billion settlement agreement resolving the litigation against Purdue Pharma and the Sackler family in their role in the opioid crisis. For years, they aggressively marketed OxyContin and other prescription painkillers. Under the terms of the agreement, they are permanently prohibited from selling, promoting, or manufacturing opioids in the United States.

Opioid distributors now face enhanced oversight and accountability, along with being subject to an independent monitor. This monitor will track the nationwide distribution of opioids. This is designed to prevent deliveries to places where misuse or diversion could happen. Pharmacists are also subject to this oversight. They are required to flag suspicious orders and refuse to fill them.

A Patient’s Right to Pain Management

The issue of patients’ right to pain management became more complex after the opioid crisis and the following regulatory responses. Medical organizations recognize the ethical obligations related to pain relief. The American Medical Association understands a physician’s duty to relieve patients’ pain and suffering, a position echoed by the World Health Assembly. It’s agreed that healthcare professionals have an ethical duty to alleviate patients’ pain and suffering.

The United States tackles this issue with a more complex legal framework. At present, there is no federal right to pain treatment. The only law that controls the prescription of pain medicines is the Controlled Substances Act (CSA). 

However, several states enacted provisions that protect patients’ right to pain treatment. These regulations often require documentation in medical records to support treatment options. For instance, Washington State explicitly mentioned that physicians should not fear disciplinary action if they prescribed controlled substances for legitimate medical reasons. Other states with similar state laws are Arkansas, California, Colorado, Montana, and North Dakota.

If you would like to learn more about your right to pain management under your state laws, speak with a healthcare attorney.

The MAT Act

The Medication-Assisted Treatment for Addiction and Treatment (MAT) Act is a federal policy. It aims to help those struggling with drug addiction. The act focuses on those suffering from opioid use disorder (OUD) and alcohol use disorder (AUD). This Act simplified how physicians treat opioid addiction. 

Prior to this law, physicians needed special permission to prescribe certain medications. They had to have a waiver to prescribe medications that help people recovering from opioid addiction. The MAT Act eliminated these waiver requirements. All practitioners with updated DEA registration can prescribe buprenorphine. These practitioners must have Schedule III authority. Buprenorphine is a medication used for opioid disorder.

Contact a Healthcare Attorney for Opioid Related Cases

The opioid legal landscape continues to evolve with new federal laws and policies to uphold patients’ rights. If you or someone you know was impacted by the opioid crisis, contact a healthcare attorney. They can help you understand how these cases and policy changes can affect your rights and protect your interests.