In holding the firm liable after a seven-week, non-jury trial, Judge Thad Balkman of Cleveland County District Court in Norman, Oklahoma, said the state proved that J&J's misleading marketing and promotion of its Duragesic and Nucynta painkillers created a public nuisance.
"The opioid crisis is an imminent danger and menace to Oklahomans," Balkman stated.
Oklahoma wanted the pharmaceutical company to help it address the epidemic for the next 30 years by funding addiction treatment and prevention programs.
The judge said in his written ruling that the award covered only one year of addressing the crisis because Oklahoma did not demonstrate the time and costs needed beyond that.
Lance Lang, a 36-year-old recovering user of opioids turned activist in Oklahoma City, said it was “short-sighted” for the judge to have only ordered funding for a year. “There’s going to be people struggling with this for years,” he added in an interview.
This is still a lot less than the amount the state's attorney general who had filed the lawsuit was seeking - US$17 billion - to address the impact of the drug crisis on Oklahoma.
J&J said it would appeal the decision, adding it will ask that the award be put on hold during an appeal process that could stretch into 2021.
The case was brought by Oklahoma Attorney General Mike Hunter, who argued that Johnson & Johnson's marketing practices helped fuel the opioid epidemic by flooding the market with painkillers.
"Johnson & Johnson will finally be held accountable for thousands of deaths and addictions caused by their actions," Hunter stated.
Some plaintiffs' lawyers have compared the opioid cases to litigation by states against the tobacco industry that led to a US$246 billion settlement in 1998.
Joe Rice, a lead plaintiff's attorney for municipalities in the federal litigation, said if the Oklahoma ruling were extrapolated to other states, it could mean an annual abatement cost of around US$38 billion.
“It does indicate that if I’m in the pharmaceutical business, I’ve got to think long and hard about annual payments of my share of that,” he said.
The judge overseeing the federal litigation in Ohio has been pushing for a global settlement.
During the Oklahoma trial, lawyers for the state argued that J&J carried out a years-long marketing campaign that minimized the painkillers' addiction risks and promoted their benefits.
The lawyers called J&J an opioid "kingpin" and argued that its marketing created a public nuisance as doctors over-prescribed the drugs, leading to a surge in overdose deaths.
Opioids were involved in almost 400,000 overdose deaths from 1999 to 2017, according to the U.S. Centers for Disease Control and Prevention. Since 2000, some 6,000 Oklahomans have died from opioid overdoses, according to the state's lawyers.
More than 47,000 people died in 2017 in the United States, of which about 36 percent involved drugs that had been supplied as per medical prescriptions.
Roughly 2,500 lawsuits have been brought by states, counties, and municipalities nationally seeking to hold drugmakers responsible for opioid abuse nationwide. Oklahoma's case was the first to go to trial, while some drugmakers have chosen to settle cases.