We are hopeful that a judge’s decision this week in Oklahoma is the first legal clamp to have a notable impact on the opioid crisis, which has become a national plague.

On Monday, a judge found Johnson & Johnson, which sells prescription opioids and supplies other drug companies with opiate ingredients, was responsible for contributing to the state’s opioid crisis, and ordered the company to pay $572 million.

That decision apparently was the first domino to fall. On Tuesday, Purdue Pharma, which manufactures OxyContin, and the Sackler family, which owns that company, offered to settle thousands of similar lawsuits with billions of dollars.

As many pundits have noted, it is not unlike the unprecedented 1998 agreement between tobacco manufacturers and 46 states, which had sued the company for deceptive marketing practices. The payout there was $125 billion to the states, including Vermont, over 20 years.

(Unfortunately, two decades later, only a fraction of the tobacco proceeds — less than 3 % nationally in 2019 — has been spent on public health matters related to tobacco use, according to published reports this week.)

Regardless, those are serious — and necessary — reparations. And while it did not stop people from buying tobacco products, it changed the dialogue and many behaviors.

It needs to happen again. Here in Vermont, we need this week’s clamp-down to have a lasting effect. As it is, the opioid crisis has reshaped Vermont’s health-care system, education, public safety, and much more. The tentacles of addiction are tearing at our communities, and costing us dearly.

According to the National Institute on Drug Abuse, in 2017, there were 114 drug overdose deaths involving opioids in Vermont — a rate of 20.0 deaths per 100,000 persons, compared to the national rate of 14.6 deaths per 100,000 persons. The greatest increase was among deaths involving synthetic opioids other than methadone (mainly fentanyl) with 77 deaths in 2017. Heroin-involved deaths also rose from 10 deaths in 2012 to 41 deaths in 2017. Overall, deaths involving prescription opioids have not changed since 2013.

In addition, the NIDA reports that in 2017, Vermont providers wrote 50.5 opioid prescriptions for every 100 persons. This was among the lowest prescribing rates in the country and lower than the average U.S. rate of 58.7 prescriptions. However, while most states have seen a decreasing trend since data collection began in 2006, the opioid prescribing rate in Vermont has declined marginally, by 10 %, over the last decade.

The rate of overdose deaths involving opioid prescriptions increased steadily beginning in 2014, from 4.3 deaths per 100,000 to 6.3 deaths per 100,000 persons.

For a state of about 625,000 residents, those numbers touch all of us in one way or another.

For certain, the lessons of the tobacco experience are on health officials’ minds this week. And rightly so. According to the Associated Press, some 400,000 people have died of opioid overdoses nationally over the past two decades. The crisis also has taken a staggering toll on the nation’s economy, costing an estimated $78.5 billion a year in health care, lost productivity and involvement by the criminal justice system, according to the Centers for Disease Control and Prevention.

But this — literally — is a manufactured crisis. The epidemic began with the rampant overprescribing of those painkillers, and their overuse was fueled by the pharmaceutical industry’s efforts.

And now a judge has put the companies that make opioids on notice.

Hopefully, challenges made by states like Vermont will begin to compensate for the damage caused by this greed, which cost so many Americans (and Vermonters) their lives.

Moving forward, we hope future judgments create means by which we can continue the fight to combat opioid addiction.

Certainly, the Vermont Drug Task Force and the Department of Public Safety would appreciate the help. As would methadone clinics around Vermont that are facing a steady clientele.

Let the dominoes fall.

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