A ruling in a landmark legal case over the opioid crisis has Johnson and Johnson being ordered to pay the state of Oklahoma $572 million in the first trial of an opioid manufacturer for the destruction wrought by prescription painkillers.

A judge ruled that Johnson & Johnson bears responsibility for helping to fuel the state’s opioid epidemic by aggressively marketing painkillers and, in collaboration with poppy growers in Tasmania, supplied 60 percent of the opiate ingredients that drug companies used for opioids like oxycodone.

The verdict comes in the first case to go to trial of more than 2,000 brought by state and local municipalities nationwide seeking to hold the pharmaceutical industry accountable for widespread opioid abuse.

Oklahoma Attorney General Mike Hunter filed suit in 2017, alleging several drug companies created a “public nuisance” through deceptive marketing that encouraged over-prescription and an oversupply of opioid-laced medications which created an epidemic of abuse. Hunter has said that Johnson and Johnson has acted like a “drug kingpin.”

The “public nuisance” argument that was previously used successfully to fight Big Tobacco is expected to now be used in opioid lawsuits set to go to trial in Ohio this fall.

In addition to the cases in Ohio, suits were filed last week in West Virginia accusing Johnson & Johnson, as well as Teva, of misrepresenting the risks of their opioid products.

Purdue Pharma, the company behind the painkiller OxyContin, and drug manufacturer Teva had already settled with Oklahoma. Both companies agreed to pay hundreds of millions of dollars to the state to fund addiction treatment leaving Johnson and Johnson as the sole defendant.

Johnson and Johnson’s billion-dollar Nucynta and Duragesic drugs were pushed alongside OxyContin. Internal court documents show Janssen, part of Johnson and Johnson, targeted doctors with a track record of prescribing large amounts of OxyContin in an effort to switch them to Duragesic.

However, Johnson & Johnson’s role in opioid crisis may be worse than Purdue’s. Oklahoma has alleged that two Johnson & Johnson subsidiaries, Tasmanian Alkaloids and Noramco, “created, grew, imported and supplied to J&J and its other co-conspirators, including Purdue, the narcotic raw materials necessary to manufacture the opioid pain medications thrust upon the unsuspecting public since the 1990s.”

Wells Fargo analyst David Maris and Yale law professor Abbe Gluck spoke of the possibility of a master settlement. Maris stated that this case is no joke: The drugmakers, distributors and manufacturers involved could be liable for up to $100 billion. Gluck echoed Maris saying “that a $100B+ master settlement is in the realm of possibility and could ultimately result in company bankruptcies if they cannot meet the obligations.”