Document Type


Publication Title

Emory Corp. Governance & Accountability Rev. Perspectives

Publication Date

Spring 1-3-2023


Since 1999, 932,000 people in the United States have died from a drug overdose. In 2021 alone over 100,000 people died from a drug overdose. Seventy-eight percent of those overdoses involved opioids. As the opioid epidemic has torn families apart and decimated American communities, the natural response is to find someone to blame. State and local governments, Native-American tribes, labor unions, insurance companies, hospitals, and individuals have all pointed the finger at the same culprits: opioid manufacturers and distributors.

The result—over 3,000 state and local governments alongside Native American tribes joined In Re Opiate Litigation, a multidistrict litigation, alleging “improper marketing of and inappropriate distribution of various prescription opiate medications into cities, states and towns across the country.” On February 25, 2022, five years after these actions were first centralized in the Northern District of Ohio, the “Big Three” distributors (“the Distributors”)—McKesson, AmerisourceBergen, and Cardinal Health—finalized a $21 billion settlement for their role in the opioid crisis. This perspective analyzes the two main provisions of the opioid settlement—the abatement fund and Clearinghouse provisions—and compares them to equivalent provisions in the Tobacco Master Settlement Agreement (“tobacco settlement”). This juxtaposition highlights that while the opioid Global Settlement Agreement (“opioid settlement”) took a cue from the tobacco settlement agreement’s ineffective abatement fund provisions, the opioid settlement failed to mirror the biggest strength of the Tobacco Master Settlement Agreement: strong, robust transparency provisions.

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