New York State filed a lawsuit against numerous pharmaceutical manufacturers, including Johnson & Johnson, and distributors, including AmerisourceBergen, Cardinal Health, and McKesson, alleging their responsibility for the widespread availability and abuse of prescription opioid painkillers. The lawsuit claimed the defendants “deliberately betrayed their duties” to prevent the misuse and diversion of controlled substances “through a persistent course of fraudulent and illegal misconduct.” The lawsuit specifically accused AmerisourceBergen, Cardinal Health, and McKesson of “grossly negligent and/or willful misconduct” including failing to fix deficiencies in their compliance systems, hiring inadequately qualified and trained compliance and sales staff, helping pharmacies circumvent their opioid limits, and retaliating against employees who raised concerns about pharmacies that made suspicious opioid orders. In July 2021, several states announced they reached a settlement with J&J, AmerisourceBergen, Cardinal Health, and McKesson. J&J agreed to pay $5 billion, and the three distributors agreed to pay a combined total of nearly $21 billion: AmerisourceBergen – $6.4 billion; Cardinal Health – $6.4 billion; McKesson – $7.9 billion.