Saint Louis University Journal of Health Law & Policy

Document Type

Student Note


In response to the opioid epidemic, counties and cities across the United States waged In re: National Prescription Opiate Litigation, better known as the opioid MDL, against manufacturers and distributors of opioids. The county and city plaintiffs appear to have taken their litigation strategy straight from Big Tobacco playbook of the 1990s. This is to the great disdain of state attorneys general, who fronted Big Tobacco litigation with state-sponsored parens patriae litigation.

The state attorneys general vehemently assert that the MDL claims are the province of state governments rather than local governments. However, the attorney general-led Big Tobacco litigation of the 1990s left much to be desired. While the states were able to procure a $206 billion tobacco Master Settlement Agreement in 1998, a seemingly enormous win for tobacco victims, the state attorneys general allocated a devastatingly low amount of the proceeds to the intended purposes of smoking cessation programs and public health initiatives. Just like Big Tobacco litigation, a global opioid settlement purported to resolve the MDL claims seems inevitable—and states are eager to undermine local efforts in reaching a settlement.

This Note argues that state attorneys general should not be permitted to overthrow settlement negotiations in the county-and-city-led opioid MDL, positioning that counties and cities are better suited than states to implement evidence-based public health initiates in their own communities. Spending shortfalls of the Master Settlement Agreement demonstrate precisely why allocating settlement money to the states guarantees little to no spending accountability. This Note further identifies three reasons why, despite many similarities in the litigation tactics between tobacco and opioids, a global opioid settlement agreement will be far smaller than the $206 billion tobacco Master Settlement Agreement of 1998. Therefore, a smaller settlement would be best utilized by apportioning settlement proceeds directly to the local governments, which are the most impacted by the opioid epidemic.