Johnson & Johnson settled another opioid epidemic lawsuit ahead of a major case in the ongoing legal battles over the drug overdose crisis.

On Tuesday, Johnson & Johnson agreed to a $20.4 million deal with Cuyahoga and Summit counties, according to the Washington Post. As part of the deal, the health care company will pay the counties $10 million in cash, reimburse $5 million for legal costs, and put $5.4 million toward opioid-related nonprofit programs.

The settlement, however, does not include an admission of liability.

Johnson & Johnson sells opioid products, which experts say helped fuel particularly the first wave of the opioid crisis starting in the late 1990s. Johnson & Johnson claims it marketed the drugs responsibly, even as the proliferation of opioid painkillers contributed to the more than 700,000 overdose deaths in the US since 1999.

Last month, a judge in Oklahoma also ruled against Johnson & Johnson and ordered it to pay more than $570 million to help address the crisis. The company appealed that ruling.

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The latest settlement comes just before the Cuyahoga and Summit case goes to trial this month, with other opioid manufacturers and distributors remaining on the case as defendants. The trial is considered a “bellwether” — meant to test how more than 2,000 opioid epidemic lawsuits consolidated by a federal judge in Ohio will go. After the trial for the two counties, more cases are expected to be tried in the coming months and years.

Besides Johnson & Johnson, generic opioid maker Mallinckrodt Pharmaceuticals previously reached a $30 million “settlement in principle” in the Cuyahoga and Summit case.

Meanwhile, OxyContin maker Purdue Pharma agreed to a deal worth up to $12 billion to settle the more than 2,000 lawsuits. As part of the deal, Purdue filed for bankruptcy, and the company will effectively dissolve, reform, and continue selling OxyContin — but with sales revenue going to plaintiffs in the settlement. Purdue will also donate drugs for treating addiction and overdoses. The Sackler family, which owns Purdue, will contribute another $3 to $4.5 billion to the deal as well.

The hope with the lawsuits is to not just hold Johnson & Johnson, Purdue, and others allegedly involved in the opioid epidemic accountable for the crisis, but also force them to pay for addiction treatment that could help combat the epidemic. Treatment is notoriously underfunded in the US, with experts in recent years calling on the federal government to invest tens of billions of dollars in building up treatment infrastructure. (For reference, a 2017 study from the White House Council of Economic Advisers linked a year of the opioid crisis to $500 billion in economic losses.)

So legal settlements continue trickling out, resulting in more money to hopefully address a crisis that now results in tens of thousands of fatal drug overdoses a year in the US.

How drug companies helped cause the opioid epidemic

The opioid epidemic can be understood in three waves. In the first wave, starting in the late 1990s and early 2000s, doctors prescribed a lot of opioid painkillers. That caused the drugs to proliferate to widespread misuse and addiction — among not just patients but also friends and family of patients, teens who took the drugs from their parents’ medicine cabinets, and people who bought excess pills from the black market.

A second wave of drug overdoses took off in the 2000s when heroin flooded the illicit market, as drug dealers and traffickers took advantage of a new population of people who used opioids but had either lost access to painkillers or simply sought a better, cheaper high. And in recent years, the US has seen a third wave, as illicit fentanyl offers an even more potent, cheaper — and deadlier — alternative to heroin.

It’s the first wave that really kicked off the opioid crisis — and where opioid makers and distributors come in.

Manufacturers of the drugs misleadingly marketed opioid painkillers as safe and effective, with multiple studies tying the marketing and proliferation of opioids to misuse, addiction, and overdoses. Opioid makers like Johnson & Johnson, Purdue, Endo, Teva, and Insys are all accused of playing a role here.

As a group of public health experts explained in the Annual Review of Public Health, the companies exaggerated the benefits and safety of their products, supported advocacy groups and “education” campaigns that encouraged widespread use of opioids, and lobbied lawmakers to loosen access to the drugs.

The result: As opioid sales grew, so did addiction and overdoses.

It’s not just that the opioids were deadly; they also weren’t anywhere near as effective for chronic non-cancer pain as the companies claimed. There’s only very weak scientific evidence that opioid painkillers can effectively treat long-term chronic pain as patients grow tolerant of opioids’ effects — but there’s plenty of evidence that prolonged use can result in very bad complications, including a higher risk of addiction, overdose, and death. In short, the risks and downsides outweigh the benefits for most chronic pain patients.

Yet even as these risks became apparent over the years, drug companies continued marketing the opioids widely. So different levels of government are now trying to hold the companies responsible — and that’s why we’re seeing all of the latest legal settlements.

For more on the lawsuits against opioid companies, read Vox’s explainer.