There’s a great deal to be done. Some 400,000 people have died of opioid overdoses nationally over the past two decades. The crisis also has taken a staggering toll on the nation’s economy, costing an estimated $78.5 billion a year in health care, lost productivity and involvement by the criminal justice system, according to the C .D.C .

The opioid industry has been quick to point out that today’s overdose crisis is driven more by street drugs like heroin and fentanyl than by prescription opioids like OxyContin. And that’s true. But there’s no question that this epidemic began with the rampant overprescribing of those painkillers and that their overuse was fueled, quite deliberately, by the pharmaceutical industry’s efforts. As innumerable court documents and investigations have shown, opioid makers, including Purdue and Johnson & Johnson, routinely and knowingly misled the public about their products. They played down the risks of addiction, insisting that their drugs were safe and, if anything, underutilized. And they combated growing concerns with aggressive lobbying and public relations campaigns.

These tactics contributed to sky-high levels of opioid abuse, addiction and overdose. They led, almost directly, to the street drug problem that the nation is confronting today. And they secured handsome profits for opioid makers and suppliers.

So far, industry payouts have been meager compared with opioid makers’ profits and with the cost of the opioid crisis. The state of Oklahoma, for example, says that it will need roughly $17 billion over the coming decades to effectively combat the epidemic. This week’s judgment against Johnson & Johnson, combined with previous settlements with Purdue ($270 million) and Teva Pharmaceuticals ($85 million), another opioid maker, would cover only a few years of that effort.

And that’s only if the money is spent as it ought to be . So far, more money from that Purdue settlement has been allocated to litigation costs than to supplying communities with anti-addiction medicine or to helping local governments grapple with the direct costs of opioid addiction and overdose. It remains to be seen if the company’s latest proposal — to declare bankruptcy and morph into a public trust whose profits would go directly to plaintiffs — will fare any better. Health officials have long worried that any opioid settlement would meet the same fate as the global tobacco settlement — especially after some of the proceeds from early opioid settlements in states like West Virginia were spent on things unrelated to the crisis. As plaintiffs settle their cases with drug makers, or as judges award damages, they would do well to ensure that the resulting payouts go directly to combating opioid addiction.