A judge has ruled on a landmark opioid lawsuit case, demanding that pharmaceutical giant Johnson & Johnson give $572million to the state of Oklahoma in the first ever court ruling to hold a company responsible for the opioid crisis.

Judge Thad Balkman handed down his ruling on Monday after a two-month long trial.

He said the company was responsible for 'ravaging' the state of Oklahoma by misleading customers with its marketing and creating an opioid crisis that resulted more than 6,000 deaths over nearly two decades.

They did so by sponsoring medical journals and creating unbranded marketing campaigns which made their drugs sound safer than they actually were, he said.

'The defendants misleading marketing and promotion of opioids created a nuisance.

'Those actions compromised the health and safety of thousands of Oklahomans,' he said.

'Specifically, they caused an opioid crisis that is evidenced by increased rates of addiction, overdose deaths and neonatal absence syndrome in Oklahoma.

Scroll down for video

Judge Thad Balkman, of Cleveland County District Court in Norman, Oklahoma, arrives in court to give his ruling against Johnson & Johnson

'The opioid crisis is an imminent danger and menace to Oklahomans.

'This is a temporary nuisance that can be abated. The opioid crisis ravaged the state of Oklahoma. It must be abated immediately,' he said.

The opioid crisis ravaged the state of Oklahoma. It must be abated immediately Judge Thad Balkman

In his ruling, which DailyMail.com obtained on Monday afternoon, he expanded on his rebuke.

Balkman said that since 1997, the company had 'embarked' on a 'major marketing' campaign after being inspired by its rival, Purdue Pharma, which is responsible for bringing Oxycontin to market.

HOW J&J MISLED THE MARKET In his 42-page ruling, the judge outlined how the company was to blame for the crisis. He said they were guilty of creating a nuisance - the term that they were being sued for - because they misled the market into thinking drugs were safe. They did this in a number of ways, he said. Unbranded marketing campaigns The judge noted how J&J sponsored medical journals and created campaigns about pain management and opioids without attaching its name to it so consumers were unaware in their vested interest. It began in the 1990s after executives watched Purdue Pharma's success with Oxycontin Targeting doctors Throughout a doctor's career, they would be targeted many times, at many different points, by sales reps from J&J, the judge ruled. The doctors were referred to as 'key customers' for the 'pain franchise' Sales reps would bring them food and offer them coupons to buy more of the products. Doctors were also rewarded with speaking engagements for which they would win huge financial compensation if they bought products, it was claimed. Dodging the question of addiction When pushing their products, sales teams were told to avoid 'the addiction ditch'. Instead, they were told to talk about how pain was being undertreated in the US. Payments to organizations The judge noted that J&J made a 'number of payments' to pain advocacy groups and other organizations including The American Academy of Pain Meidicne, American Pain Society, American Pain Foundation, American Geriatrics Society, American Chronic Pain Association and more. Ignoring warnings about Duragesic, its fentanyl patch The judge found that J&J ignored warnings from scientists, doctors and the FDA about how dangerous one of its products - Duragesic - was. Specifically, as far back as 2001, they were told by their own, in-house advisor that their marketing was 'dangerous' due to Duragesic's 'lethal nature' and that to an increase of sales would 'surely cause an increase in abuse of and addiction to the drug.' Advertisement

'They embarked on a major campaign in which they used branded and unbranded marketing to disseminate the messages that pain was being undertreated and "there was low risk of abuse and a low danger" of prescribing opioids to treat chronic, non-malignant pain,' he wrote.

The marketing was not targeted towards patients but to doctors and it was 'designed' to hit them multiple times throughout their career.

The drugs that were specifically pushed were Duragesic, a fentanyl patch, and Noramco.

When training sales reps, the judge said Johnson & Johnson told them to downplay the risk factors of its drugs and avoid the 'addiction ditch'.

Instead, they were told to focus on their claim that chronic pain management was 'undertreated'.

They targeted doctors, referring to primary care physicians as 'key customers' for their 'pain franchise' and even offered coupon programs to try to boost sales.

'Defendants' opioid marketing, in its multitude of forms, was false, deceptive and misleading,' Balkman wrote.

They also tried to woo doctors by bringing them breakfast, lunch and dinner and by sweetening them with speaker strategies, the judge claimed.

While the first of its kind, the settlement is a far cry from the $17billion the state had asked for.

Johnson & Johnson is worth an estimated $340billion.

On Monday, its stock took a brief dip as news of the ruling spread.

It was the first of its kind and accused Johnson & Johnson, one of the world's largest drugs manufacturers, of being responsible for the opioid crisis in Oklahoma.

The company, unlike its competitors, fought it.

In a statement after the decision, one of its lawyers said it would appeal.

'We have sympathy for all who suffer from substance abuse but J&J did not cause the opioid abuse crisis here in Oklahoma or anywhere in this coutnry.

'We do not believe that the facts or the law supports the decision today. We have many strong grounds for appeal and we intend to pursue those vigorously,' Sabrina Strong said.

Purdue Pharma and Teva, the two other opioid manufacturers most commonly blamed for the crisis, settled with Oklahoma out of court.

Mike Hunter, Oklahoma's Attorney General, welcomed the news.

'J&J will finally be held accountable for thousands of deaths and addictions caused by their activities.

'Throughout the trial, our team proved what we have alleged all along.

Oklahoma Attorney Genera Mike Hunter welcomed the decision on Monday. The case took more than eight weeks at trial

Johnson & Johnson, one of the larges pharmaceutical manufacturers in the world, said it would appeal the decision

That the company used misleading information that downplayed the risks of opioids,' he said at a press conference after the hearing.

He added that the company create 'broken homes, families and communities.'

THE COMPANIES THAT SETTLED TO AVOID TRIAL Purdue Pharma Purdue, which produces the drug OxyContin and is run by the Sackler family of New York, gave Oklahoma $270million in a settlement. It denies that it is to blame for the nation's opioid crisis. However, in its statement after the settlement was reached, the company said: 'Purdue is very pleased to have reached an agreement with Oklahoma that will help those who are battling addiction now and in the future.' Teva Generics Teva, which is based in Israel, agreed to pay $80million just days before the trial began. It had been named as a defendant alongside Purdue and Johnson & Johnson and fought until the last minute. Teva makes generic drugs and sells them around the world. Advertisement

'We showed how the company repeatedly ignored warnings... and the risks of marketing of its products.

'The company promoted its products through unbranded campaigns and funding patient groups meant to look like grass roots organizations.

Johnson & Johnson built its billion dollar brand out of greed and on the backs of pain and suffering of innocent people,' he said.

As part of their case, prosecutors presented evidence from a range of experts including the families of young people who had overdosed on opioids to marketing experts and medical examiners.

They told how J&J used aggressive marketing practices to push their goods onto the market and into doctors' hands.

The company argued that it was not to blame for the crisis and that if doctors over-prescribed their products, they should not be held accountable.

Its lawyers also argued that while other drugs may have clocked up deaths, its products were scarcely associated with overdoses.

It was not the first time a pharmaceutical company has been sued before for opioids abuse, but it was the first time the case went to trial.

In the past, the pharmaceutical giants have settled privately.