MICHEL MARTIN, HOST:

We want to focus now on another of the public health crises we just mentioned - the opioid epidemic. This week, four of the world's biggest health care companies, including Johnson & Johnson, reached a $26 billion settlement for their role in the opioid crisis. These corporations made and distributed huge quantities of prescription pain pills at a time when addiction and overdose rates in the U.S. were surging. So what happens now? NPR correspondent Brian Mann reports full time on addiction and is with us now to walk us through this complicated deal. Brian, welcome. Thank you so much for joining us.

BRIAN MANN, BYLINE: Thanks for having me.

MARTIN: First, could you just go over the main points of the settlement?

MANN: You know, these companies - the drugmaker Johnson & Johnson and also these three big drug wholesalers, AmerisourceBergen, Cardinal Health and McKesson - they've agreed to pay a maximum amount of $26 billion. And as part of that agreement, a huge percentage of the money will go to drug treatment programs and social service programs, health care, things like that. And negotiators say this is a big improvement over the tobacco settlement of the 1990s, where, if you remember, a lot of the money has been siphoned away by governments for other things not used to reduce smoking. So this money would be paid out over 17 years. And supporters say that will mean a steady stream of funding for programs that might help with this long-term process of ending this devastating public health crisis.

MARTIN: Now, two states, Washington state and West Virginia, have already announced that they won't sign on to this national settlement. And the city of Philadelphia has also rejected it. Why is that? Is there something that they say is missing?

MANN: Yeah. For one thing, there's no admission of wrongdoing by these companies or their executives. You know, as part of this wave of lawsuits against these corporations that got deep into the opioid business, we've learned factual details about how they flooded communities with pain pills. They kept growing that drug pipeline, even as addiction rates and deaths grew. Internal documents from some of these firms showed that, at times, executives joked about the people suffering addiction.

And a lot of these officials who reject this deal say, for all of those reasons, it doesn't include enough money. Twenty-six billion - it sounds like a ton of cash, right? But because it'll be spread out over the entire country and because the payments will be spread out for nearly two decades, critics say it doesn't provide enough help right now. And so I think bottom line is there's a big question that these officials will be asking. Does this deal hold companies accountable, or is this payout just sort of the price of doing business?

MARTIN: And this deal won't be finalized unless enough state and local governments sign on and agree to give up their lawsuits. Do you have a sense of what that decision-making process will look like?

MANN: Well, first, it's going to be fast. States have just 30 days to opt in. And the bipartisan group of state attorneys general who negotiated the settlement, they say they believe they'll get 40 or more states on board. And then we'll see if all the thousands of local governments, like Philadelphia, also sign on and agree to end their lawsuits.

If there's not enough critical massive support around the country, this deal does have a clause that would allow the corporations to pay significantly less money. Or theoretically, they could just walk away from the settlement. So what backers of this deal are telling me is they plan to mount a full court press to get as many government officials on board as possible. And we should know by late August whether they're going to succeed.

MARTIN: But let's not forget the human beings, you know, behind all these numbers and legal terms and so forth. Like, what's happening now with this opioid epidemic, and what's your sense of whether this settlement could help?

MANN: You know, public health officials I'm talking to are really shaken by what they're seeing. Over the last 20 years, these prescription opioids helped create this huge addiction problem. And now street dealers are feeding that addiction with this really toxic, illegal synthetic opioid called fentanyl. And it's killing a lot of Americans. The Centers for Disease Control and Prevention says about 93,000 Americans died last year from drug overdoses. The numbers keep getting worse. So one of the arguments being made by supporters of this deal is that financial aid needs to start flowing from these companies now, quickly, so lifesaving programs can start ramping up.

MARTIN: Brian Mann is NPR's addiction correspondent. He was telling us about this week's landmark national opioid settlement and reaction to it. Brian, thank you so much.

MANN: Thank you. Transcript provided by NPR, Copyright NPR.