U.S. District Judge David Faber previously ruled that West Virginia's public nuisance law does not apply to the marketing and sale of opioids, as it traditionally pertains to conduct interfering with public property.

Defense attorney Steve Ruby argued that recognizing opioid distribution as a public nuisance could lead to an influx of activist litigation.

Justice Haley Bunn delivered the majority opinion, while dissenting opinions were issued by Chief Justice Bill Wooton and Circuit Judge Tera Salango, with some justices disqualified from the case.

Cardinal Health declined to comment on the ruling, while attempts to reach representatives from AmerisourceBergen and McKesson were unsuccessful.

The state Supreme Court was asked to clarify whether opioid distribution could constitute a public nuisance under West Virginia law, but the justices opted not to engage with this question.

The recent ruling from West Virginia's Supreme Court returns a significant opioid distribution case to the 4th U.S. Circuit Court of Appeals, nearly three years after a federal judge sided with major drug distributors AmerisourceBergen, Cardinal Health, and McKesson.

The ruling comes amidst thousands of lawsuits against opioid distributors, many of which have settled for over $50 billion, although trial outcomes have varied significantly.

This case originated from a lawsuit filed by Cabell County and the city of Huntington, accusing the distributors of exacerbating a public health crisis by distributing 81 million opioid pills over eight years.

The plaintiffs are seeking over $2.5 billion to fund opioid prevention, treatment, and education efforts over the next 15 years.

The opioid crisis in Cabell County has been dire, with over 1,000 emergency responses to suspected overdoses in 2021 and at least 162 overdose deaths, underscoring the urgency of the plaintiffs' request for $2.5 billion for prevention and treatment initiatives.

Despite the court's decision, the West Virginia Mass Litigation Panel has indicated that opioid distribution could support a public nuisance claim, highlighting the complex legal landscape surrounding these cases.

Attorney Paul Farrell Jr., representing the plaintiffs, expressed disappointment with the court's decision but remains committed to pursuing justice, noting that the appeals court still has legal and factual issues to address.