**Yes – the 4th U.S. Circuit Court of Appeals revived a landmark $2.5 *billion* public nuisance lawsuit on October 28, 2025, against the “Big Three” opioid distributors: Cencora (formerly AmerisourceBergen), McKesson, and Cardinal Health.
Case Snapshot: City of Huntington & Cabell County v. Distributors
| Aspect | Details |
|---|---|
| Plaintiffs | City of Huntington + Cabell County, WV (~100K residents; “Ground Zero” for U.S. opioid crisis) |
| Claims | Public nuisance under WV common law: Distributors flooded area with 81M opioid pills (2006-2014) – ~800+ pills per resident – ignoring “suspicious” orders, violating federal Controlled Substances Act duties. |
| Damages Sought | $2.5B abatement fund (15 yrs) for treatment, prevention, education. |
| Trial Court (2022) | Judge David Faber (S.D. WV): Dismissed – WV public nuisance doesn’t apply to prescription drugs; distributors met reporting duties. |
| 4th Circuit Ruling | Reversed & Remanded (49-page opinion by Sr. Judge Barbara Milano Keenan): • Public nuisance APPLIES to opioid over-distribution (“flexible doctrine”). • Distributors breached duties by shipping orders > their own “suspicious” thresholds w/o reporting/ halting. • Monetary abatement OK under WV law. |
Why “Public Nuisance?” – Key Legal Takeaways
- WV Law is Broad: No exclusion for prescription drugs or controlled substances; covers “unreasonable interference” with public health/rights (e.g., addiction epidemic).
- Federal Overlay: Distributors must monitor, report, refuse suspicious orders (DEA regs). Evidence: Raised order limits to evade flags; shipped massive volumes anyway.
- Remedy Focus: Not damages – equitable abatement to fix the harm (funds for abatement = public good).
“We’re ecstatic… vindicated our core theories.” – Plaintiffs’ lawyer Anthony Majestro
Next: Back to Judge Faber for full trial/reevaluation (likely 2026+). Distributors (Cencora: “disappointed, may appeal”) eyeing en banc/SCOTUS.
Broader Opioid Litigation Context
- $50B+ in national settlements (4K+ suits); this holdout tests public nuisance post-settlement.
- Signals: Strengthens abatement claims where settlements fell short (e.g., WV got ~$1B total).
Read the opinion: 4th Cir. Docket (search “Huntington”). Huntington Mayor: “Hold them accountable for devastating harm.” 🚀