A US district judge in Norman, Oklahoma, has ordered Johnson & Johnson to pay $572 million for allegedly fueling the crisis sweeping the country. The country’s largest healthcare company, which is already fighting more than 15,000 lawsuits charging its talc baby powder caused the plaintiffs’ cancer, said it will appeal.

The judgment in the Oklahoma case, the first of thousands involving manufacturers and distributors of opioids, was expected to be one of the harshest but despite being the highest it was less than analysts feared, explaining the rally in the J&J share price following the ruling. Expectations were for a fine of up to $2 billion.

Earlier this year, OxyContin producer Purdue Pharma settled with the state for $270 million, and Israeli generics producer Teva paid $85 million. In the case just heard, there was no jury.

The state said the fines would be used to pay for the care and treatment of opioid addicts. Commenting on the court’s decision, Oklahoma’s attorney general, Mike Hunter, said "Johnson & Johnson will finally be held accountable for thousands of deaths and addictions caused by their actions."

According to the US Centers for Disease Control and Prevention (CDC), opioids were involved in almost 400,000 overdose deaths across the US from 1999 to 2017. Since 2000, around 6,000 people in Oklahoma – one of the poorest US states – are said to have died from opioid overdoses.

Branding J&J an opioid "kingpin,” during the seven-week trial the state’s lawyers successfully argued that the company carried out a marketing campaign minimizing the risks of its painkillers, Duragesic and Nucynta, while “deceptively” promoting its benefits. The company also makes a fentanyl patch for pain relief.

J&J argues that its claims for the drugs’ benefits had scientific support and they moreover accounted for only a small fraction of opioids prescribed in Oklahoma. The company feels it is being scapegoated, as it says since 2008 its painkillers have accounted for less than 1% of the US market, including generics.

Alongside the talc cases, J&J currently faces lawsuits from private citizens claiming to have been harmed by its opioid drugs. Some 2,000 cases are due to go to trial in the state of Ohio in October, unless an out-of-court settlement can be reached. The healthcare giant has asked for the Oklahoma fine to be put on hold during its appeal process, which reports say  could last until 2021.