The courtroom was beige and forgettable. The company on trial was anything but.
In the summer of 2019, Oklahoma’s attorney general stood before a district judge and accused Johnson & Johnson—yes, that Johnson & Johnson—of acting as the quiet kingpin in America’s opioid epidemic. Not Purdue Pharma. Not just the Sacklers. But the company that made Band-Aids, baby shampoo, and children’s Tylenol.
For over a century, Johnson & Johnson cultivated a reputation so pristine that it was almost untouchable. It was the company families turned to in moments of pain, fear, or illness. It made the products people trusted to heal their children, soothe their ailments, and signal safety. It wasn’t just about corporate greed—it was about misplaced trust, weaponized branding, and the price of public naïveté.
In Illinois alone, opioid overdoses claimed over 3,000 lives in 2022—nearly double the number of homicide deaths that year. In Cook County, the toll has been especially brutal, with Black communities on the West and South Sides facing disproportionately high fatality rates. Chicagoans have watched entire blocks hollow out, parents bury their children, and grandparents step in as guardians—again.
So yes, this trial happened in Oklahoma. But the story—this story—is about what’s been hiding in plain sight across America, including in our own neighborhoods. When the company your mother trusted for baby powder turns out to be one of the largest suppliers of opioid ingredients in the world, you have to ask: what else have we overlooked?
The lawyers called it a public health emergency. The judge called it a public nuisance. At the end of the trial, Johnson & Johnson was ordered to pay $572 million. The ruling was brief but devastating: Johnson & Johnson’s conduct had “compromised the health and safety of thousands of Oklahomans.”
The judgment would later be overturned on appeal. But in a small courtroom in Norman, Oklahoma, the company that had spent over a century building trust was publicly, legally named as part of an epidemic that had already claimed over 400,000 lives nationwide—and counting. The documents entered into evidence—emails, PowerPoints, sales scripts, supplier contracts—told a story not of an accidental contributor, but of an orchestrator.
To understand Johnson & Johnson’s role in the opioid crisis, you have to start where the painkillers do—not in pharmacies, but in poppy fields.
The Sales PitchIn the 1990s, a J&J subsidiary based in Tasmania—Tasmanian Alkaloids—developed a genetically modified poppy plant called “Norman,” bred to produce high concentrations of thebaine and oripavine. These are the chemical building blocks for powerful synthetic opioids like oxycodone, hydrocodone, and oxymorphone.
That was the play: control the source. Through Tasmanian Alkaloids and its U.S.-based processor Noramco, Johnson & Johnson became the dominant supplier of raw opioid ingredients to nearly every major pharmaceutical company in the U.S. Purdue Pharma, the creators of OxyContin, was among the largest.
By 2015, Johnson & Johnson was supplying more than 60% of the active ingredients used to make opioid pills sold in the United States. According to one DEA report, the company controlled a stunning share of the world's legal narcotic material—at one point, responsible for up to 80% of global oxycodone production inputs.
In 1998, Purdue signed a deal to buy 100% of its thebaine supply—key to manufacturing OxyContin—from J&J’s Noramco. It was a lucrative, long-term relationship. And it wasn’t the only one.
Their drugs didn’t just show up in orange bottles—they made the contents that filled those bottles. And because the supply chain was legal, federally approved, and highly profitable, there were few questions—at least at first.
Behind the soft lighting and family branding was an industrial narcotics empire hiding in plain sight.
In the same years that its subsidiaries dominated the supply chain, Johnson & Johnson was developing and selling its own opioid products through Janssen Pharmaceuticals, a division it had owned since 1961.
Duragesic, a fentanyl-based patch, launched in 1990. Later came Nucynta, a pill-based synthetic opioid approved by the FDA in 2008.
Internally, the mission was clear: expand the market. That meant targeting patients far beyond end-of-life cancer care. Janssen sales reps were trained to pitch opioids for chronic back pain, joint pain, and routine post-operative recovery. They downplayed risk. They emphasized quality of life. They used language the industry had perfected over years of shaping medical opinion: “low abuse potential,” “pseudoaddiction,” “undertreatment of pain.”
The term “pseudoaddiction” became gospel in pain clinics. It suggested that drug-seeking behavior in patients was not a sign of addiction but of inadequate dosing. The cure? More opioids.
And J&J made sure that message stuck.
Influence by DesignTo spread this message further, Johnson & Johnson invested heavily in pain advocacy groups, medical journals, and continuing education programs for doctors. These initiatives emphasized opioids as a humane solution to chronic pain and portrayed addiction risks as overstated.
At medical conferences, Janssen-funded speakers argued passionately that opioids were being unjustly vilified. These voices were often influential doctors or researchers, whose credibility lent weight to Johnson & Johnson’s strategic messaging.
Sales representatives, trained meticulously, flooded doctors’ offices with assurances about safety profiles, leaning heavily on selectively chosen studies and testimonials that minimized addiction risks. They hosted dinners and events designed to subtly influence prescribing behaviors, always careful to remain within the boundaries of legality.
Johnson & Johnson also used regulatory channels to their advantage. The Drug Enforcement Administration (DEA) sets annual quotas for opioid production. Behind closed doors, J&J subsidiaries lobbied persistently for higher quotas, arguing public health demanded ample opioid availability. The result: production limits soared, flooding the market with more opioids than ever.
Over the next two decades, Johnson & Johnson spent millions funding pain organizations, advocacy groups, and medical societies that pushed for looser prescribing standards. These included the American Pain Foundation, the American Geriatrics Society, and the Joint Commission, which created hospital guidelines still in use today.
They didn’t need to place an ad that said “More Pills.” They just needed doctors to believe that under-treating pain was more dangerous than overprescribing opioids.
This wasn’t fringe influence. It was the institutional center of American medicine—molded, funded, and co-written by one of the most trusted corporations on earth.
The Lie That LingeredBy the late 2000s, red flags were everywhere. Emergency rooms were overwhelmed. Entire counties saw more opioid prescriptions than residents. Still, Johnson & Johnson stayed largely out of view.
That’s partly because their branded opioids never held a dominant share of the market. Purdue had OxyContin. Insys had Subsys. Mallinckrodt was flooding the market with generics. But Johnson & Johnson was making the base ingredients for all of them.
Their defense was always the same: we made a tiny fraction of the pills. But they never talked about how many kilograms of raw oxycodone and hydrocodone they manufactured—only that it was approved by the DEA.
What’s rarely mentioned: those DEA quotas? Johnson & Johnson lobbied to expand them.
The Oklahoma FilesIn 2019, Oklahoma became the first state to bring Johnson & Johnson to trial for its role in the epidemic. Unlike other companies that settled early, J&J chose to fight in court. That turned out to be a mistake.
The trial revealed hundreds of internal documents. Emails showed executives debating how aggressively to market Nucynta to general practitioners. Sales presentations encouraged reps to downplay risks and avoid the word “addiction” entirely. Managers shared strategies for targeting nursing homes and high-prescribing physicians.
And then there was the supply chain—contracts showing Purdue Pharma purchasing 100% of its thebaine requirements from J&J’s Noramco division.
Judge Thad Balkman didn’t mince words. He ruled that Johnson & Johnson had “caused an opioid crisis that is evidenced by increased rates of addiction, overdose deaths, and neonatal abstinence syndrome in Oklahoma.”
The award: $572 million.
It was the first opioid trial to end in a judgment against a manufacturer. And while it would later be reversed on appeal, the evidence was now public—and damning.
A Strategic RetreatIn 2021, facing mounting legal pressure, Johnson & Johnson agreed to a $5 billion nationwide settlement—without admitting wrongdoing. It was a strategic retreat aimed at protecting their broader reputation.
Under the terms of the deal, the company agreed to exit the opioid business entirely in the U.S. Noramco and Tasmanian Alkaloids were sold off. The damage, however, was already done.
Even after exiting the opioid market, the consequences lingered: hundreds of thousands dead. Families shattered. Communities permanently scarred.
The company had moved on—publicly emphasizing vaccines and sustainability initiatives, quietly distancing itself from the opioid years.
No More TearsIn 2025, longtime health journalist Gardiner Harris released No More Tears: The Dark Secrets of Johnson & Johnson. It was the first book-length investigation into the company’s role in the opioid epidemic.
Drawing on whistleblower interviews, sealed depositions, and internal memos, Harris documented a company that had built its pharmaceutical strategy around pain—and then built its public image to conceal it.
One former executive, quoted anonymously, put it this way: “We weren’t trying to be villains. But we also weren’t trying to be heroes. We were trying to stay ahead of Purdue, stay off the radar, and stay paid.”
The book laid out how deeply the company embedded itself in medical education, federal lobbying, and even DEA quota-setting. According to Harris, J&J had once petitioned for increased opioid production limits while simultaneously funding messaging that cast opioids as underprescribed.
It wasn’t just about drugs. It was about narrative control.
Exporting the ModelAs Johnson & Johnson pulled out of the U.S. market, parts of its pain franchise quietly moved overseas.
In Brazil, India, and South Africa, versions of Nucynta continued to circulate—often accompanied by marketing materials that echoed the same language J&J used in the States two decades prior: “High control.” “Fast relief.” “Low abuse potential.”
In nations with less regulatory oversight and greater unmet pain needs, these drugs were framed as breakthroughs. Critics saw echoes of a familiar playbook: build trust, sell relief, downplay risk.
And although Johnson & Johnson no longer officially sold opioids, the infrastructure it helped create—the research, the branding, the network of partners—remained in place.
International watchdogs, including the WHO and the Pain & Policy Studies Group, raised concerns about “opioid liberalization” campaigns taking hold in developing markets. In some cases, the same medical experts who once helped shape U.S. prescribing practices were now conducting speaking tours abroad.
The epidemic had gone global. And much of the scaffolding was built by companies like Johnson & Johnson.
The Disappearance ActBy the time No More Tears hit bookshelves, Johnson & Johnson had already rebranded. Its consumer health division was spun off. Baby products were updated. The logo was modernized. It leaned into vaccine development, sustainability, and social impact.
For most consumers, the opioid chapter never even happened.
And yet, the numbers remain: over 700,000 Americans dead from opioid overdoses since the late 1990s. Roughly 2.5 million people still living with opioid use disorder. Entire towns hollowed out. Families torn apart. Children orphaned.
And behind it all, a company that built its empire on trust—then sold that trust, one pill at a time.
History may remember Purdue as the face of the opioid epidemic, but the machinery behind it—legal, logistical, and cultural—was built by giants who wore the mask of responsibility.
Johnson & Johnson didn’t just profit from the crisis; it helped design the system that made it possible.
And unlike many of its peers, it walked away with its name intact. The consequences endured by individuals, families, and entire towns stand in stark contrast to the relative impunity enjoyed by the company itself. For those seeking justice or closure, the scars of this epidemic are permanent.
But in boardrooms and shareholder calls, the lessons were merely strategic. The machine adapts, evolves, and moves on—until someone else, somewhere else, pays the price.