Massive opioid case may end with huge settlement. Where would the money go?

The largest civil trial in U.S. history is scheduled to begin in a matter of days, putting those who made, marketed, distributed and dispensed prescription painkillers under the legal spotlight. But those on the front lines of the opioid epidemic are already looking beyond the courtroom to the massive settlement they expect will ultimately resolve the case.

Experts have little doubt it would be the most complex payout the country has ever seen. It would exact so much, from so many companies. And it would need to do so much for so many people, starting with the 2 million Americans ensnared in addiction.

A settlement in the case known as Multidistrict Litigation 2804 would have many pricey pieces. The total cost could easily range upwards of $100 billion.

It would need to fund — potentially for years — counseling and addiction treatment for those ready to try it.

It would have to broaden access to the opioid-reversal drug naloxone and underwrite the development of newer, more effective rescue drugs, so that those who overdose have a chance to get clean.

It could pay for drug abuse prevention campaigns for the public, safe-prescribing seminars for doctors and abuse awareness programs for pharmacists.

It would probably include drug screening for pregnant women as well as treatment for infants exposed to opioids in the womb.

It might fund support groups for families of the addicted and grief services for those left behind.

It would reimburse state and local health departments for the money they’ve spent treating millions of victims.

That’s not even an exhaustive list. And, of course, there’s no amount of money that can bring back the 400,000 Americans who lost their lives to opioids.

A global settlement would require the consent of the roughly 35,000 plaintiffs...