"While no amount of money nor any action can ever make up for the hundreds of thousands of lives lost or the millions more addicted to opioids, we can take every action possible to avoid any future devastation."

The words of New York Attorney General Letitia James on Wednesday when she announced a massive $26 billion settlement to resolve claims against four US drug giants for their roles in creating and fuelling America's opioid crisis.

The agreement involves three of the largest drug distributors in the US; McKesson Corporation, Cardinal Health and Amerisource Bergen, as well as one of America's biggest drug manufacturers, Johnson & Johnson.

"Johnson & Johnson, McKesson, Cardinal Health, and Amerisource Bergen not only helped light the match, but continued to fuel the fire of opioid addiction for more than two decades," the New York Attorney General said.

She announced that the money will help deliver desperately needed relief to communities struggling with opioid addiction with billions of dollars being used to fund prevention, treatment and recovery programmes.

The four companies have denied wrongdoing but as part of the deal Johnson & Johnson agreed to stop the sale of opioids and the three drug distribution companies agreed to coordinate and share data with an independent monitor.

The settlement now needs to be approved by a number of states and local governments across the US and, if it is accepted, it would resolve the claims of nearly 4,000 entities that have filed lawsuits against the four companies.

Fourteen states were involved in securing the deal and other states have been given 30 days to sign up.

The money will be divided using a formula that takes into account the impact of the opioid crisis on a particular area looking at figures such as overdose deaths, the number of residents with substance abuse problems and the number of opioids prescribed.

The size and scope of this multi-billion-dollar settlement is a stark reminder of the scale of the US opioid crisis, an epidemic that has claimed 500,000 lives since 2000.

Opioids are a class of powerful drugs derived from opium poppies. They are sold as legal prescription medications but also as illegal street drugs, such as heroin.

The US opioid crisis can be traced back to the late 1990s, when pharmaceutical companies reassured the medical community that patients would not become addicted to prescription opioid pain relievers.

Doctors began to prescribe these drugs at greater rates, often for minor conditions that did not require such powerful painkillers.

Many people who become addicted to prescription opioids end up turning to heroin.

According to the US National Institute on Drug Abuse, around 80% of people who use heroin first misused prescription opioids and 6% of people who misuse prescription opioids transition to heroin.

In 2005, Steve Rummler was prescribed the powerful opioid OxyContin for chronic back pain. He became addicted to the medication and eventually found a so-called 'pill mill' doctor who would prescribe the drugs he wanted in the quantities he requested.

He turned to heroin in July 2011 and the first time he used it, it killed him. His family set up the Steve Rummler Hope Foundation with the goal of helping others who struggle with chronic pain and addiction.

Steve's story is just one of the hundreds of thousands of cases of suffering and loss that have stemmed from America's opioid crisis. Families have been destroyed and entire communities overwhelmed by the scale of the epidemic.

Purdue Pharma, the makers of the painkiller at the root of Steve's problems, OxyContin, pleaded guilty to criminal charges last year for its role in fuelling the crisis.

The company was accused of aggressively marketing its opioids even though it knew they were addictive and was charged with defrauding health agencies and of making illegal payments to doctors. Purdue had filed for bankruptcy a year previously and the guilty pleas were part of a multibillion dollar settlement.

The deal was immediately criticised however for being too lenient on the founders of Purdue Pharma, the billionaire Sackler family.

Earlier this month, 15 US states dropped their opposition to a bankruptcy plan for Purdue after reaching an agreement that would see the Sacklers paying an additional $50 million.

If approved, the deal will require the family to pay out $4.3 billion over the next nine years to settle cases related to the opioid crisis.

Multibillion dollar settlements, stricter regulations and promises of reform give the impression that it is a problem of the past, that the crisis is now over.

That, unfortunately, is not the case and drug addiction continues to be a major problem.

A record 93,000 people died of overdoses in the US last year, an increase of nearly 30% from 2019.

The majority of the deaths, almost 70,000, were linked to opioids.

Researchers believe the Covid-19 outbreak may have fuelled the rise in drug use with lockdowns leading to isolation and stress, as well as restricting access to treatment services.

When the stark overdose figures were released earlier this month, experts described it as a devastating collision of health emergencies and an epidemic within a pandemic.

A successful vaccine roll-out is having a big impact on one of those crises, the other continues to plague communities across the US and around the world.