Maryland Top Court Nixes Baltimore’s $152 Million Opioid Public Nuisance Verdict

The city of Baltimore suffered a defeat in its efforts to address the opioid epidemic last week when the Maryland Supreme Court vacated a $152 million public nuisance verdict won by the city against drug distributors McKesson and AmerisourceBergen.

The state’s high court erased the verdict and returned the case to the Baltimore City Circuit Court, ordering that court to follow the high court’s March 2026 opinion (Express Scripts, Inc., et al. v. Anne Arundel County) in which it answered “no” to the question of whether the actions of drug distributors can constitute an actionable public nuisance, which was the legal basis for city’s suit.

The high court in answering that question for a federal court found that companies that have legal licenses to distribute controlled substances cannot be held liable for misuse of those legal drugs as a public nuisance under Maryland common law.

“Maryland has not expanded the public nuisance doctrine beyond the traditional historical principles embodied in the common law—namely, that a public nuisance action was not regarded as a tort but was instead a public action by a government entity to pursue criminal prosecutions or seek injunctive relief to abate harmful conduct. The Court has never recognized a government actor’s ability to recover damages for public nuisance,” the high court said in Express Scripts.

The city initially won a $266 million verdict in a trial against McKesson and AmerisourceBergen (now Cencora) in November 2024. That amount was later reduced to $152 million.

The city had argued that pharmacy benefit managers, mail-order pharmacies, and retail pharmacies created a public nuisance by partnering with opioid manufacturers in deceptive and dangerous marketing of opioids for financial gain, and by spurring opioid abuse by placing these drugs on formularies with preferred status and without restriction on their approval for use. The city claimed that McKesson and Cencora “recklessly” sent more than 300 million oxycodone pills into the city from 2006 to 2019, creating a public nuisance.

But the pharmaceutical companies argued that they had complied with federal regulations and should not be held liable for the misuse of the painkillers or the addiction of users.

The high court remanded the case back to the lower court for proceedings consistent with its stricter “public nuisance” standard set forth in Express Scripts. In effect, the high court said that public nuisance is not the correct legal avenue for the city to use in pursuing opioid claims because the public nuisance law is designed for public right interference, not for regulating legal business activity.

Legal Strategy

Baltimore opted not to join other municipalities in national suits against the drug industry over the opioid epidemic and instead filed its own lawsuits. It has managed to negotiate settlements worth about $400 million with several companies including Walgreens, Allergan, CVS, Teva and Cardinal Health.

The funds are being used to mitigate the harms of the opioid crisis. The city maintains that hundreds of Baltimore citizens die every year of opioid overdoses, while others suffer from the effects of opioid use disorders including struggling to hold jobs and additional health problems.

When the original $266 million jury award was announced, Baltimore Mayor Brandon M. Scott called it “a game-changing figure that will reshape our ability to confront this crisis in every part of our city.” He said the city would “put these funds to work to save lives and build a healthier Baltimore.”

Now the city faces the likelihood it will not be able to collect the $150 million award against McKesson and Cencora. Scott said he disagrees with the latest ruling but said the city would continue to use “every available resource” to reduce overdose deaths.

The state of Maryland has participated in national opioid settlements including with Cardinal Health, McKesson, AmerisourceBergen, and Johnson & Johnson.

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