“They knew what the harm was. They did it anyway,” Attorney General Bob Ferguson told reporters Wednesday.

The attorney general’s announcement came as opioid overdose deaths more than doubled from 2019 to 2022, with 2,048 deaths recorded in 2022, according to the most recent numbers from the Washington State Department of Health.

Under the deal, the state and local governments would have to spend $123.3 million to address the opioid crisis, including on substance abuse treatment, expanded access to overdose-reversal drugs and services that support pregnant women on substances. The rest of the money would go toward litigation costs.

The harm is “left now to policymakers to grapple with,” the attorney general said, “or families and individuals who grapple in a very different way with the real tragedy of addiction.”

The settlement agreement still requires approval from a judge. If approved, the deal would send over $20 million more to respond to the opioid crisis than if the state had signed onto a national settlement in 2021 involving Johnson & Johnson, the attorney general’s office said.

Since the 2000s, drugmakers, wholesalers, pharmacy chains and consultants have agreed to pay more than $50 billion to state and local governments to settle claims that they played a part in creating the opioid crisis.

Under the agreements, most of the money is to be used to combat the nation’s addiction and overdose crisis.

Drug overdoses caused more than 1 million deaths in the U.S. from 1999 through 2021, and the majority of those involved opioids. At first, the crisis centered on prescription painkillers that gained more acceptance in the 1990s, and later heroin. Over the past decade, the death toll has reached an all-time high, and the biggest killers have been synthetic opioids such as fentanyl that are in the supply of many street drugs.

Washington state’s Democratic attorney general sued Johnson & Johnson in 2020, alleging that it helped drive the pharmaceutical industry’s expansion of prescription opioids. He also claimed that the company made a distinct mark on Washington’s opioid crisis by deceiving doctors and the public about the effectiveness of opioids for chronic pain and the risk of addiction.

Johnson & Johnson said in a written statement Monday that Duragesic, its fentanyl patch, and its Nucynta opioid accounted for less than 1% of opioid prescriptions in the state and the U.S., adding that it has not sold prescription opioid medications in the country in years.

“The Company’s actions relating to the marketing and promotion of important prescription opioid medications were appropriate and responsible,” according to the statement.

The attorney general’s office noted that the company was one of the largest suppliers of the raw narcotic materials needed to produce opioid drugs.

Funds will be awarded by the end of this fiscal year, which means that the Legislature can earmark the money during the current legislative session. Half of the money will go to a state account, while the other half will go to an account for local governments, according to the attorney general’s office.

Democratic Sen. June Robinson said Wednesday that her children have lost friends to addiction and that she has known parents who have lost children in similar ways.

“The fact that these lawsuits have played out since then, they can’t unfortunately bring back the lives that we lost,” she said. “But they are bringing resources to our communities and to our state that we are able to invest in ways that will help people recover and hopefully help to prevent future addiction and future crises like the one that we’re seeing right now.”

The deal comes about two years after the nation’s three largest opioid distributors agreed to pay the state $518 million, with the vast majority being directed toward easing the addiction epidemic.

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AP reporter Geoff Mulvihill in Cherry Hill, New Jersey, contributed.