"This case challenges us to rethink traditional notions of liability and causation," wrote Justice James Winchester. "The state presented us with a novel theory—public nuisance liability for the marketing and selling of a legal product, based upon the acts not of one manufacturer, but an industry. However, we are unconvinced that such actions amount to a public nuisance under Oklahoma law."

Chief Justice Richard Darby and two other justices joined in the majority opinion, which also held that such an "expansion of public nuisance law allows courts to manage public policy matters" better left to the legislative and executive branches.

Justice Dana Kuehn wrote a separate concurring opinion calling on the Oklahoma legislature to amend the law.

"I am concerned that, because some believe the statutory language is vague, it leads to any interpretation of what public nuisance can be, including marketing a product," she wrote. "The legislature should consider reexamining the public nuisance statute to prevent further misapplications. If the public nuisance law can be broadly interpreted as is suggested by the appellants, I believe the law will become the newest fictional shape-shifting monster."

In the sole dissent, Justice James E. Edmondson called the majority's view of public nuisance law "too narrow."

"The issue is not whether J&J's opioid products may be prescribed in a safe manner and may be medically beneficial, but whether the deception of J&J caused its opioid products to be prescribed in an unsafe manner which resulted in, or contributed to, a public nuisance in this state," he wrote. "The attorney general's basic theory of the case is tenable, both in law and equity."

But he also would remand the judgment for a jury trial on damages, concluding Balkman had failed to limit the scope of his award to only Johnson & Johnson's conduct in Oklahoma.

Two justices were disqualified, while one recused.

In a statement, Johnson & Johnson said: "We recognize the opioid crisis is a tremendously complex public health issue, and we have deep sympathy for everyone affected. The company's actions relating to the marketing and promotion of these important prescription pain medications were appropriate and responsible. Today the Oklahoma State Supreme Court appropriately and categorically rejected the misguided and unprecedented expansion of the public nuisance law as a means to regulate the manufacture, marketing, and sale of products, including the company's prescription opioid medications."

A representative for the Oklahoma Attorney General's Office did not respond to a request for comment.

The case was the first opioid trial in the nation. Purdue Pharma and Teva Pharmaceuticals reached settlements totaling $355 million prior to trial, leaving Johnson & Johnson to defend its marketing of opiate pharmaceuticals, prescribed for chronic pain. Johnson & Johnson had appealed Balkman's judgment, which the judge lowered from an original award of $572 million.

The judgment, had it been upheld, would have provided an abatement fund for one year, allocating money to 21 government programs focused on treatment and prevention of opioid addictions and overdoses. Oklahoma's attorney general also had appealed, insisting that Johnson & Johnson should pay $9.3 billion over 20 years.

The decision focuses on Oklahoma's public nuisance statute, which became law in 1910 but, according to Tuesday's opinion, has been amended only once. The majority held that the allegations in the case are more akin to products liability law and cited unpublished opinions siding with Johnson & Johnson in opioid cases in North Dakota and South Dakota, as well as rulings in other states that rejected public nuisance claims against manufacturers of firearms and lead paint.

"Public nuisance is fundamentally ill-suited to resolve claims against product manufacturers, including J&J in this case," Winchester wrote. For one reason, he said, prescription opioids have a lawful use in treating pain. For another, a manufacturer does not have control over its product once sold. Further, Johnson & Johnson, which no longer sells its opioids, should not be responsible for drugs made by other manufacturers, particularly since its products made up only 3% of the market.

"In reaching this decision," Winchester wrote, "we do not minimize the severity of the harm that thousands of Oklahoma citizens have suffered because of opioids. However grave the problem of opioid addiction is in Oklahoma, public nuisance law does not provide a remedy for this harm."

The ruling follows another win for drug manufacturers in opioid cases this month.

On Nov. 1, in the public nuisance case in California, Orange County Superior Court Judge Peter Wilson concluded the plaintiffs—three large counties and the city of Oakland—had failed to differentiate between legitimate uses of opioids, approved by the U.S. Food and Drug Administration, and the illegal activities that led to addictions and overdoses.

Other opioid trials are ongoing, including another bench trial in West Virginia federal court. Jury trials are ongoing in New York state court and Ohio federal court.