Oklahoma has become the first US state to take a major pharmaceutical company to trial over an epidemic of deaths from prescription opioid overdoses.
Johnson & Johnson and subsidiary Janssen Pharmaceuticals, which produced an opioid patch and pill, created a public health crisis that has killed 4,653 Oklahoma residents from 2007 to 2017, according to Oklahoma Attorney General Mike Hunter.
During opening statements on Tuesday, Hunter said Johnson & Johnson disregarded the dangers related to opioid abuse in marketing their products and created "the worst man-made public health crisis in the history of our country and the state - the prescription opioid epidemic."
He said the company "embarked on a cynical, deceitful, multi-billion-dollar brainwashing campaign to establish opioid analgesics as the magic drug."
The case is the first of nearly 2,000 cases pending against pharmaceutical companies across the US.
The case comes after Oklahoma settled with Purdue Pharma for $US270 million ($A390 million) in March and Israeli company Teva for $US85 million ($A123 million) on Sunday.
Johnson & Johnson's lawyers defended the company in court, saying there was government oversight over the drugs and cited warning labels on the products.
According to the Centres for Disease Control and Prevention (CDC) 46 people in the US die every day from overdoses involving prescription opioids.
In 2017 prescription opioid drugs were involved in more than 35 per cent of 47,600 opioid-related overdose deaths.
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