Hundreds of Native American tribes have reached a tentative $590 million settlement with Johnson & Johnson and the three largest U.S. drug distributors over their role in fueling an opioid epidemic that has devastated Indigenous communities. Most of that money would be used for substance use treatment and prevention efforts overseen by tribal health experts. J&J did not admit wrongdoing as part of the settlement. Native Americans have endured the highest per capita rate of opioid overdose.