A federal jury ruled on Tuesday that CVS, Walgreens and Walmart recklessly distributed prescription opioids in two Ohio counties. The case will likely reverberate across the legal system; America’s opioid epidemic has precipitated thousands of lawsuits against drug makers and distributors.

The Associated Press reports that “Lake and Trumbull counties were able to convince the jury that the pharmacies played an outsized role in creating a public nuisance in the way they dispensed pain medication into their communities.”

The ‘public nuisance’ legal argument has been deployed in opioid cases before. Judges in California and Oklahoma rejected it earlier this month in separate proceedings.

“But in this case,” reports The New York Times, “lawyers used the legal theory successfully, arguing that for years, the pharmacies turned a blind eye to countless red flags about suspicious opioid orders, both at the local counter with patients and at the corporate headquarters, whose oversight requirements were, according to Mark Lanier, the counties’ lead trial lawyer, ‘Too little, too late.'”

Roughly 140 million prescription painkillers were dispensed in the two counties between 2012 and 2016 — equivalent to over three hundred doses per resident.

The Times reports that the jury ruling represents “the first time the retail segment of the drug industry has been held accountable in the decades-long epidemic.”

A trial judge will determine how much the pharmacies have to pay the counties. Settlement deals have already been reached with Rite Aide and Giant Eagle.

An attorney for the counties said treating the opioid epidemic has cost Lake and Trumbull a billion dollars each.