Lawyers meeting in a federal courtroom in Cleveland today to discuss a settlement of opioid litigation face the difficult task of crafting a deal that will not only pay their clients — mostly towns and cities — but include states and even the federal government while spreading the cash evenly across the country.

That reality was expressed repeatedly at a conference last week in San Francisco, where plaintiff lawyers discussed the strategies they are pursuing against opioid manufacturers and distributors as well as the complexity of the unprecedented litigation wave they have launched. Most of the attendees were private lawyers who have signed contingency-fee contracts with municipal clients, under which they stand to collect a percentage of whatever their clients earn from the litigation.

“Obviously there’s no resolution here unless it’s for the entire country,” said Jayne Conroy, a partner with Simmons Conroy, one of the plaintiff law firms leading the multi-district litigation. “You can’t have rehab programs in some areas and not others.”

With plaintiffs ranging from small towns to cities as large as New York and Chicago, plus hospitals and union healthcare plans, the MDL consolidated in a federal court in Ohio represents a multibillion-dollar threat to the opioid industry.

But plaintiff lawyers have their own challenges: A number of states have filed lawsuits in state court, potentially competing for the same dollars as the clients of private attorneys. And last week the federal government announced its interest in the litigation, saying it may intervene to recover billions of dollars in Medicare and Medicaid expenditures associated with opiate addiction.

Lawyers for both sides are scheduled to meet today for a new round of settlement talks in the courtroom of U.S. District Judge Dan Aaron Polster in Cleveland. But the sheer complexity of the litigation raises questions about how the parties will craft an agreement that ends the threat of further lawsuits against the industry while distributing cash to all the varied entities who have sued.

Some lawyers participating HarrisMartin’s Opioid Litigation Conference in San Francisco on Friday admitted it will be politically difficult to negotiate terms that reward towns and counties that sued and leave others with nothing. Attendees spoke of using the litigation proceeds fund addiction-treatment programs as well as helping governments recoup a huge variety of opiate-related costs, from unreimbursed hospital care to special high schools for the children of addicts.

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