Hundreds of Native American tribes that have suffered disproportionately high addiction and death rates during the opioid epidemic agreed on Tuesday to a tentative settlement of $590 million with Johnson & Johnson and the country’s three largest drug distributors.

Together with a deal struck last fall between the distributors and the Cherokee Nation for $75 million, the tribes will be paid a total of $665 million. Purdue Pharma has already committed at least tens of millions more to the tribes in a settlement that is in mediation.

“We are not solving the opioid crisis with this settlement, but we are getting critical resources to tribal communities to help address the crisis,” said Steven Skikos, a top lawyer for the tribes.

Native Americans have endured disproportionately high opioid-related overdose deaths, by many metrics. In 2016, for example, Oglala Lakota County in South Dakota, home to the Oglala Lakota tribe, had an opioid-related death rate of 21 people per 100,000, more than twice the state average. According to one study, pregnant American Indian women were as much as 8.7 times more likely than pregnant women from other demographic groups to be diagnosed with opioid dependency or abuse.

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