One in 12 U.S. doctors received more than $46 million from 2013 to 2015 in payments from drug companies that were selling strong painkillers, according to a study released Wednesday afternoon in the American Journal of Public Health.

The objective of the study was to identify payments that involved opioid products from the pharmaceutical industry to physicians.

The research found 375,266 nonresearch opioid-related payments were made to 68,177 physicians, totaling $46,158,388. The top 1% of physicians received 82.5% of total payments, the study said. Most payments were for speaking fees or honoraria, about 63% of all payments. Physicians specializing in anesthesiology received the most in total annual payments.

The study concluded that the findings should prompt an examination of industry influences on opioid prescribing. The study’s authors were Scott E. Hadland, Maxwell S. Krieger and Brandon D.L. Marshall.

The publishing of the research comes as the United States grapples with an epidemic of abuse of painkilling treatments. A 24/7 Wall St. story in June said accidental poisoning, primarily drug overdose, is the leading cause of death among young people in the United States. About one in every five deaths of people 18 to 34 are caused by unintentional poisoning.

Most drug overdose deaths, about 60%, involve opioids such as heroin and prescription drugs. According to the Centers for Disease Control, 91 people on average die every day from opioid overdoses.

Prescription drugs such as oxycodone, hydrocodone and methadone have been driving the increase in opioid overdoses. These prescribed drugs are sold today at four times the rate they were at the turn of the century.

A recent New York Times story said drug overdose deaths in 2016 most likely exceeded 59,000, the largest annual jump ever recorded in the United States

The research published in the American Journal of Public Health follows a recently published report from the National Bureau of Economic Research that said physicians in the United States who completed their initial training at a higher-ranked medical school write significantly fewer opioid prescriptions annually than those from lower-ranked schools, even if those physicians practice in the same specialty and county.

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