US doctors have been paid $46,158,388 to push painkillers to patients, new research reveals.

Approximately one in 12 doctors in the US has received a payment from a pharmaceutical company that manufacturers opioids, a study found.

Among the top one percent of doctors, each physician averaged an annual pay out of more than $2,600, the research adds.

Lead author Dr Scott Hadland from Boston Medical Center, said: 'Even though most payments were small, they add up to a shocking number and may have a wide-reaching influence on physician behaviors.'

The researchers are concerned inappropriate prescriptions may be behind the thousands of opioid-related deaths that occur each year in the US.

One in 12 doctors in the US has received a payment from a pharma giant that makes opioids

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How the study was carried out

The researchers analyzed the Open Payments program database from the Centers for Medicare and Medicaid Services.

The Physician Payment Sunshine Act requires drug companies report all payments to doctors in the US. In the UK, such declarations are voluntary.

Opioid-related payments made to doctors by drug manufacturers between August 2013 and December 2015 were assessed.

Payments were defined as 'transfers of value', which could include direct money, travel reimbursement, meals, or speaking or consulting fees.

One in 12 doctors receive payment

Results reveal approximately one in 12 US doctors received an opioid-related payment during the study's duration.

During the trial, 375,266 non-research opioid-related payments were made to 68,177 doctors, totaling $46,158,388.

The average payment was $15, with most doctors receiving one fee per year.

Yet, the top one percent of doctors collectively received more than $38 million and averaged over $2,600 in annual payments each.

Speaking fees were of the largest value, while payments for food and drink were given out most frequently.

The findings were published in the American Journal of Public Health.

'Wide-reaching influence on physician behaviors'

Previous research suggests payments from drug companies may lead to increased prescribing by doctors, even when the amount of money given is low.

Dr Hadland said: 'Even though most payments were small, they add up to a shocking number and may have a wide-reaching influence on physician behaviors.

'We need to take a hard look at how the pharmaceutical industry may be influencing care and prescribing at the ground level.'

Michael Botticelli, executive director of the Grayken Center for Addiction Medicine and former director of the White House Office of National Drug Control Policy under President Obama, said: 'There's no denying that we have a widespread and systematic problem.

'Pharmaceutical companies should take responsibility for how these payments are contributing to the growing epidemic.

Mr Botticelli, who was not involved in the study, added: 'Physicians also have a role to play by prescribing judiciously and advancing safe opioid prescribing education on the front lines.'

The researchers add thousands of opioid-related deaths occur every year in the US, which may be driven by inappropriate prescriptions.

They add policy makers should consider capping opioid-associated payments from manufacturers to doctors.