America's opioid crisis worsens each year, but there might be more to it than meets the eye, particularly the factors behind opioid prescriptions and the doctors that give them out.

According to an analysis by CNN and researchers from Harvard University, it appears manufacturers of opioids are paying physicians a great deal of money for prescribing opioids. More importantly, it seems that the more they prescribe, the better the payout.

Manufacturers paid doctors six-figure sums for speaking, consulting, and other services in 2014 and 2015, as CNN reports. It raises ethical and legal concerns as the country's opioid epidemic shows no sign of calming down. Nearly half of the 811,000 doctors who gave Medicare patient prescriptions wrote at least one for opioids. Over 200,000 of those doctors received payouts from opioid manufacturers — representing about 54 percent of the pool.

The Opioid Crisis: More Prescriptions, More Money

"Physicians who prescribed particularly large amounts of the drugs were the most likely to get paid," according to CNN.

What's not clear is if bigger payouts lead to more prescriptions, or vice versa. Even still, Michael Barnett, an assistant professor of health policy and management at Harvard, claims that it promotes the notion that prescribing more opioids creates value.

Across the country, 46 people died each day from prescription opioid overdoses in 2016, according to the Centers for Disease Control and Prevention. From 1999 to 2015, over 183,000 lives have been claimed by this epidemic. The figures are astonishing, but so are the payouts doctors receive by prescribing more opioids. One such doctor even received an astounding $200,000 over three years from a manufacturer of a fentanyl drug, despite it having destroyed one of their patients' lives.

John Kapoor, the founder of the company that makes that drug, was summoned to federal court in October 2017 for reportedly bribing doctors for increasing their prescriptions for opioid.

Another doctor received over a million dollars in a two-year period.

"Once I found out he was being paid, I thought, 'was it really in my best interest, or was it in his best interest?'" said Carey Ballou, in reference to the doctor.

A Doctor's Role In The Opioid Crisis

Concerns over opioid manufacturers paying doctors to prescribe their medicine made headlines last year via a study published in the American Journal of Public Health by researchers from Boston University. That study looked at the database of Centers for Medicare and Medicaid Services from 2013 to 2015 and found that there were 375,266 payments made related to opioids, with 68,177 being paid a collective amount of over $46 million.

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