Photo: John Moore (Getty Images)

President Donald Trump has called for the death penalty for drug dealers. But would that include doctors and pharmaceutical company CEOs?

A new report by CNN based on analysis conducted with Harvard researchers has found a direct link between opioid manufacturers and large payouts to doctors who prescribe their pain–relief medications the most. The report raises ethical and legal concerns as the U.S. opioid crisis rages on.

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According to CNN:

In 2014 and 2015, opioid manufacturers paid hundreds of doctors across the country six-figure sums for speaking, consulting and other services. Thousands of other doctors were paid over $25,000 during that time.

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

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Researchers said it isn’t clear if the payouts lead to more prescriptions, or more prescriptions lead to higher payouts. Regardless, “It’s cementing the idea for these physicians that prescribing this many opioids is creating value,” Harvard’s Michael Barnett, an assistant professor of health policy and management, told CNN.

According to the Centers for Disease Control and Prevention, in 2016, more than 46 people died every day in the U.S. from prescription opioid overdoses. From 1999 to 2015, more than 183,000 died. The numbers are staggering. So are the amounts of money that some opioid–prescribing doctors are earning, along with the numbers of prescriptions being written.

Over a two–year period from 2014 to 2015, nearly half of the 811,000 doctors who wrote prescriptions to Medicare patients wrote at least one prescription for opioids, CNN said. More than 200,000 of those doctors received payments from opioid manufacturers.

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One doctor featured in the report received more than $200,000 over a three–year period from the maker of a fentanyl–based pain reliever, despite the drug having ruined the life of at least one of the doctor’s patients.

The founder of the company that makes that painkiller, billionaire John Kapoor, was arraigned in federal court last October for allegedly exchanging bribes and kickbacks in return for increased prescriptions from doctors.

CNN’s findings are in line with another study by Boston University researchers published last August in the American Journal of Public Health. That study, based on a review of a Centers for Medicare and Medicaid Services database from August 2013 to December 2015, found that 375,266 opioid–related payments were made to 68,177 physicians, totaling more than $46 million.

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“Approximately 1 in 12 US physicians received a payment involving an opioid during the 29-month study,” the authors wrote.

“It’s not like they’re spending this money and just letting it go out into the ether,” Barnett, who worked on the CNN analysis, said. “They wouldn’t be spending this money if it weren’t effective.”

Read the entire report here.