The opioid crisis – with prescription drugs intermingling with the black-market heroin trade, producing record-breaking numbers of annual deaths of Americans from all walks of life – didn’t come from nowhere.

A new Boston University Medical Center study contends that a huge group of doctors – one in 12 nationwide – are being paid by pharmaceutical companies on topics related to opioids.

“These findings should prompt an examination of industry influences on opioid prescribing,” they conclude, in the paper published in the American Journal of Public Health.

The study spanned 29 months, from August 2013 to December 2015. Using a Centers for Medicare and Medicaid Services database, the researchers analyzed the “Open Payments” data requiring reporting of such payments since the passage of the Affordable Care Act in 2010.

A massive number of 375,266 non-research opioid payments were made to 68,177 physicians during that time frame, they report. The payments totaled $46.16 million dollars, they add.

But the payments were not all equal. The average payment was $15, with almost all doctors receiving one payment per year. And food and beverage payments made up the vast majority of the tab – just under 94 percent of the costs, they add.

But the top one percent of the physicians who received the payments took in the vast majority of the overall pot of money – some 82.5 percent of that $46.16 million, they report.

Most of those dollars were for speaking fees or honoraria (some 63.2 percent of the total), they add. Anesthesiologists received the most in total annual payments, with a median tab of $50 per payment, they add.

The phenomenon continues to grow, as well. The total payment dollars increased more than 10 percent from 2014 to 2015, they find (from $18.96 million to $21 million).

“Even though most payments were small, they add up to a shocking number and may have a wide-reaching influence on physician behaviors,’ said Scott Hadland, a pediatrician and specialist on adolescent additions, and lead author. “We need to take a hard look at how the pharmaceutical industry may be influencing care and prescribing at the ground level.”

One limitation of the study remains: further details about the interactions between industry and physicians were not available. That means some or many of the payments could have involved education on addiction care or intervention strategies, the authors add.

President Donald Trump announced today that he would declare the opioid crisis a "national emergency."