A new study from NYU School of Medicine and Boston Medical Center presents some of the strongest evidence to date that there is a correlation between pharma-sponsored marketing of opioids to physicians and the rate of opioid deaths in the U.S. counties where these targeted physicians practice. The findings were reported by The New York Times and several national media outlets across the country.

The study team, co-led by Magdelena Cerdá, DrPH, associate professor in the Department of Population Health and director of the Center for Opioid Epidemiology and Policy at NYU Langone, determined that $39.7 million in opioid marketing was distributed to nearly 68,000 physicians in 2,208 U.S. counties between 2013 and 2016. This direct-to-physician marketing includes paying for meals, trips, speaking fees, and more.

Counties that received more industry marketing saw an increase in the number of opioids prescribed and an increase in opioid overdose deaths. Importantly, the researchers found that marketing interactions with physicians were more strongly associated with deaths than dollar amounts spent. More payments of low monetary value—such as multiple meals reimbursed—may lead to more opioids prescribed, and consequently more deaths, than a single high-priced speaking engagement.

Read more from The New York Times.