BOISE, Idaho — Powerful opioid painkillers like OxyContin, Vicodin and fentanyl have become a significant part of Idaho’s medical landscape over the last decade, with doctors issuing enough opioid prescriptions last year to put the drugs in the hands of three out of four Idaho residents.

A joint investigation by The Associated Press and the Center for Public Integrity has found that opioid proponents are a major part of Idaho’s political landscape as well, with donations from members of the Pain Control Forum — a group that touts prescription painkillers as improving the quality of life for millions of Americans — making up a huge chunk of lawmakers’ campaign cash.

In fact, Idaho ranks sixth in the nation for having a large amount of the state’s total political contributions come from Pain Control Forum members. Between 2006 and 2015 (and with only part of the financial data for 2015 available), Pain Control Forum members contributed more than $207,000 to Idaho political campaigns. That includes more than $44,000 contributed to Gov. C. L. “Butch” Otter and more than $5,000 each for several Idaho lawmakers in positions to set legislative agendas or on health-related committees. Federal lawmakers from Idaho saw even bigger contributions, including more than $121,000 for U.S. Sen. Mike Crapo.

Otter’s spokesman said he was unavailable for comment and Crapo’s office didn’t immediately respond to inquiries from The AP. But Idaho Senator Pro Tem Brent Hill, a Republican from Rexburg who has received just over $4,000 from Pain Control Forum members in the last decade, said he doesn’t think the donations have any impact on drug policy legislation.

“I don’t remember being contacted by any representatives (of the group) as far as a specific bill at the state level,” Hill said. “Nor can I think of any time that we’ve even discussed anything that might promote opioids in any way or make them more available.”

Hill said he just attended a conference that looked at opioid abuse, and he plans now to approach the Idaho Medical Association to discuss ways to curb the problem.

“I’m not as concerned about the number of prescriptions per capita as I am with the length of the prescription,” Hill said. “Five pills might be appropriate for the pain, but the patient doesn’t need a 30-day supply. And at the same time we need to try to educate prescribers of other options that aren’t as dangerous or addictive.”

Drug companies say they are committed to solving the problems linked to their painkillers. Perdue Pharma, one of the largest opioid producers by sales, said it does not oppose policies “that improve the way opioids are prescribed” even if they result in lower sales.

The investigation by the AP and Center for Public Integrity comes as the number of overdose deaths from prescription painkillers has soared, claiming the lives of 165,000 people in the U.S. since 2000. Reporters analyzed campaign finance and lobbying data from 2006 through 2015, reviewed hundreds of documents and conducted more than 150 interviews. The AP and Center for Public Integrity found that drugmakers and allied groups employed an annual average of 1,350 lobbyists in state capitals around the country and contributed to a total of 7,100 candidates for state-level office.

The drugmakers and their allies also spent more than $880 million on campaign contributions and lobbying over the last decade nationwide as they worked to influence state and federal policies. The groups have an array of political interests that include opioid advocacy, and their spending was eight times that of the gun lobby during the same period. By comparison, groups advocating for limits on opioid prescribing spent about $4 million.

Meanwhile, reported drug overdose deaths have skyrocketed 63 percent in Idaho between 2006 and 2014, with a total of 1,544 deaths during that period.

Elisha Figueroa, director of the Idaho Office of Drug Policy, cautions that the drug overdose number is likely inaccurate, however. Her office has worked to teach coroners the signs of drug overdose from opioids and other drugs, and encouraged the local officials to include the type of drug involved in the overdose on the death certificate. As a result, more coroners are recognizing and reporting opioid deaths than in the past, she said.

Still, she said, the drug overdose number has increased, and she’s also concerned about Idaho’s opioid prescription rates. Her office has taken a multi-pronged approach, including trying to get more doctors to use the state’s prescription monitoring program, encouraging residents to lock up their opioid prescriptions and campaigns to get residents to turn in unneeded painkillers to law enforcement drop boxes.

The legislature has also addressed opioid abuse in recent years by making it easier for people to access Naloxone, a medication that temporarily reverses opiate overdoses, Figueroa said.

Rick Dixon, the clinical supervisor at the Coeur d’Alene substance abuse treatment center Port Of Hope, said the state saw a spate of legislation designed to curb methamphetamine use 10 years ago, but as meth use declined, heroin and opioid abuse increased.

“The older doctors aren’t trained in addiction … The doctors’ intentions are honorable,” Dixon said. “I think every medical doctor out there should go through a three- or four-day program just on addiction so they understand it.”

Dixon said he doesn’t expect to see much legislation targeting opioid abuse until the matter becomes politicized, much like the creation of Mothers Against Drunk Driving helped lead to a national minimum drinking age. Still, he’s optimistic that doctors will begin addressing the issue themselves.

“I truly believe that with what’s happening in the news, doctors are becoming more and more aware. Though we do have a few Dr. Feelgoods, as we call them,” Dixon said.