RALEIGH, N.C. — Manufacturers of opioid painkillers and allied advocacy groups have given more than $63 million to state political campaigns in the past decade, but less than one percent of that in North Carolina, a joint investigation by The Associated Press and the Center for Public Integrity found.

The investigation looked at the 50-state strategy of contributions and lobbying by the Pain Care Forum — a coalition of drug-makers, trade groups and nonprofits supported by industry funding that has flown under the radar until now. 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.

The forum’s members donated more than $500,000 to state elected officials and political parties in North Carolina in the past decade, a relatively puny amount for the country’s ninth-largest state. The contributions were near the lowest in the country when compared to the campaign funding by other interest groups, the investigation found.

The drug-makers also haven’t beefed up their North Carolina lobbying efforts. As a proportion of all lobbyists, Raleigh had fewer opioid industry and affiliated lobbyists deployed than most other state capitals.

Opioid prescriptions are common in North Carolina, with nearly one for each of the 10 million people in the state, the investigation found.

Drug-makers that produce opioid painkillers and allied advocacy groups spent more than $880 million on campaign contributions and lobbying over the past decade to influence state and federal policies, the investigation found. The bulk went to federal officeholders, with more than $63 million of that spent to influence state decisions.

One theory to explain the forum’s limited North Carolina spending is that the pharmaceutical industry’s long and deep presence in the state means politicians are predisposed to listen when companies come calling, said Bob Hall, executive director of Democracy North Carolina, which tracks political contributions. North Carolina is one of the country’s hubs with hundreds of pharmaceutical companies including GlaxoSmithKline and Merck engaged in drug development, testing and manufacturing.

Existing ties between North Carolina policymakers, drug companies and their lobbyists means less can be spent on the getting-to-know-you dance that consumes most lobbying money and effort, said Joe Stewart, executive director of the North Carolina Free Enterprise Foundation, a business-backed political research and analysis organization.

“If you already know them, you don’t need to go about the business of trying to do that,” Stewart said.

But opioid industry lobbying hasn’t skipped North Carolina.

Legislation introduced in the General Assembly last year contained nearly identical language as bills in 18 other states that would have required coverage of abuse-deterrent formulations of opioids — a move that would benefit pharmaceutical companies. Lawmakers in at least five of the states said drug company lobbyists provided or helped with the language for the legislation.

But the North Carolina legislation failed to even get a public hearing. Of the four sponsors, only one received industry donations totaling $800.

A second bill introduced this year would have kept insurance companies from key limitations on abuse-deterrent opioids. It, too, died without a hearing. Two of the chief sponsors received a combined $2,500 from drug makers this year.

In June, North Carolina became the third state to make the opioid antidote drug naloxone available to anyone who thinks they should have it available. A new law allows all pharmacies to prescribe the overdose antidote to anyone. The drug has reversed more than 2,000 overdoses in North Carolina since 2013. Only Maryland and Pennsylvania have similar standing orders.

Overdose deaths from prescription painkillers have soared in recent years, claiming 165,000 lives in the U.S. since 2000.

In North Carolina, deaths from all drug overdoses have increased by 28 percent between 2006 and 2014. But compared to its population size, North Carolina’s overdose death rate was below the national average in 2014. The U.S. Centers for Disease Control has indicated that prescription opioids and heroin account for the majority of drug deaths.


Follow Emery P. Dalesio at http://twitter.com/emerydalesio. His work can be found at http://bigstory.ap.org/content/emery-p-dalesio .