ATLANTA (AP) – A joint investigation by The Associated Press and the Center for Public Integrity found that drug makers and related advocacy groups hire hundreds of lobbyists and give millions in campaign contributions to help kill or weaken measures aimed at prescription opioids that have contributed to the death of 165,000 Americans.

Makers of prescription painkillers have spent $880 million nationwide on lobbying and campaign contributions from 2006 through 2015, more than 200 times what those advocating for stricter policies spent, according to a 50-state review. In Georgia, state lawmakers received more than $1.2 million and were lobbied each year by an average of 41 people representing drug makers and related advocacy groups.

Here’s a look at how the drug makers and others seek to influence policy in Georgia:

CONTRIBUTIONS AND LOBBYING

Members of the Pain Care Forum, a coalition of companies and advocacy groups that meets to discuss opioid-related issues, gave more than $1.2 million to state lawmakers, candidates and parties from 2006 to 2015. That total put Georgia eighth in the nation when painkiller producers’ contributions are ranked using a ratio that factors in all campaign contributions.

Pfizer Inc. spent the most in Georgia among all drug companies and advocates – at least $622,686 from 2006 through 2015. The company’s contributions in 2012 were the highest for a single year, totaling $91,550.

The company has several locations in Georgia, including a manufacturing plant in Albany.

The companies and advocacy groups are involved in a number of issues beyond opioids, so it’s not possible to say whether the contributions are related to trying to influence laws about the drugs.

Gov. Nathan Deal received the most financial support among state lawmakers and candidates in Georgia, reporting at least $89,900 from 2006 through 2015. He received the seventh-highest total among state candidates nationally who received donations from the organizations, behind Alabama Gov. Robert Bentley and ahead of former Virginia Gov. Bob McDonnell.

Deal, a Republican, ran for statewide office twice during the period reviewed. Both were competitive contests that saw him raise more than $8 million in 2010 and more than $16 million in 2014.

Drug makers and advocates hired an average of 41 lobbyists each year to keep tabs on legislation and try to sway lawmakers from 2006 through 2015. Those totals put Georgia 36th in the nation when drug makers’ lobbying hires are ranked using a ratio accounting for all lobbyists in each state.

Some of Georgia’s prominent lobbyists appear on reports the group members must file with state authorities. The Washington-based advocacy group Pharmaceutical Research and Manufacturers of America, for instance, lists both John “Trip’’ Martin, a veteran lobbyist, and Arthur “Skin’’ Edge, a former state senator who led the Senate Republicans for part of his time in office.

Caitlin Carroll, communications director for the group, said it is “committed to working with patients, providers, first responders, policymakers and many others to address the scourge of opiate abuse.’’

“We have long supported a comprehensive policy approach that includes mandated prescriber education on appropriate prescribing of opioids and non-opioid alternatives; mandated training and use of state-based data bases to prevent abuse; the need for clinical guidelines to help guide prescribers in determining when and under what circumstances an opioid may or may not be appropriate; expanding access to treatment including medications for assisting overdose victims; and accelerating the development of abuse deterrent formulations of opioid medications, alternatives to opioids and medications to treat addiction and prevent drug overdose and death,’’ Carroll said in a written statement.

LEGISLATION

A 2015 bill introduced by Georgia state Sen. Rick Jeffares contained nearly identical language to 20 other proposals introduced nationally calling for required coverage of abuse-deterrent formulations of opioids. The move 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. Jeffares, a Republican from McDonough who chairs the Senate’s Regulated Industries and Utilities committee, didn’t return requests for comment this week. Jeffares has received $2,500 from drug makers Baxter International Inc. and Pfizer Inc. since 2006, far below what Deal, legislative leaders and other influential officials received.

Senate leaders assigned the Georgia bill to the chamber’s Insurance and Labor committee but it never received a hearing or a vote in the full chamber.

USE AND DEATHS

Opioid prescriptions in Georgia since 2013 put the state in the middle of the pack nationwide. According to data collected by health care information company IMS Health, doctors wrote 7.8 million prescriptions in Georgia in 2015. The data doesn’t specify whether individual patients received more than one prescription.

Between 2006 and 2014, more than 9,100 drug overdose deaths have been reported in Georgia, increasing 45 percent during that time span. That’s higher than the 37 percent increase in overdoses nationally during the period. The Centers for Disease Control doesn’t specify how many of those deaths were caused by opioid use, but CDC officials have said the majority of drug deaths are caused by prescription opioids and heroin.