Reducing opioid-related overdoses and deaths is a national patient safety priority. Little is known as to the extent to which direct-to-provider marketing of opioids by pharmaceutical companies influences physician prescribing and patient mortality related to overdose from prescription opioids. In this study, researchers analyzed data from both the Centers for Medicare and Medicaid Services Open Payments database and the Centers for Disease Control and Prevention on opioid prescribing and fatal overdoses at the county level within the United States from August 2014 through December 2016. They linked this to pharmaceutical company marketing data from August 2013 to December 2015. Using the Open Payments database, they found that there were 434,754 payments related to opioid marketing made to 67,507 providers across 2,208 counties accounting for almost $40 million. Further analysis revealed that marketing to providers was associated with increased prescribing of opioids and mortality from opioid overdoses. An accompany commentary concludes that numerous approaches will be necessary to effectively mitigate the opioid epidemic.