Fatal overdoses are continuing their grim march upward in Maryland, and the bulk of the deaths continue to be related to the powerful opioid fentanyl, according to the latest figures from the state Department of Health.

The deaths recorded in the first nine months of 2018 jumped 8 percent from the same period the year before to 1,848.

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Of those, 1,648 were related to opioids and 1,449 were linked specifically to fentanyl, a much stronger synthetic opioid that law enforcement has said largely comes from illicit factories in China and has been ravaging the state and the country. Deaths from fentanyl are up 24 percent from a year ago in Maryland.

The increase overshadowed reductions in deaths directly linked to other opioids. That includes those linked to heroin, which dropped 23 percent from last year; those related to prescription opioids, which dropped 10 percent; and those linked to carfentanil, designed as an elephant tranquilizer, which nearly evaporated.

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Cocaine-related deaths also jumped by 41 percent, but only when the drug was mixed with opioids, a mix known on the street as a speedball.

“We’ve seen a continued decline in heroin-related deaths since the third quarter of 2017, but despite that positive trend fentanyl-related deaths and cocaine-related deaths in combination with opioids continue to surge," said Robert R. Neall, state health secretary. "Treatment and prevention options are available 24/7 for those who need help by dialing 211 and pressing 1, or by texting your ZIP code to 898-211."

An increase in resources for treatment and prevention has done little to stem the deaths statewide, which have been climbing since 2010. The biggest increase in the number of fatal overdoses was in Baltimore City, which had by far the most deaths at 664 in the nine-month period, up by 89.

Overdose deaths rose in half the counties in Maryland. The biggest drop in deaths was in Prince George’s County, which dropped by 38 to 90 fatal overdoses.

In the region, overdose deaths jumped by 37 to 194 in Anne Arundel County, by 24 to 296 in Baltimore County, by 16 to 59 in Carroll County and by four to 80 in Harford County. Fatal overdoses declined by eight to 31 in Howard County.

Maryland's drug-related deaths increase for seventh straight year, reach all-time high in 2017

The number of drug and alcohol-related deaths increased 9 percent in 2017, according to data released by the Maryland Department of Health. Most of them were opioid related.

Adrienne Breidenstine of Behavioral Health System Baltimore, which provides services in the city, said the numbers are not surprising. The number of prescriptions is declining, pushing people to illicit drugs such as heroin. And those drugs increasingly are adulterated with powerful fentanyl and users don’t know.

There have been efforts to educate and deter people from using drugs that might contain the drug. Breidenstine said she wants to add more peer counselors whose “lived experience” makes them better at reaching users and helping them to treatment and sustained recovery.

She also said there should be more focus on so-called social determinants of health, such as housing and jobs that support recovery.

“We need to invest more in that,” she said. “I think that is largely absent in our conversations.”

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