Drug overdose deaths in Maine increased again in 2019 after a one-year decline, fueled by spikes in deaths that involved cocaine and methamphetamine, as well as the continued prevalence of the powerful synthetic opioid fentanyl.

According to a report released Friday by the Maine Attorney General’s Office, 380 people died last year from a drug overdose, up 7 percent from the 354 deaths in 2018. Before that, overdose deaths had increased every year from 2011 through 2017 – topping out at 417. Over the last five years, 1,799 people have died, an average of almost one every day.

Attorney General Aaron Frey said in a statement that the latest report is a reminder that the opioid epidemic remains a major public health challenge.

“It is important as Maine, appropriately, focuses its energy on combating the COVID-19 pandemic, that we also maintain and increase our efforts to fight the opioid epidemic,” he said. “The data in this report confirms how significant this crisis remains.”

Of the 380 deaths, 341 were classified as accidental overdoses and 34 were suicides. Five deaths were undetermined.

Geographically, overdose deaths were more likely to occur in populated areas. Cumberland County saw 100 deaths (26 percent) and Portland 55 (14 percent). Waldo County and Piscataquis County tied for the fewest deaths, with three each.

The report, compiled by Marcella Sorg at the University of Maine’s Margaret Chase Smith Policy Center, revealed that 84 percent of the deaths in 2019 were caused by at least one opioid, with the powerful synthetic fentanyl being the most prevalent. But there also were increases in the involvement of non-opioid drugs, such as cocaine and methamphetamines.

The number of deaths caused by cocaine, alone or in combination with other drugs, ranged between 10 and 14 from 2010 through 2013. By 2015, it jumped to 35, and by 2017, it was 91. Last year, 110 people died from cocaine. Deaths attributable to methamphetamine, alone or in combination with other drugs, have followed a similar trajectory. Between 2010 and 2013, there was only one death combined. By 2017, there were 16 deaths and last year, they jumped to 47.

Cocaine was included as a cause of death in 34 percent of fentanyl deaths and 36 percent of heroin deaths. Methamphetamine was combined with 13 percent of fentanyl deaths and 18 percent of heroin deaths.

Fentanyl, though, remains the deadliest drug. Although the first deaths attributed to fentanyl didn’t show up until 2014, its prevalence has soared. Last year, 207 deaths involved fentanyl and another 52 were from a combination of fentanyl and heroin. Some of those deaths also involved other non-opioid drugs.

Data from 2020, even partial data, will not be available for some time, but experts worry about a spike in overdose deaths during the coronavirus pandemic because of prolonged isolation, disruption of routine and challenges accessing treatment. Officials said Maine people need to be reminded regularly that help is still available.

“Behind these numbers are our friends, neighbors, and loved ones throughout Maine who have been affected by substance use disorder,” Jessica Pollard, director of the state’s Office of Behavioral Health, said in a statement. “We recognize the lives lost to this disease, the grief that reverberates throughout their families and communities, and the need to continue to adapt our response to support effective prevention, treatment and recovery. We want all Maine people to know that even in the face of this pandemic, help is still available.”

Dr. Mary Dowd, who treats patients with substance use disorder at Catholic Charities in Portland and Discovery House in South Portland and is the medical director of Milestone Recovery’s detox center, said the coronavirus pandemic has made things challenging.

“Video appointments and phone appointments are a real drag. Everybody hates it,” she said. “It’s always better when you can see someone in person.”

Dowd said the numbers were, of course, discouraging, and a sign that the opioid crisis is still ravaging Maine. She said the prevalence of fentanyl, which is powerful and often mixed with other drugs, is likely the major driver, but she wasn’t surprised to see cocaine and methamphetamine showing up regularly.

The death numbers for 2019 came despite Gov. Janet Mills administration’s focus on combating the opioid epidemic. She named the first-ever director of opioid response to coordinate efforts across different agencies, increased distribution of the overdose-reversing drug naloxone, also known by the brand name Narcan, and opened up access to treatment by expanding Medicaid for low-income individuals.

Mills, in a statement, said her administration will continue to provide access to treatment and support, even as the state’s economy has been besieged by the coronavirus pandemic.

“We will continue to put the full force of this administration behind conquering this disease, supporting the families who have lost loved ones, the businesses who have lost valued employees, and all the communities that have been diminished by this public health crisis,” Mills said. “This epidemic grew over a long, long time, and it will take a long, long time to defeat it and make our state whole again.”

Dowd said one thing that stood out to her in the latest report was how few people had naloxone in their system when they died – 110 cases, or 29 percent.

“That tells me that we need more out there. It should be everywhere,” she said.

More information about substance use disorder support and resources by calling 211, or by visiting the Maine 211 website.