The number of Mainers who died from drug-induced deaths rose to 418 in 2017, compared with 376 who died the previous year, according to the Maine attorney general’s office.

“While the increase is not as significant as the nearly 40 percent increase in deaths in 2016 over the previous year, the number of deaths in 2017 was driven by a sharp increase of 27 percent in deaths due to illegal fentanyl and fentanyl analogs, while heroin deaths decreased,” Attorney General Janet Mills said in a Thursday release.

Fentanyl killed 247 people and five died as a result of carfentanil, a synthetic version of fentanyl.

Traffickers often lace heroin with fentanyl and sell fentanyl as heroin because fentanyl is cheaper to make and the profit margin for dealers is so much higher.

“When people ingest this powerful powder, they often believe it is heroin, and have been told it’s heroin,” Mills said. “But no one should take a chance with these substances. Even as dangerous as heroin is, fentanyl is hundreds times more likely to kill you. The equivalent of a few grains of fentanyl can take your life.”

Mills, who has served on two recent task forces charged with improving the state’s response to its opiate crisis, has outlined steps that must be taken to reverse the trend, from expanding access to addiction treatment to diverting some criminal offenders into drug courts instead of incarcerating them.

Asked Thursday about priority steps, Mills — a Democratic frontrunner in the campaign for the Maine governorship in 2018 — said Maine hospitals should use their emergency departments to provide prescriptions to the addiction management drug Suboxone and peer recovery coaches, making it easier for drug users to enter treatment.

“Otherwise, we’re just [treating them with the overdose reversing drug Narcan] and sending them back into the street,” she said.

And Mills said Narcan, long tied up in bureaucratic wrangling, should be made available to consumers in Maine pharmacies as soon as possible. Mills, who used her office to directly provide Narcan to law enforcement groups over a year ago, said about 325 lives have been saved using the drug so far.

Gov. Paul LePage recently called for limiting the purchase of over-the-counter Narcan to individuals 21 years old and older, but has not yet signed off on the rule that would release the drug to retail pharmacies.

[Thousands of overdose deaths linked to shocking increase of fentanyl in drug supply]

The highest number of drug overdose deaths last year, more than a quarter of the total statewide, were in Cumberland County. Fifty-seven overdose deaths — more than one a week — took place in Portland, the report said.

York County saw 82 deaths, or 20 percent of the statewide total, with 23 deaths in Biddeford, according to the report.

In Portland, Dr. Mark Publicker said he was not surprised that drug deaths are still going up. Although prescribing practices may have changed to reduce the amount of prescription opioids available on the street, he said, that change may drive more Mainers to illicit Fentanyl or heroin.

Publicker, an addiction specialist who manages patients with Suboxone and other drugs used for medication-assisted treatment, said more Mainers would enter treatment if they could simply get the medication they need without mandated group counseling and other care. Until Maine makes addiction treatment more straightforward, available and affordable he said, “My prediction is that the death rate continues to go up.”

Penobscot County had the third highest number of deaths, with 65, or 1 percent of the total.

Suzanne Farley, executive director at Wellspring Substance Abuse and Mental Health Services in Bangor, said the report demonstrates the need for more money in the system to pay for care. At any given time, she said, her residential and outpatient programs each has more than 100 people waiting to get into treatment.

Many in the community lack any way to pay for addiction treatment, she said, and are also reluctant to seek services for fear of social stigma. And in many cases, Farley said, people don’t know how to find treatment for their addiction. She said Maine should launch a public awareness campaign to make it easier to find help.

“I meet people in the street who are so sick,” she said. “And they had gotten into care sooner, they could be better sooner.”

[Janet Mills: Maine is losing the war against opioids. Here are 10 steps to turn it around.]

The average age of drug overdose deaths remained stable at 41, according to Thursday’s report, which is close to the average age of the population of the state.

Meanwhile, a story from the Pew Charitable Trusts on Thursday cited data from the U.S.Centers for Disease Control and Prevention showing that drug overdose deaths decreased in 14 states between July 2016 and July 2017. That report shows Maine’s deaths increasing during that period from 334 to 353, a growth rate of 5.7 percent.

The office of Gov. Paul LePage did not immediately respond to a request for comment.

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