Almost 30,000 overdose deaths were related to fentanyl and other synthetic opioids in 2017, which is 22 times the number of deaths due to these drugs in 2002, the CDC finds.
CDC data show more than 140 Americans die each day from drug overdoses - 91, or 65 percent, from opioids.
Last year, 64,000 died of drug overdoses, with 42,000 deaths related to opioids - including prescription pain pills, heroin and fentanyl.
Deaths involving cocaine also went up significantly, but deaths from heroin, prescription opioid pills and methadone fell a year ago, the data show.
Controls on prescription opioids have succeeded in flattening the once-exponential growth of legal opioids, but an influx of illicit opioids has moved into the market to meet demand. Nationwide there were 48,612 opioid overdose deaths in 2017, according to the CDC's estimate.
The provisional number of deaths is calculated using confirmed reports of death, then adjusting to account for delays in reporting and autopsy results. Nebraska had the nation's highest percentage increase at about 33 percent, but the numbers are significantly smaller with 152 deaths.
There are reasons for optimism that the recent increases in overdose deaths will not continue. Those efforts have included prevention education, more access to medication-assisted treatment that helps curb cravings for opioids, and a larger federal focus on individual overdose deaths.
The CDC cautions these figures are early estimates based on monthly death records processed by the agency. In addition, the rate of opioid-related deaths in the farming, fishing, and forestry occupations was more than five times the average rate for MA workers, despite the small number of workers in these fields.
States with the highest increases in drug deaths include Nebraska (33 percent), North Carolina (23 percent), New Jersey (21 percent), in (15 percent), Arkansas (11 percent), ME (11 percent), West Virginia (11 percent), SC (10 percent) and Tennessee (10 percent).
Barbara Marsh, the assistant to the Dayton and Montgomery County health commissioner, says she hopes the trend will hold, and provide some lessons for other parts of the state.
A safer injection facility allows people to use opioids like heroin in a supervised location where a caregiver can administer naloxone if the person overdoses. One worrying sign: Jones said there is some early evidence that drug distributors are finding ways to mix fentanyl with black tar heroin, which could increase death rates in the West.