Florida’s substance-use crisis continues unabated.

The latest annual figures show that total drug-related deaths in Florida increased by almost 14 percent in 2015 over 2014. Especially alarming are the rising overdose deaths from heroin and fentanyl.

Data for 2015 from the Florida Medical Examiners Commission shows that “occurrences of heroin increased by 74.3 percent and deaths caused by heroin increased by 79.7 percent when compared with 2014” while “occurrences of fentanyl increased by 69.3 percent and deaths caused by fentanyl increased by 77.6 percent when compared with 2014.”

The drug that killed Prince in April 2016 is a synthetic opiate that can be 100 times more potent than morphine and is increasingly mixed with heroin. Annual fentanyl-related deaths, now over 900, never reached 300 before 2013.

(Source: 2015 Florida Medical Examiners Commission Drug Report)

(Source: 2015 Florida Medical Examiners Commission Drug Report)

In September, the Miami Herald reported a more than 20 percent increase of fatal fentanyl overdoses in Miami-Dade County for the first eight months of 2016. “The problem is bad and it’s getting worse,” said Miami Fire Chief Maurice Kemp as quoted by the Herald. According to Kemp, paramedics administered Narcan (Naloxone)—an antidote for opioid overdoses—to 1,023 people in Miami during the first eight months of 2016. In 2015, the Miami fire department used 493 doses all year.

Heroin can kill users by gradually depressing the ability to breathe, but the process might take hours. Since it is much more powerful, illicit fentanyl can kill within minutes by paralyzing chest muscles and causing a rapid onset of asphyxia. Often, this doesn’t give first responders enough time to administer Narcan.

The federal Drug Enforcement Administration issued another severe warning when it announced results from the 2016 National Drug Threat Assessment in December, stating that the opioid epidemic has been exacerbated by the national re-emergence of fentanyl.

“It is usually mixed into heroin products or pressed into counterfeit prescription pills, sometimes without the users’ awareness, which often leads to overdose,” warns the DEA.

“Sadly, this report reconfirms that opioids such as heroin and fentanyl—and diverted prescription pain pills—are killing people in this country at a horrifying rate,” said DEA Acting Administrator Rosenberg. “We face a public health crisis of historic proportions. Countering it requires a comprehensive approach that includes law enforcement, education, and treatment.”