The number of people who died in Connecticut from drug overdoses in 2019 was the most the state has recorded in a single year, even after a dip in deaths in 2018.

New state data show that 1,200 people died, an 18% jump from the previous year, according to the Office of the Chief Medical Examiner.

Opioids continue to drive fatal overdoses — different kinds like heroin, morphine and prescription drugs were involved in 94% of all cases. But Dr. James Gill, the state’s chief medical examiner, said the stronger synthetic opioid fentanyl remains a constant presence in deadly outcomes.

“The problem with fentanyl is that it’s so potent, it’s so strong, that getting that dose in the packet you buy a little bit wrong, a few extra little granules of fentanyl, can be the difference between life and death,” Gill said.

Medical examiners also recorded that 85% of deaths from cocaine also involved fentanyl.

“I think there is some evidence out there that people who think they’re buying cocaine actually are getting fentanyl mixed in with the cocaine,” Gill said. “You never know what you’re getting on the street. You know, there’s no FDA out there checking these little drug packets, so you’re really relying on the supplier to what they put in and how much they put in.”

People between 17 and 74 years old were the victims of drug overdoses last year. In many cases, toxicology reports found a mixture of substances. Some people died with different opioids in their systems, while other deaths also involved alcohol, a class of antidepressants called benzodiazepines, and amphetamines.

Gill said that over the years, new drug combinations have been found in overdose deaths. Manufacturers of illegal drugs can alter chemical structures just slightly, creating a new combination.

That can sometimes make it more difficult for medical examiners to determine exactly which drugs were involved in someone’s death, but Gill said his office works with law enforcement and crime lab experts to pinpoint the elements.

Beginning in 2019, state medical examiners found a new drug involved in fentanyl-related overdose deaths. It’s a veterinary tranquilizer called Xylazine and it was detected in 71 cases.

“For some reason, people have been adding it to fentanyl in Connecticut. I’m not sure why,” Gill said. “It has popped up in other parts of the country as well, but it’s something that law enforcement may potentially be able to use to track where those drugs are coming from because it almost has a signature now.”

The state Medical Examiner’s Office performed about 2,700 autopsies last year, “which is the most we’ve ever done,” Gill said. And a significant portion of cases were overdose deaths.

The office collects and releases overdose data annually.

“That helps people who are working in this field to address some of the new issues that may come up, such as new drugs that may be out there,” Gill said. “And it gives you a sense of where the epidemic going. Is it getting better? Is it getting worse?”

Final 2019 overdose deaths exceeded earlier state predictions.

This story first appeared Feb. 14, 2020, on the website of Connecticut Public Radio.