America’s opioid epidemic continues: The latest numbers from the Centers of Disease Control and Prevention, released Friday, show that one in four drug overdoses in 2015 was related to heroin. In 1999, just 6% of all overdoses were related to the drug.

When looking at overdoses overall, opioid-related deaths represented the majority. In 2015, overdoses involving opioids represented 60% of all overdose deaths, a significant jump from about 50% in 2010. Opioids include heroin as well as drugs with a similar chemical structure, such as oxycodone and illicit synthetics like fentanyl.

Dr. Holly Hedegaard of the National Center for Health Statistics, who co-authored the study, also noted that this was the first time the number of overdose deaths in the United States exceeded 50,000. In 2010, there were 38,329 overdose-related deaths, and by 2015, that number had climbed to 52,404. By comparison, in 2015, there were 36,252 total firearm-related deaths across the country.

As with heroin, there was also a significant increase in deaths involving synthetic opioids such as fentanyl, the drug that was blamed for pop star Prince’s death. In 2010, these types of drugs were involved in just 8% of all overdose deaths, and by 2015, they were involved in 18% of all overdose deaths.

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