"It seems that 2019 is the new high for drug overdose deaths," said Bob Anderson, chief of mortality statistics at the CDCs National Center for Health Statistics. "Data are still provisional at this point, but the increase in the last few months of 2019 was steep enough to push it over the top by a little more than two hundred deaths."

Trump campaigned on ending the opioid crisis and, along with Congress, invested more than $21 billion in the effort over the past four years, according to figures supplied by the White House Office of National Drug Control Policy. Trump during this year's State of the Union address touted a 4.6 percent drop in overdose deaths in 2018, which was the first decline in fatal overdoses in nearly 30 years.

With unyielding commitment, we are curbing the opioid epidemic, Trump declared in early February.

It's still possible the overdose data may be adjusted slightly when it's finalized later this year. But experts say that progress made in 2018 was short-lived, as the epidemic shifts toward more potent opioids and deaths from other drugs are on the rise.

It was premature to declare victory in 2018, said Chuck Ingoglia, president and CEO of the National Council for Behavioral Health, a trade association for mental health and addiction treatment providers. We still dont have enough capacity to reach people who need it. Even with the new investments we are still woefully underfunded.

A year after administration officials struck an optimistic but cautious tone that the tide was beginning to turn on the deadly drug epidemic, they warned on Wednesday that a tough fight lay ahead.

"We understand that there is an extraordinary amount of work to do, especially now as we are also dealing with the COVID-19 pandemic that could markedly affect our nations mental and psychological health and risk of substance use," said Assistant Secretary for Health Brett Giroir in a statement.

White House spokesman Judd Deere said the new data is "an important reminder that the Crisis Next Door is not over and continues to evolve."

Anderson, the CDC expert, said last year's increase was largely driven by synthetic opioids like illicit fentanyl, though deaths involving methamphetamine and cocaine have been increasing.

A substantial portion of those are combination drugs, where fentanyl is being mixed with meth or cocaine, he said.

Dan Barden, vice president of clinical services at Tucson, Ariz.-based CODAC Health, Recovery and Wellness, noted a dramatic rise in illicit synthetic opioids like fentanyl. His state saw a nearly 14 percent increase in overdose deaths in 2019, according to the CDC data.

Some of it is homemade fentanyl," Barden said. "Were finding it in everything pressed into pills to look like Xanax. Its been laced into marijuana and added to prescription opioids.

Addiction experts say the federal focus on opioids has been too narrow and should be extended more broadly on all substances, including alcohol.

We lobbied heavily with our congressman to say get the word opioid out of any bill youre putting out there, said Lenette Kosovich, the CEO of Rimrock Foundation, an addiction treatment center in Billings, Mont. Focusing on the word 'opioid' didnt do us any favors out here in the West and Midwest.

CDC data from 2018 and 2019 showed a significant uptick in meth-related deaths largely in regions of the country, while opioid-related deaths remained more prevalent in the Northeast. Montana saw a 19 percent increase in drug overdose deaths last year, according to the CDC data.

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Fatal overdoses climbed to record high in 2019, reversing historic progress - POLITICO