The data is not complete for 2013, but the state of New Hampshire is already seeing one of its worst years yet when it comes to heroin deaths, according to the state medical examiner's officer.

Kim Fallon, a chief forensic investigator with the department, said that in 2013, 63 people died from heroin, with between 30 and 40 other drug death cases pending that have not been determined. In 2012, 37 people were recorded by the department as having died from heroin.

Fallon said there were two broad categories of users who had died in the last year, those who are taking the drug for recreational purposes and those who start out taking prescription drugs or other narcotics and "end up needing more." The latter, she said, tends to be middle-aged adults, while young people are the recreational users.

"We consider heroin an urgent public health issue," she said, noting the dramatic increase in year over year deaths.

According to Fallon's data, toxicology reports often show other substances in the chemical makeup of the deaths, but heroin tends to be the more toxic of the substances and the primary reason people died. She said the department hoped to be able to finalize all 2013's cases soon. Some of the cases showed false positives, so the department runs a second test to make sure. A quantitative test is run to see how much is in someone's system. A confirmatory test is then run after that test, she said.

Today's street heroin is also has a very "high purity," according to reports from the department, and is cheap when compared to Oxycodone and Hydrocodone. New Hampshire and other states are also seeing the heroin mixed with fentanyl in some of their cases.

"It can take two to three months to get the test results back," she said.

The department is still working on a number of drug deaths from last year and also this year. All of January's heroin deaths have not been confirmed to be heroin, she said. Most law enforcement agencies are assuming that many of the deaths are due to heroin because of what they see at the scene of the deaths, the previous knowledge with the individuals who died, or what witnesses tell them, but it isn't always accurate information.

While the 2013 data isn't complete, when looking at the data from previous years, heroin deaths are clearly escalating in the state.

In 2000, there were about 50 deaths in the state directly related to illicit drug use. In 2006, drug deaths surpassed traffic deaths in New Hampshire and there have been more drug deaths than traffic deaths every year since, with the exception of 2008, which had a slight dip in drug deaths.

By 2011, the drug death number had steadily increased to 201, with a little less than half of the deaths coming from people who were prescribed the drugs. In 2012, deaths had dropped back down to 164, with about half of those people gaining access to the drugs in an illicit manner.

Between 2005 and 2010, state officials say that Methadone caused the most drug deaths in New Hampshire, with cocaine and Oxycodone rounding out the top three. But by 2011, that had shifted, with Oxycodone causing the most deaths in the state, followed by heroin and Methadone. In 2012, Heroin caused the most drug deaths, followed by Oxycodone and Methadone.

Opiates, as a general category, have consistently made up between 30 and 43 percent of drug deaths in New Hampshire during the past decade, according to state officials.

According to state data, most of the drug deaths are accidental although during the last decade, anywhere between 20 and 40 of the deaths each year were determined to be suicides. In 2001, it was more than a third, according to the data. Fallon said there was usually "compelling evidence" from notes, texts, or some other indication, showing that the people were attempting or planning on ending their lives.

County consumption

The state analyzes most of the drug death data by county of use, not necessarily where the person died. The person may have been using in one area of the state but was pronounced dead or died in a hospital in another county.

The three counties with Patch community websites have seen a varying number of deaths during the past few years, with nearly all the numbers on the upswing.

In 2008, two people died from heroin in Merrimack County and no one died from heroin in 2010, whereas seven people have died, so far, in 2013.

Rockingham County has seen its heroin death numbers increase too, from lows of two in 2010 and four in both 2008 and 2009, to 11 in 2011 and nine so far last year.

Hillsborough County though has been the hardest hit in the state.

In 2008, seven people died from heroin. By 2011, that number increased to 19. In 2012, it was 21. And last year, again, with incomplete data, 17 people had perished from the drug.

While men solidly outnumbered women when measuring heroin deaths, the gender numbers are shifting. Hillsborough County, as an example, showed a sizable increase in the number women dying at the hands of the drug. No women in 2008 passed away and only one died in 2009. But by 2012, seven women between the ages of 20 and 39 had been killed by the drug, with four, between 30 and 59, dying of the drug last year.

Both Merrimack and Rockingham counties saw similar increases.

What to do

Fallon said each agency in both state and local government had its own role to play in the process of disseminating information about the urgency of the heroin problem. For her, and the medical examiner's office, it's about getting the information into the public realm.

"We try to get the data, to reporters, to get the word out that people are dying from this," she said, adding that celebrity deaths like Phillip Seymour Hoffman should also prompt people to take a look at the situation.

"I think people will pay more attention to it," she added.