Nearly 80 percent of Pennsylvania counties have fatal overdose rates that exceed the national average, according to data released Thursday.



Pennsylvania's rate is 36.5 fatal overdoses per 100,000 people. The most-recently published national rate is 16.3 per 100,000 people.



In 2016, that equated to 4,642 deaths -- up 37 percent from 2015. A national rate based on 2016 data has yet to be published. However, Pennsylvania's rate is likely to remain among the nation's worst. Pennsylvania had the sixth-highest rate based on 2015 data.

Eighty-five percent of the Pennsylvania overdoses involved an opioid such as heroin, prescription painkillers or fentanyl.

Here is a breakdown of Harrisburg-region overdoses.



The new surge comes after several years of efforts to warn people about the danger of opioids, get doctors and hospitals to stop prescribing so many, and help addicts get treatment.



Yet people who see the crisis from the ground level aren't surprised by the accelerated pace of overdose deaths.



That includes Jack Carroll, the head of drug and alcohol programs for Cumberland and Perry counties. He said the surge is partly due to better reporting of overdose deaths.



But he believes the number of deaths is also rising. He attributes it to factors including Pennsylvania's new prescription drug database, which is intended to cut down on people feeding their addiction by obtaining prescriptions from multiple doctors. One unfortunate consequence, which experts predicted, is that some addicts who are cut off from their supply will turn to street heroin, which is more dangerous.



Also, fentanyl, which is many times stronger than heroin and is often mixed with it, has become common in Pennsylvania in recent years, resulting in more overdoses.



Beaver County has the state's highest fatal overdose rate, 59.8 per 100,000 people, followed by Philadelphia with 59.4. In Beaver that equaled 102 fatal overdoses. In Philadelphia it equaled 907.



The DEA analysis found that slightly more than half of the overdoses involved fentanyl or fentanyl-related substances. That's a big increase from 2015, when only 27 percent involved those substances. Addicts buying heroin laced with fentanyl often don't know it, and thus don't know the actual potency of the dose.



Seventy percent of the fatal overdoses involved men. Men were more likely to die of overdoses involving fentanyl and heroin. Woman were more likely to have died of an overdose involving prescription painkillers such as oxycodone.



Seventy-seven percent of the overdose victims were white, 12 percent were black, four percent were Hispanic, and seven percent were listed as other.



Pam Gay is the coroner in York County, which had 127 fatal overdoses in 2016. A former nurse, she has delved deeply into the crisis, learning what she can from families and circumstances of overdose victims, and speaking at events to promote awareness and understanding of the crisis.



Gay predicts the overdose total will continue to rise -- perhaps for a half-dozen years or more. "These numbers are going to continue to be high for a while. I truly believe that," she said.



That's based on her belief there is still a significant population of people who became addicted before public awareness campaigns, and before efforts to get doctors to prescribe more carefully. "Those are the people we weren't able to reach with that education soon enough," she said. "We're still seeing the fallout from that and will be for some time."



She believes the deaths will eventually begin to drop as a result of things like the new prescribing guidelines, efforts to educate young people about the dangers of opioids, and better access to addiction treatment.



Of those presently addicted, she said "The only way we can help this group right now is through increased access to treatment."



Still, a glimmer of hope came Thursday in a different report which found a decline in opioid abuse among young Pennsylvanians. Among the findings, from a workgroup within the state health department, was that opioid abuse among 18- to 25-year-olds fell from nearly 11 percent in 2011 to 8.7 percent in 2014. Among 12- to 17-year-olds it fell from 6 percent to 4.5 percent.



Jennifer Smith, Pennsylvania's acting director of drug and alcohol programs called the report "an encouraging sign in our fight against the opioid epidemic."