In nine months, Vanderburgh County has already passed last year’s total of drug overdose deaths.

Fifty-five people in the county died this year from overdosing on drugs like meth, heroin and prescription medication as of Friday, County Coroner Steve Lockyear said. Last year’s total was 50 people.

The number of deadly opioid overdoses rose quickly in 2016, when the county saw 29 heroin or fentanyl-related deaths, more than four times as many as in 2015. That rate has dipped this year, contrary to Lockyear's prediction this spring, while methamphetamine-related deaths seem to be on the rise.

Fatal overdoses:Heroin deaths continue to rise in Evansville

Preventing and treating addiction:A digital approach to tackling drug abuse

People can die from each of those drugs individually, Lockyear said, but his office is more likely to see people with a combination of drugs in their bloodstream.

“Very seldom do we have one single drug in the system when someone dies,” he said. “There may be one that stands out more than the others.”

Because of that, it’s hard to nail down the exact number of deaths any one drug has caused, Lockyear said.

Combining substances can intensify their effects. Cutting another drug with medication like Xanax or Klonopin, both benzodiazepines, can be especially deadly.

“It seems to be the tipping mechanism that can provide a lethal event,” Lockyear said, though he again stressed that individual drugs can be deadly on their own.

Local emergency responders have started carrying naloxone, which can reverse the effects of an opioid overdose. Nonprofit Overdose Lifeline donated about 300 kits to the Evansville Police Department last year.

Lockyear estimated about 15 people died of heroin or fentanyl overdoses this year, or a combination of the drugs. While that’s better than last year, it’s still more than twice 2015’s total of overdoses related to those two drugs.

“I don’t think this is something that is picky. It doesn’t discriminate,” said state Sen. Jim Merritt, who has advocated for measures to fight Indiana’s opioid epidemic. “This epidemic is incredibly pervasive. It is in small towns, it’s in large towns, it’s everywhere.”

Fentanyl, a synthetic drug sometimes used to treat chronic pain, is 50 to 100 times as powerful as morphine, according to the National Institute on Drug Abuse. When it’s added to heroin or cocaine, it is more potent and also more difficult to combat with overdose antidote naloxone.

“The heroin’s been around for a while, two, three years, and now the stuff that’s laced with fentanyl is making its way into the area,” said Nate Boyett, who runs Boyett Treatment Center in Evansville.

Related:He used to be a meth addict; now he runs a treatment center

The Boyett Center used to only find heroin and prescription drug traces in patient’s drug screens when the patient relapsed. Now the staff is seeing fentanyl too.

Relapsing is already dangerous for a recovering addict whose tolerance has dropped since they last used. Using heroin cut with fentanyl can make it worse.

“If they’ve been clean for a while, and then they go out and get some heroin that’s laced with fentanyl, they’re at a very, very high risk for overdose death,” Boyett said. “Basically, it’s a shock to their system and it sends them into cardiac arrest, respiratory failure.”

Local efforts to combat addiction:Deaconess announces effort to target prescription drug, opioid abuse

Alleged drug ring indicted:Eight indicted in Evansville heroin scheme

Overdose emergencies increase:Indiana ERs see opioid overdose up over 5-year period

A powerful mixture of opioids and other drugs called “Gray Death” that can endanger the user and anyone who even touches the drug took its first life in Vanderburgh County in May when a 45-year-old woman overdosed.

Drug overdoses killed people from age 22 to 81 in the county by the end of August this year, Lockyear said. The average age of the victims was about 40 years old. Six of those deaths were ruled suicides.

Lockyear said he hopes the number of heroin and fentanyl deaths continues to go down -- a trend he attributes to good law enforcement. Merritt and Lockyear both said they believe clear records on the causes of death could help decrease drug overdoses, by giving people a clearer picture of what substances or other factors are a problem in the community.

“We’re trying to track them the best we can so we can give treatment centers, law enforcement and such the tools they need to go out and combat this,” Lockyear said.

Get help:

More information about drug overdoses and addiction is available from the state Health Department at in.gov/isdh and the National Institute On Drug Abuse at drugabuse.gov.

More information about addiction recovery and treatment in the Evansville area is available at msatf.org, the official website of the Mayor’s Substance Abuse Task Force.

If you or a loved one are in immediate danger, call 911.