The number of fatal heroin overdoses has increased five-fold since 2002 according to a new study, which predicts drug deaths will claim more than 70,000 lives in 2017.

Data from the National Institute on Drug Abuse released Thursday paints a grim outlook of the current drug crisis ravaging American communities. It shows the number of active heroin users in the U.S. more than doubled between 2002 and 2016 from 404,000 to 948,000. Over this same period heroin overdose deaths spiked 533 percent, reports CNN.

The study predicts the addiction epidemic in America will continue to deteriorate, pushing drug deaths to an estimated 71,600 in 2017. If the estimates prove accurate, 2017 will be the second year in a row drug deaths surpass U.S. casualties from the Vietnam War.

The drug epidemic in America is increasingly fueled by synthetic opioids like fentanyl, which overtook heroin as the deadliest substance in the U.S. in 2016. Synthetic opioids, including fentanyl and its analogs, claimed roughly 20,100 lives in 2016, up from 9,945.

The National Center for Health Statistics, part of the Centers for Disease Control and Prevention (CDC), released their first preliminary report, giving an accounting of drug overdose deaths in 2016. The CDC estimates that drug deaths rose by more than 22 percent in 2016, killing 64,070 Americans. Opioid deaths rose from 33,000 in 2015 to nearly 50,000 in 2016, driven primarily by fentanyl.

Fentanyl, which is roughly 50 to 100 times more powerful than morphine, is also fueling an increase in cocaine deaths, as dealers are increasingly cutting the fatal painkiller into their cocaine supplies. The CDC estimates cocaine overdose deaths increased from roughly 4,000 in 2009 to more than 6,700 in 2015.

Officials say cocaine overdose deaths are about to explode in 2017 to nearly 11,000.

The Drug Enforcement Agency issued new guidance to police departments across the country in June on how to handle heroin and other narcotics due to the increasing prevalence of fentanyl. Deputy Attorney General Rod Rosenstein warned it only takes two milligrams of fentanyl, “the equivalent of a few grains of table salt,” to cause a fatal overdose.

“Fentanyl exposure can injure or kill innocent law enforcement officers and other first responders,” Rosenstein said in remarks June 6. “Inhaling just a few airborne particles could be fatal. The spread of fentanyl means that any encounter a law enforcement officer has with an unidentified white powder could be fatal. Our officers and first responders must approach these situations with the utmost caution.”

Drug overdoses are now the leading cause of accidental death for Americans under 50.

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