More than three-fourths of all fatal drug overdoses in Virginia last year stemmed from opioids as the death toll from drug abuse continued to rise, according to preliminary figures released by the state.

ARLINGTON — More than three-fourths of all fatal drug overdoses in Virginia last year stemmed from opioids as the death toll from drug abuse continued to rise, according to preliminary figures released by the state.

The latest quarterly report from the Virginia Department of Health released this month said there were an estimated 1,420 drug-related deaths in the commonwealth in 2016. Of those, 1,133 were tied to opioids.

The department noted that 60 cases remain pending, and so the total deaths due to drug overdoes will change.

In 2015, there were 1,028 drug overdose deaths statewide, up from 799 in 2012. In that same time period, opioid related overdose deaths rose from 572 to 811.

Drug overdoses remain the No. 1 unnatural cause of death in Virginia, a title held since 2013 when drug deaths outpaced motor vehicle and gun-related deaths.

Last year, the state recorded 1,057 gun-related deaths, which also have been rising but at a much slower pace than drug deaths. The number of deaths from crashes in the state — 889 — has held steady.

A massive uptick in fentanyl and heroin use is blamed from the increase in drug overdoses. And the state has declared a public health emergency to try and reverse that trend.

Four years ago, of the 572 opioid overdose deaths, 185 were connected to fentanyl and/or heroin use. Prescription drugs were blamed for the remaining 435 deaths.

But in 2016, 810 out of the 1,133 deaths from opioid overdoses were tied to fentanyl and/or heroin. Just, 469 were connected to prescription overdoses, according to state health department figures.

The number of deaths attributed to fentanyl alone nearly tripled compared to 2015 figures, according to the estimates.

Fairfax County led the state in drug-related deaths with 103 cases. About 80 of those fatalities were tied to opioid overdoses.

Richmond was second statewide with 94 deaths, 79 of them connected to opioids.

In Northern Virginia, there were 310 drug-related deaths — a significant increase from the 180 seen just five years ago.

Prince William, Northern Virginia’s second-largest county, had the second-highest total after Fairfax County with 58 deaths, 49 connected to opioids.

Loudoun, the third-largest county in the region, had 41 drug deaths, 29 tied to opioids.

However, Fredericksburg had the most drug and opioid-related deaths per capita with 11 fatal overdoses in 2016.

A look at fatal overdoses around the region

Alexandria: 12 drug overdose deaths in 2016 (7.5 per 100,000), eight were opioid related (five per 100,000). Generally flat over the past five years.

Arlington County: 26 drug overdose deaths in 2016 (11.1 per 100,000), 22 were opioid related (9.4 per 100,000). That is nearly double the 13 opioid deaths seen in 2015.

Fairfax City: One drug overdose death in 2016 (4.3 per 100,000), which was also opioid related. Fairfax City generally sees one to four overdose deaths each year.

Fairfax County: 103 drug overdose deaths in 2016 (9.1 per 100,000), 80 were opioid related (7.1 per 100,000). Fairfax County has seen a large increase in fatal overdoses in recent years. Just two years ago, the county recorded just five drug deaths per 100,000 and four opioid deaths per 100,000.

Falls Church: No overdose deaths since 2011.

Fredericksburg: 11 drug overdose deaths in 2016 (40.8 per 100,000), 10 were opioid related (37.1 per 100,000). Fredericksburg has generally been above the state average in recent years, but 2016 was the first time that the death toll reached double digits.

Loudoun County: 41 drug overdose deaths in 2016 (10.9 per 100,000), 29 were opioid related (7.7 per 100,000). 2016 was the deadliest year in Loudoun County. The next closest was the 27 deaths in 2014 and 22 deaths in 2013. Otherwise, drug overdoses had generally stayed in the area of five deaths per 100,000.

Manassas: Seven drug overdose deaths in 2016 (16.8 per 100,000), all were opioid related. The 2016 figure is generally in line with recent numbers.

Manassas Park: No drug overdose deaths. The city saw one in 2015 and two in 2014.

Prince William County: 58 drug overdose deaths in 2016 (13.1 per 100,000), 49 were opioid related (11 per 100,000). Prince William had not seen more than 40 overdoses in recent years. But there were 39 in 2014 and 2012.

Spotsylvania County: 28 drug overdose deaths in 2016 (21.7 per 100,000), 27 were opioid related (20.9 per 100,000). Spotsylvania County had seen no more than 19 overdose deaths in recent years, reaching that total in 2015 and 2013.

Stafford County: 23 drug overdose deaths in 2016 (16.4 per 100,000), 21 were opioid related (15 per 100,000). Stafford County recorded 21 overdose deaths in 2015, but the number of fatal overdoses has ranged from six to 16 in the past decade.