In 2013 King County saw an average of nearly one drug related death per day, the highest count in 15-years, according to the latest edition of an annual University of Washington study released Wednesday.

The 312 drug related deaths in 2013 represent a 30% increase from 2009. Capitol Hill retains the unfortunate distinction of being an area where all types of drug overdoses occur, said the report’s author Dr. Caleb Banta-Green.

“Capitol Hill is kind of the home to everything. You see methamphetamine, cocaine, heroin, and prescription opiates. You have a lot of mortality there,” Banta-Green said. “The good thing is you have good treatment access.”

The report did not break out drug related deaths by cities or neighborhood.

Last year CHS wrote about a series of heroin overdoses on Capitol Hill that experts said were likely tied to high potency drugs and inexperienced users. At the time, Shilo Murphy, who runs the People’s Harm Reduction Alliance needle exchange in the University District, told CHS he had seen an increasing number of young people using heroin. Banta-Green said the data from 2013 has shown that to be true.

“I didn’t expect to see these young adults, to see people in their twenties dying,” he said, adding that restricted access to opiate pain pills likely has caused young addicts to seek out cheaper fixes like heroin. Drug treatment center interviews also showed an increasing number of people 17 and under had reported using heroin in the prior month. And heroin involved deaths among those under 30 has increased from 7 deaths (14%) in 2009 to 34 deaths (34%) in 2013.

According to the report, around 75% of those who died from drugs had more than one drug in their system. Banta-Green said the use of heroin and meth at the same time, known as a goofball, is on the rise. Overdoses are significantly more likely if users combine drugs, whether prescription or illicit, he said.

Deaths related to prescription opiates like methadone and Oxycodone are still down from their peak in 2009, but they continue to be the most deadly at 125 deaths in 2013.

Banta-Green said King County is making promising strides in increasing access to methadone for addicts. He said more work should be done to increase access to buprenorphine, a prescription medicine used to treat addiction that can be filled at a regular pharmacy.

The report was released one day after the state’s first legal sale of recreational marijuana began in shops from Seattle to Spokane.

The report also shows that from 2011-2013 men who had sex with men represented 67% of HIV cases in King County. That’s down from 2008-2010 when the population accounted for 73% of HIV cases.