Deaths involving powerful painkiller fentanyl have risen by almost a third, official figures show.
There were 75 fatalities linked to the opioid in England and Wales last year, an increase of 29% from 2016 when there were 58.
The figures, published by the Office for National Statistics (ONS), also show a rise in deaths involving cocaine for the sixth consecutive year.
The number rose from 371 in 2016 to 432 last year, but it is not possible to distinguish if the substance related to these deaths was powder cocaine or crack cocaine.
A total of 3,756 deaths involving legal and illegal drugs were registered in England and Wales in 2017.
This is the highest number since comparable records started in 1993, but similar to 2016 when there were 3,744 deaths related to drug poisoning.
ONS health analysis statistician Ellie Osborn said: “The figures published today show that the level of drug poisoning deaths in 2017 remained stable.
However, despite deaths from most opiates declining or remaining steady, deaths from fentanyl continued to rise, as did cocaine deaths, which increased for the sixth consecutive year.
Last year, there were 2,521 male drug-related deaths and 1,235 female.
Most were from drug misuse, which accounted for 67% of the total number of drug poisoning deaths.
Carfentanyl, a synthetic opiate which is more powerful than fentanyl, was mentioned on death certificates for the first time in 2017 and accounted for 27 deaths.
However, deaths involving heroin and morphine decreased by 4% last year to 1,164, the first decline since 2012.
The truth is that most drug-related deaths are preventable
Fatalities from so-called “legal highs” reduced by more than a half in 2017, from 123 in 2016 to 61, following the Government’s introduction of a blanket ban on new psychoactive substances.
Karen Tyrell, executive director of alcohol and drug charity Addaction, said: “The truth is that most drug-related deaths are preventable.
People who use opioids often have cumulative physical and mental health problems.
Most of them have had very difficult, often traumatic lives and we’re letting them down if we don’t give them the best care that we can.
Nobody wakes up in the morning and decides to become dependent on drugs.
Everyone deserves help, and we know that every person can recover with the right support.