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The U.S. reached a grim milestone amid the ongoing coronavirus pandemic with deaths caused by drug overdoses topping 100,000 for the first time, according to the Centers for Disease Control and Prevention.

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In a 12-month period from May 2020 to April 2021, more than 100,300 people across the U.S. died of drug overdoses, according to preliminary data released Wednesday by the CDC. The number was nearly 30% higher than the about 78,000 deaths reported by the CDC from May 2019 to April 2020.

Nearly two-thirds of the deaths were caused by synthetic opioids, primarily fentanyl, according to CNN. Fentanyl can be as many as 100 times more potent than morphine and 50 times more potent than heroin, according to the Drug Enforcement Administration. Earlier this year, the agency warned that as little as two milligrams of the opioid — a dose small enough to fit on the tip of a pencil — can be lethal.

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“What we’re seeing are the effects of these patterns of crisis and the appearance of more dangerous drugs at much lower prices,” Dr. Nora Volkow, director of the National Institute on Drug Abuse, told CNN. “In a crisis of this magnitude, those already taking drugs may take higher amounts and those in recovery may relapse. It’s a phenomenon we’ve seen and perhaps could have predicted.”

On Wednesday, officials with the Biden administration said they plan to encourage states to make medications like naloxone, which can reverse an opioid overdose, more widely available through legislation, The New York Times reported.

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“I believe that no one should die of an overdose simply because they didn’t have access to naloxone,” Dr. Rahul Gupta, director of National Drug Control Policy, told the newspaper. “Sadly, today that is happening across the country, and access to naloxone often depends a great deal on where you live.”

In September, officials with the Drug Enforcement Administration warned that they were seeing a sharp increase in the number of fake prescription pills being sold containing fentanyl and methamphetamine, sometimes in deadly doses. Volkow told the Times that “many people are dying without knowing what they are ingesting.”

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Last month, the Department of Health and Human Services launched a new overdose prevention strategy aimed at stymieing overdoses through prevention, harm reduction, treatment and support.