Overdose deaths in Maine set a record for the third straight year in 2022, claiming an estimated 716 people and offering another grim reminder that the opioid crisis continues to rage even as access to treatment and the overdose-reversing drug Narcan has increased.

“Worsened by the growing presence of deadly fentanyl, the scourge of addiction continues to reach into every corner of our state – rural and urban – robbing us of our friends, family and loved ones, and harming our communities, our people and our future,” Gov. Janet Mills said in a statement. “My heart breaks with every life lost to a drug overdose, and my administration will not rest until we reduce this number to zero.”

The Maine Attorney General’s Office released its latest report Thursday, tracking deaths from Jan. 1 through Dec. 31, 2022. In 2021, 631 residents died from an overdose and in 2020, the number was 502. Before 2014, the total had never gone above 200.

In all, 10,110 overdoses were reported in 2022, which means about 7 percent resulted in death. The death toll would certainly be even greater if not for the increased availability of Narcan, which can reverse the effects of an overdose if taken in time.

Although Narcan has become increasingly available in the community, it hasn’t led to a sharp increase in usage. According to state data, there were 2,283 instances of overdose reversals with Narcan in the community or by law enforcement last year, an increase of less than 5 percent over the previous year. And Narcan only has a chance to work when it’s available at the time of overdose. Of the 716 people who died last year, only 180 (25 percent) were administered Narcan.

Roughly four out of every five fatal drug overdoses last year were attributable to the powerful synthetic opioid fentanyl, either on its own or in combination with another drug. Fentanyl is often so powerful that Narcan doesn’t work.

The Mills administration also has increased access and funding for treatment, something that wasn’t always prioritized under the previous administration, but that hasn’t reversed the trend. A recent report by researchers at the University of Vermont’s Center of Rural Addiction and the University of Southern Maine’s Cutler Institute found that despite increased availability of treatment, major barriers exist for both providers and patients, including transportation, paid time off and childcare.

“We are committed, in partnership with Maine’s remarkable community of recovery advocates and volunteers, to work together to help every person in Maine with substance use disorder enter recovery, find treatment options that work for them, and most important, stay alive,” said Gordon Smith, the state’s director of Opioid Response. “We will use every avenue available to support all Maine people, families and communities affected by the opioid crisis, and bring resources for prevention into every community and school in our state.”

In her biennial budget proposal, Mills proposed $237 million in federal and state funding for behavioral health investments, which includes increasing MaineCare rates for mental health and substance use disorder services. Her administration also continues to work on strategies to invest nearly $200 million that’s coming to Maine from legal settlements against pharmaceutical companies.

Dr. Noah Nesin, innovation adviser at Penobscot Community Health Care in Bangor, said access to opioid use disorder treatment has improved in recent years, but “is not yet adequate” to meet the demand.

Nesin said there’s now potential for treatment access to expand even more, as federal rules that previously limited the use of prescribing Suboxone to treat opioid use disorder were relaxed starting in January. The new rules eliminated caps on the number of patients doctors could treat with Suboxone and eased other burdensome requirements that previously made it more difficult for doctors to prescribe the medicine.

But Nesin said it remains unclear if more doctors will start prescribing Suboxone for their patients with opioid use disorder, or if old stigmas will persist, resulting in a reluctance to treat.

“This will be where the rubber meets the road,” he said. “Doctors can treat as many people as they wish to treat now. There’s no excuse for not (prescribing Suboxone) except for bias.”

Maine first started to see a noticeable increase in drug-related deaths in 2014, when the total eclipsed 200 for the first time. By that point, prescription opioids had given way to heroin, which now has been supplanted by fentanyl.

Eight years later, the number of deaths is more than three and a half times higher. In the last five years alone, 2,588 Maine residents have lost their lives to overdoses.

The opioid crisis has affected every state, some worse than others. In 2021, more than 107,000 people in the United States died from an overdose, according to the U.S. Centers for Disease Control and Prevention.

And there are no signs that things are improving. The 75 deaths in Maine in December 2022 would translate to 900 over a full calendar year. Additionally, Portland police responded to six fatal overdoses in January alone, out of 56 total overdose calls.

Staff Writer Joe Lawlor contributed to this story