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Heroin overdose deaths in East Baton Rouge Parish dropped slightly in 2016 from record levels the year before, but the news isn't much of a relief, as overdose deaths from other drugs — primarily prescription painkillers and synthetic black-market opioids like fentanyl — rose significantly.

The death toll from drug overdoses in the parish stands at 74, with two more deaths suspected to be linked to drugs still awaiting final confirmation, said Dr. William "Beau" Clark, the East Baton Rouge Coroner. In 2015, a total of 75 people died from drug overdoses, Clark said.

At least 31 people died from heroin overdoses in the parish in 2016, Clark said, with one case still pending. That represents a significant drop from 2015, when the drug claimed a record number of lives — 41 — to top a grim and dramatic spike in opiate deaths that began in 2013.

But even as heroin deaths dropped, an assortment of other drugs claimed a growing number of lives. Clark said that mix points to a growing and potentially deadly assortment of drugs being peddled on the street to heroin users, including the incredibly potent prescription drug fentanyl, which is manufactured in growing quantities on the underground market.

Clark said he suspects drug users often aren't aware what exact substances they're being sold and using, bringing heightened dangers. Heroin and synthetic opioid drugs — such as morphine, oxycodone and fentanyl — can vary dramatically in their potency, making it difficult for those addicted to the drugs to gauge dosages and potentially raising the risk of an overdose.

Toxicology reports now regularly show a variety of drugs, Clark said, even when the primary killer appears to be heroin.

"If you're an addict and have absolutely no idea what you're about to use, it can make it incredibly deadly," he said.

Dr. SreyRam Kuy, an official with the Louisiana Department of Health, described the dramatic rise of opioid overdoses in the state — which mirrors alarming trends across the country — as an epidemic and a public-health crisis. Kuy said a huge boom in the past decade in prescriptions for potent painkillers has played a significant role in driving addiction.

"We have one of the highest rate of opioid prescriptions in the entire United States and actually have more opioid prescriptions than people," Kuy said, "and when we look at opioid deaths, Louisiana has one of the highest rates of overdose deaths in the Deep South."

In response, state officials have made Naloxone, a powerful and highly effective opiate antidote also known by the brand name Narcan, available over-the-counter at pharmacies.

Lawmakers and Baton Rouge officials have also pushed stiffer penalties for distributing heroin in an effort to deter would-be dealers. In 2014, state Sen. Dan Claitor, R-Baton Rouge, sponsored a bill that raised the maximum prison term for second-time dealers to 99 years. Clark, the coroner, has spoken in favor of imposing even harsher prison terms to combat the epidemic.

Some public health advocates have argued those measures are counter-productive, pushing drug users further underground and making them less likely to seek treatment or call for help.

The number of heroin overdose deaths in Baton Rouge regularly numbered in the single-digits until about five years ago. Deaths spiked dramatically between 2012 and 2013, shooting from five deaths in 2012 to 35 in 2013.

Paramedics in the parish also saw the numbers of overdose calls more than double and continue to rise over that same time period. In 2013, as deaths spiked, East Baton Rouge EMS paramedics responded to 1,049 overdose calls, a figure that covers both drugs and alcohol, said Mike Chutz, an agency spokesman. This past year, that number stood at 1,960.

Clark said drug overdoses are now the leading cause of accidental death in the parish by a wide margin, dwarfing the next leading cause, car crashes, which killed 46 people in 2016. For most of the year, overdose deaths also outpaced homicides in the parish, said Clark.

But a rash of violence during the last two months of the year — when more than a quarter of the parish's homicide victims died — meant that, as in past years, homicides ended up outpacing overdoses in the parish.  

Follow Bryn Stole on Twitter, @BrynStole.