Fentanyl is taking over the illicit drug market in the greater Cincinnati area, sparking a 1,000% increase in overdose deaths in Hamilton County. 

In 2013, authorities there logged 24 fentanyl-related deaths. Last year, they counted 324, according to the Cincinnati Enquirer. 

The drug’s popularity has grown so explosively it’s overshadowed heroin deaths. Last year, the Hamilton County coroner found fentanyl involved in 85% of overdose deaths the office examined, while the county’s crime lab detected the substance in more than 90% of the drugs tested in the first five months of this year.  

"Fentanyl and similar synthetic opiates have produced overdoses and deaths in not only unprecedented numbers but previously unimaginable,” Newtown Police Chief Tom Synan told the Ohio paper. "It is no longer a heroin epidemic but a synthetic-opiate epidemic."

The problem in Ohio mirrors the issue nationwide, Synan said. In 2016, according to a research letter published in the Journal of the American Medical Association, fentanyl was involved in roughly half of opioid-related deaths.

"It's the small amounts of the extremely deadly substances that are killing people,” Hamilton County coroner Dr. Lakshmi Sammarco told the paper.

Just days after the Cincinnati paper published its report, the Billings Gazette in Montana detailed an apparent uptick in fentanyl-related deaths in the county that houses Fort Peck Indian Reservation. There, officials are bumping up naloxone training efforts and considering reactivating a regional drug task force. 

And in May, the Minneapolis Star Tribune detailed a spike in fentanyl-related overdoses in Minnesota, where officials are pushing to treat fatal overdoses as homicides. 

Even as the epidemic spreads, officials in Ohio are warning it could get worse as underground chemists start pumping out new analogues of the dangerous drug, some of which could be more potent. 

And, as officials elsewhere have warned, fentanyl is starting to pop up in cocaine and meth supplies. 

"The introduction of synthetic opiates like fentanyl has killed tens of thousands of Americans and should be seen as the country's most pressing health, national security issue and social crisis we face right now," Synan said. "There is nothing that worries me more than synthetic opiates—and what will be the next, more powerful synthetic that hits the street."

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