As an opioid epidemic swept the nation in 2016, Massachusetts saw a devastating 16% uptick in suspected opioid deaths—an increase that authorities have blamed largely on the fatal popularity of fentanyl. 

“I’ve never seen a year as bad as this past year,” Joanne Peterson of the nonprofit, Learn to Cope, told the Boston Globe. “There are not many weeks where we aren’t dealing with a death.”

Massachusetts State Police investigated 877 possible opioid-related deaths last year, according to the Beantown newspaper. That was a shocking rise from the 756 they examined in 2015. 

But, as it turns out, even those sobering statistics could be low, since they don’t include Boston, Worcester and Springfield, the state’s largest cities. The full figures won’t come out till later this month when public health officials announce opioid overdose data for the final quarter of 2016. 

In the first nine months of the year, health officials reported 1,005 opioid-related deaths, while the 2015 year-end total was 1,574. That 2015 total was among the nation’s highest, according to the Centers for Disease Control and Prevention. 

Although that national data doesn’t offer breakdowns by type of opioid, Massachusetts officials point to fentanyl as a major cause for concern. “It provided maybe an extra boost in the effects of heroin. As a result it became popular with those who use heroin,” Colonel Richard D. McKeon, state police superintendent, told the Globe. “We’ve seen them chasing fentanyl.”

The majority—77%—of the 2016 deaths under investigation were men. The average age was 37. Overall, those deaths accounted for more than one-fifth of fatalities investigated in 2016. 

Even though women formed the minority of those lost to the opioid epidemic, Peterson says that number still represents a disturbing uptick in fatalities among female users. “It used to be 95 or 97% were men, but that’s not true,” she said. “Women are starting to be a factor.”

It’s not all doom and gloom, though. During the summer of 2016, Middlesex County saw a dip in the number of deaths. It’s not clear why that happened, but—as the first decline since 2012—it could offer a short spot of hope. 

“Obviously if we could, we would replicate what that was and try to bring the numbers down,” said Middlesex District Attorney Marian Ryan. In the meantime, advocates like Peterson are growing desperate. 

“My wall is covered in obituaries,” she said. “It could be wallpaper if this doesn’t get better.”