An alarming surge in deaths linked to the synthetic opioid fentanyl were reported in Minnesota in 2017.
The Minnesota Department of Health released preliminary figures of overdose deaths last year and found a 74 percent rise in those caused by synthetic opioids.
Of the 172 synthetic opioid-related deaths, 156 them involved the use of fentanyl.
Fentanyl is a painkiller 50 times stronger than heroin, which was most notably behind the death of Prince in 2016.
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"This dramatic increase shows that the opioid epidemic in Minnesota has also become a fentanyl public health crisis," said Minnesota Health Commissioner Jan Malcolm.
"These data confirm that Minnesotans addicted to opioids may unknowingly be exposing themselves to far greater and more deadly risks than they know.
"It is more important than ever for us to support Minnesotans in their efforts to seek help and treatment."
The MDH says the growth in fentanyl deaths is "outweighing progress in other areas," noting that prescription opioid and heroin deaths are down.
Overdose deaths overall rose from 675 in 2016 to 694 last year, mainly because of rising fentanyl fatalities.
Overdosing on prescription opioids and methadone is still the most common cause of opioid deaths in Minnesota, with 188 cases last year, but that's only 16 more than synthetic opioids, which have surged in the past three years.
Heroin deaths meanwhile dropped 29 percent between 2016-17.
Of the 694 statewide deaths, 438 happened in the 7-county metro area.