West Virginia's death toll from drug overdoses has improved slightly, with 872 deaths last year.
The state hit a grim record in 2016 of 887 fatal overdoses, or 52 per 100,000 residents, the highest drug-related death toll in the nation.
Public Health Commissioner Dr. Rahul Gupta says he's cautiously optimistic about progress.
West Virginia is taking action with new laws to limit painkiller prescriptions, improve overdose reporting and equip all emergency responders with opioid antidotes.
The health commission report describes how fatal overdoses soared from just 212 in 2001, initially driven by pharmaceuticals and then a shift to illicit heroin 2012, followed with more potent fentanyl being added to street drugs. The report says 750 of last year's deaths involved at least one opiate, including 508 from fentanyl.
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