By Jon Kamp at The Wall Street Journal 

The U.S. opioid crisis shows no sign of receding as a new year begins, with the latest data from several hard-hit cities and states showing overdose fatalities reaching new peaks as authorities scramble to stem the tide. The synthetic opioid fentanyl, which has up to 50 times the potency of heroin, remains the chief culprit driving the increase in fatalities, according to medical examiners and health and law-enforcement authorities in abuse hot spots, such as Ohio, Maryland and New England.

Federal data for 2015 deaths came out only last month, showing a nearly 16% climb to 33,091 opioid deaths in the year. Many jurisdictions are still compiling the grim tallies for 2016.

“We’re just really awash in drug deaths, and it got acutely worse,” said Thomas Gilson, the medical examiner in Cuyahoga County, Ohio, which includes Cleveland and is the state’s most populous county.

So far, his office has recorded 517 deaths from heroin and fentanyl in 2016, more than double the number from the previous year. And he isn’t done counting.

Fentanyl is a potent painkiller often used by cancer patients, but a bootleg version commonly made in China has become the major problem behind overdose deaths, according to law-enforcement and health authorities. Chemical cousins known as analogs are also on the rise, authorities said, sometimes as overseas labs switch recipes to keep ahead of law enforcement.

The worsening opioid crisis remains a major policy challenge for lawmakers. At the federal level, new legislation passed last month includes $1 billion over two years to help states improve abuse prevention and treatment initiatives. States have been working to monitor opioid prescribing, expand access to medically assisted treatment and distribute more naloxone, an overdose reversal drug.

Availability of data on overdose deaths varies city by city, and state by state. The same states with signs of higher fatal-overdose rates last year are among the 19 that posted statistically significant increases in 2015, according to the federal Centers for Disease Control and Prevention.

Ohio is likely months away from tallying statewide numbers, according to a spokeswoman for the Ohio Department of Health, but Dr. Gilson expects a sharp increase for the state as a whole.

Similarly, Pennsylvania is on track to have a significant statewide rise in 2016, said Patrick Trainor, a special agent in the Philadelphia office of the U.S. Drug Enforcement Administration, which tallies overdose data for the state. Philadelphia alone may surpass 900 overdoses in 2016, up from 720 the prior year, he said.

In Maryland, the latest data show an estimated 1,468 overdose deaths through September 2016, which exceeds the entire tally from 2015. Authorities in Baltimore, a longtime heroin hot spot with a rising fentanyl problem, said overdose deaths surged 68% to 481 in the first nine-months last year, compared with the same period a year earlier.

New England states, which have among the highest fatal-overdose rates in the U.S., are broadly reporting higher death rates for 2016 as they continue to tally the data. Fentanyl, once seen largely by authorities as an additive that traffickers mixed into the heroin supply, has become a stand-alone killer in some areas.

Numbers released Wednesday by New Hampshire’s Office of the Chief Medical Examiner counted 159 deaths last year with just fentanyl, compared with two heroin-only deaths and 19 deaths with both drugs. The office projects overdose deaths will climb 7% in 2016 from 2015, adding to the 35% year-over-year rise for the prior year.

Massachusetts also is seeing fentanyl in most overdose deaths now. New England’s most populous state has tallied 2016 data through September, and the state is on pace for more drug deaths this year, said Monica Bharel, commissioner of the state’s Department of Public Health.

Connecticut and Rhode Island are seeing more fatal overdoses in 2016, compared with the prior year, according to data collected thus far. Maine has reported 286 drug-overdose deaths through September 2016, 14 deaths more than in all of 2015.

Meanwhile, fentanyl-related overdoses in North Carolina rose at least 42% in 2016, compared with 2015, according to the state health department. The state hasn’t completed its 2016 tally.

Write to Jon Kamp at [email protected]