Fatal opioid-related overdoses in the state have increased more than 300 percent since the beginning of the century, according to new figures from the Department of Public Health.
According to reports released last month, there were 338 confirmed unintentional opiate fatalities statewide in 2000.
In 2014, that number jumped to at least 1,089, according to DPH.
The figure may be closer to 1,256 once final numbers from the Office of the Chief Medical Examiner are factored in, according to the report.
Berkshire County saw its numbers rise from two deaths in 2000 to 25 last year and a total of 109 deaths during the time covered in the report.
The county reporting the highest number of deaths was Suffolk, the county Boston calls home, with 1,252 since 2000.
Apart from Nantucket, which has only reported a handful of deaths since 2000, the county with the lowest amount of deaths since 2000 is Dukes with 15.
Data for individual towns and cities from 2012 to 2014 shows a total of 35 deaths in Pittsfield during that time and eight in North Adams during the same period.
A complete list of town-by-town data is available from the state's Executive Office of Health and Human Services website.
All told, including the higher end of the 2014 estimate, there have been 9,118 opiate-related deaths in the state since 2000. (Suicides accomplished using opioids are not included in the report's figures.)
The sharpest rise in deaths has occurred since 2012 when there were 668 statewide.
That figure increased to 911 in 2013 and up to 1,256 in 2014.
Dr. Jennifer Michaels, medical director of the Brien Center and attending psychiatrist at Berkshire Medical Center, said the increase is, in part, due to a backlash from increased scrutiny of over-prescription of opioid painkillers.
Michaels said that as early as 1995, such painkillers were being over-prescribed for chronic pain, like back injuries.
As abuse grew, more scrutiny has been placed on opioid prescriptions and, as people began to run out of avenues to access those medications as easily, many turned to the cheaper and more readily available heroin, Michaels said.
For purposes of the report, the term "opioid" includes heroin, opioid-based painkillers and other, unspecified opioids.