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There were a total of 2,104 confirmed and estimated opioid overdose deaths in Massachusetts in 2020.

Opioid overdose deaths in Berkshire County jumped by 44 percent last year, to the highest level recorded, amid a slight increase in fatal overdoses statewide.

Public health officials announced Wednesday that opioid-related overdose deaths in Massachusetts rose by 5 percent in 2020, the first increase in three years.

In a year marked by the COVID-19 pandemic and the challenges it created in accessing health care and social supports, the state recorded 2,104 confirmed and estimated deaths, about the same number of fatalities as the epidemic’s 2016 peak.

The toll of the pandemic for people with opioid use disorder was particularly stark in the Berkshires, which had the second-highest rate of increase in the state. Fatal overdoses in Berkshire County rose from 39 in 2019 to 56 last year, according to the preliminary data.

Jennifer Michaels, medical director at The Brien Center, attributed the increase — it’s what some addiction experts have called the “fourth wave” in the opioid epidemic — to pandemic factors and an uptick in relapses.

“What we’ve seen, clinically, is that more people are using alone,” she said. “They’re having a harder time using in a safer environment, with other people or where Narcan is present. And the routines that help people stay sober have been interrupted.”

Use of the Bridge Program, which provides treatment and access to services through county emergency rooms, decreased substantially through the pandemic, Michaels said. She added that stimulus checks also could spark a recurrence of drug use. People with substance use disorder are at particularly high risk of death when they relapse.

“These numbers could be speaking to a more potent heroin, which is mostly fentanyl, now,” Michaels said. “Because we are a smaller area, the options for street heroin are limited, so there’s a great risk that, if there are dangerous drugs on the street, people will be exposed to that.”

The deaths in 2020 were spread out across the county, according to state data. North Adams had the highest uptick — with the number of opioid overdose deaths among residents jumping from 10 last year to 13 this year — while Pittsfield saw only a slight rise, from 21 to 22 deaths. Great Barrington, Cheshire, Lanesborough, Lee and Lenox were among the municipalities that also saw increases.

Berkshire County had not seen the flattening and decrease in deaths that took place over the past few years in other parts of the state, with fatalities trending up almost every year for the past decade.

But, the sharp upturn in deaths during the pandemic is particularly concerning to Michaels. In 2020, the Berkshires saw a rate of nearly 45 opioid overdose deaths per 100,000 residents, according to census data, well above the statewide rate of 30 deaths.

“I think we have to understand this better,” Michaels said. “And I think the whole country is going through it. We have a pandemic, but we also have this silent epidemic.”

Nationwide, Massachusetts was among the states with the smallest increases in all drug overdoses in 2020. From September 2019 to September 2020, drug overdose deaths surged by 29 percent nationally.

Among ethnic and racial groups in the commonwealth, Black non-Hispanic males experienced the largest spike in opioid overdose death rates over the year, with that figure surging from 32.6 to 55.1 per 100,000 people in 2020.

“Both the COVID-19 pandemic and the opioid epidemic have underscored the importance of supporting disproportionately impacted communities, and as we address both issues, our Administration has continued to focus on equity as a core component of our response,” Gov. Charlie Baker said in the release.

“While Massachusetts experienced a smaller increase in drug-related deaths compared to the rest of the country, these trends make clear we have to redouble our efforts,” he said. “That’s why we have continued to ensure access to life-saving tools like naloxone, focus on prevention strategies especially in communities of color, and provide pathways to treatment and supports for those struggling with addiction.”

Overall, the state’s 2020 opioid-related overdose death rate of 30.2 per 100,000 people is approximately 1 percent lower than in 2016 (30.6 per 100,000).

State House News Service contributed to this report.

This story will be updated.