Health officials in California are warning about a sharp rise in deaths linked to the powerful synthetic opioid fentanyl across the state in 2017.

Data released by the California Department of Public Health Thursday revealed 746 people died from fentanyl-related drug overdoses in 2017, more than tripling from the 237 lives lost to fentanyl in 2016. It represents a significant uptick since 2013, when 81 people died from fentanyl, and comes at a time when overall opioid overdoses in the state are falling, reported the San Francisco Chronicle.

Opioid overdose deaths across California totaled 1,882 in 2017, down from 2,031 in 2016. This pattern is emerging in a number of states as dealers increasingly cut fentanyl into the broader drug supply, including cocaine and counterfeit pills made to look like painkillers or anti-anxiety medication. (RELATED: Historic Drug Bust Yields Enough Fentanyl To Cause Nearly 30 Million Deaths)

“This is a signal fentanyl as an illicit opioid has really arrived in California,” Phillip Coffin, director of substance use research at the San Francisco Department of Public Health, told the San Francisco Chronicle.

Nationally, fentanyl overtook heroin as the U.S.s deadliest substance in 2016, claiming 19,413 lives, according to the Centers for Disease Control and Prevention.

Drug overdoses are now the leading cause of accidental death for Americans under age 50, killing more than 64,000 people in 2016. Opioid overdose made up a staggering 66 percent of all drug overdose deaths in 2016, surpassing the annual number of lives lost to breast cancer.

The epidemic is contributing to declining life expectancy in the U.S., officials said. Life expectancy dropped for the second consecutive year in 2016 for the first time since an outbreak of influenza in 1962 and 1963.

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