Overdose deaths continued to increase in 2018 in Maryland, new state data shows, with the vast majority linked to the highly potent synthetic opioid fentanyl — and with cocaine making a comeback.

Despite concerted efforts to stem the opioid epidemic, there were 2,385 total overdose deaths around Maryland last year. That fatal tally is up about 5 percent from the year before and marked the second year in a row that overdose deaths exceeded 2,000.

But it’s also the slowest growth in statewide overdose deaths since 2011.

Leaders of the state Opioid Operational Command Center, which released the preliminary figures collected by the Maryland Department of Health, said there has been progress on several fronts despite the overall increase in fatalities.

“Since Gov. Hogan declared a state of emergency in response to the opioid crisis in March 2017, Maryland has made tremendous progress in implementing prevention and educational programs, stepping up enforcement and expanding treatment and recovery programs throughout the state,” said Steve Schuh, the center’s executive director, in a statement. Of the metrics the Opioid Operational Command Center monitors, “virtually all ... are moving in a positive direction.”

The data show that Baltimore City and Anne Arundel and Baltimore counties suffered the most deaths in 2018, and the numbers rose in all three. Seven other jurisdictions also showed increases.

Adjusted for population, Baltimore City and the rural counties of Cecil and Allegany had the highest numbers of overdose deaths last year.

There were 13 counties that logged drops in overdose deaths, with Prince George’s and Montgomery showing the biggest decreases.

There also were other positive trends statewide. The number of heroin-related deaths has dropped for the past two years after a peak in 2016 of 1,212 fatal overdoses. The number of prescription opioid-related deaths also dropped for the past two years from a peak in 2016 of 418.

Cocaine, however, continues to make a comeback. There were 884 cocaine-related fatalities last year, up almost 28 percent last year.

The cocaine was mixed with fentanyl in most cases, which is known on the street as a speedball.

The predominance of fentanyl shows the difficulties that officials have in stemming the epidemic that has gripped Maryland and much of the nation. There are tens of thousands of overdoses annually from the drug, which is not the legal kind used as a potent painkiller but rather an illicit version that law enforcement authorities believe is imported from China.

Officials believe the fentanyl is being mixed with heroin in part to give dealers a leg up in the competitive black market by offering users a more potent high.

Angel Traynor, founder of the Serenity Sistas recovery program in Anne Arundel County, said she’s seen more people coming through treatment centers for cocaine addictions because they’re trying to avoid heroin mixed with fentanyl.

“What they don’t realize is that they’re actually putting fentanyl into coke,” she said.

A 2018 Johns Hopkins University study surveyed 175 people in Baltimore who admitted to using illegal drugs and found that while 85 percent of respondents were concerned about fentanyl in heroin, only 20 percent were concerned about the synthetic opioid being found in cocaine.

Traynor, herself a recovering opioid addict, said some people who admit to using cocaine are shocked to find fentanyl in their systems when they submit to a urinalysis.

But even after they find they’ve been using fentanyl, Traynor said, that doesn’t necessarily mean they’ll automatically change their habits.

“Knowing addictions ... an addict is an addict, and an addict often doesn’t care what they’re putting into their body as long as it changes the way they feel,” she said.

But she said she was optimistic the state is taking the necessary steps to tackle the issue, adding that she’s seen more state grants for wraparound services for people in addiction recovery after they’ve gone through a treatment regime.

U.S. Rep. Elijah Cummings, a Baltimore Democrat, announced this week that he’s introduced a bill to infuse $100 billion into a framework to prevent and treat substance use disorders, calling past efforts and funding insufficient.

In the state, Hogan created the Opioid Operational Command Center, which has launched several measures:

Prevention and education: The center reports that from 2017 to 2018, the number of abuse-prevention and stigma-reduction programs increased from 11 to 24. Employer support programs for those seeking treatment rose from 2 to 13. And programs for youth affected by overdose and addiction increased from 6 to 14.

Enforcement: Counties with a heroin coordinator program rose from 15 to 20.

Treatment and recovery: Counties referring inmates leaving correctional facilities to treatment rose from 10 to 22. Those with mobile crisis teams for substance use disorders rose from 10 to 16. Those with peer recovery specialists in emergency departments, schools or other settings grew from 18 to 24.

Those in the treatment community noted that the growth in total overdose deaths and opioid-related fatalities last year had slowed.

That’s a positive sign that collective efforts are helping stem the epidemic, said Adrienne Breidenstine of Behavioral Health System Baltimore, which manages addiction treatment for Baltimore.

She specifically cited a crisis stabilization center the city is operating in West Baltimore that diverts people from jail and emergency rooms when they overdose and links them to treatment and programs that distribute the overdose reversal drug naloxone.

“The numbers are still tragic; we’re not fully out it yet,” Breidenstine said. “One thing I think about are the lives we’re losing and for some people it’s hard to see hope. But our teams are out there in the trenches. ...This shows how our investment in services is working.”

Baltimore Sun reporter Phil Davis contributed to this article.