Drug overdose deaths in Maine through the first nine months of 2016 have surpassed the total for all of 2015 as the opioid epidemic continues to worsen. Mainers have died in record numbers, with 286 fatalities through Sept. 30, according to statistics released Monday by the state Attorney General’s Office.

Treatment advocates and lawmakers called for more action to alleviate the opioid crisis sweeping the nation.

“It’s awful. This just underscores that we have a long way to go,” said Rep. Drew Gattine, D-Westbrook and co-chair of the Legislature’s Health and Human Services Committee.

Gattine said he didn’t know of any specific proposals, but he believes several bills will be introduced when the Legislature convenes in January that aim to address the opioid crisis. Last winter, the Legislature approved a $3.7 million bill that boosted treatment, prevention and enforcement efforts, but at the time lawmakers called the bill and its modest funding a starting point rather than a comprehensive approach to the problem.

In 2015, 272 Mainers died from drug overdoses, a record for the state at the time. Nationwide, more people now die from drug overdoses than motor vehicle accidents. There were about 47,000 drug overdose deaths in 2014, the latest year for which federal data is available, compared with 29,000 deaths in vehicle accidents.

Samantha Edwards, spokeswoman for the Maine Department of Health and Human Services, said the state is working to expand treatment – as well as enforcement and prevention – to try to stem the drug crisis.

“The department is committed to addressing the drug epidemic facing the state of Maine,” Edwards said in an email response to questions. “Under Gov. (Paul) LePage, it has been an ‘all hands on deck’ approach to take this issue head-on.”

The crisis has been fueled by heroin, prescription opioids and fentanyl, which is often mixed with heroin.

The dramatic increase in 2016 overdose deaths is “mainly due to illicitly manufactured (non-pharmaceutical) fentanyl,” Attorney General Janet Mills said in a news release. “One person a day is dying from a drug overdose in Maine. I cannot stress how dangerous these drugs are. My office is working with law enforcement around the state to stop the trafficking of these drugs in Maine. As we work to stem the supply, we must also decrease the demand for these drugs. Maine must expand access to detox beds and long-term treatment so that people in the grips of addiction can find hope and live productive lives.”

Of the 2016 overdose deaths, 182 were caused by non-prescription opioids, such as heroin or fentanyl, either by themselves or in combination with other drugs. Prescription opioids contributed to 95 deaths.

Zoe Odlin-Platz, community health promotion specialist for Portland, said the city’s needle exchange program now has 900 enrollees, up from 800 in 2015, although it’s difficult to determine whether the jump is caused by more heroin addicts or greater awareness of the program. The exchange provides clean needles to intravenous drug users to help prevent the spread of diseases caused by shared needles.

“Our numbers are always increasing,” Odlin-Platz said. “We see a lot of people coming from all over the state.”

But Odlin-Platz said she’s not surprised by the jump in overdose deaths, because sometimes those most vulnerable to a drug overdose are people who have been in recovery for years and then relapse.

“Everyone I know who died in the last year was a long way into recovery, and they were working jobs, going to school, having children and doing amazing work,” Odlin-Platz said.

Gordon Smith, executive vice president of the Maine Medical Association, which represents doctors before the Legislature, said Maine doesn’t seem to be treating the opioid epidemic like it’s a crisis.

“We’re not doing enough. Where is the urgency? We are not doing things fast enough,” Smith said, pointing to a detox center in Bangor that was approved last winter but is not scheduled to open for several months.

Smith said a strict new prescribing bill has been helpful – the state capped the dosage and length of time that opioids can be prescribed for some chronic pain patients.

Four out of five new heroin users were first addicted to prescription opioids, according to the American Society of Addiction Medicine. More than 650,000 opioid pills are taken each day in the U.S., federal data show.

Restricting the flow of prescription opioids is the right thing to do, but it doesn’t help people already addicted, Smith said.

“The piece that is not addressed at all is access to treatment,” he said.

About 25,000 to 30,000 Mainers want drug treatment but say they don’t have access, according to a survey by the U.S. Substance Abuse and Mental Health Services Administration.

Edwards, at DHHS, pointed to several LePage administration efforts to address capacity, including the Bangor detox center that will serve more than 700, pilot programs that combine substance abuse treatment with parenting programs for families with young children, and boosting medication-assisted treatment in the correctional system.

In Portland, the Greater Portland Addiction Collaborative – led by Mercy Hospital – is on track to potentially receive millions of dollars over several years for a comprehensive plan to address the opioid epidemic. The money would come through the White House’s Pay for Success program, which matches private investors with a social cause.

But for Mainers who can now access substance abuse treatment programs through Affordable Care Act insurance, that access could be in jeopardy if the incoming Trump administration repeals the ACA. Trump had promised to repeal and replace the ACA on the campaign trail, but since the election has said he’s open to preserving parts of the law.

About 80,000 Mainers have ACA insurance, but it’s unknown how many have used the insurance to access substance abuse treatment.