More than 47,000 Americans died from drug overdoses in 2014, setting a new record, according to the Centers for Disease Control and Prevention (CDC). Drug overdoses increased 6.5 percent from 2013.

The states with the highest overdose death rates were West Virginia, New Mexico, New Hampshire, Kentucky, and Ohio, Reuters reports. Deaths from opioids, including painkillers and heroin, accounted for 61 percent of overdose deaths in 2014. Opioid deaths increased 14 percent from the previous year. Deaths involving illicitly made fentanyl, a potent opioid often added to or sold as heroin, also are increasing, the CDC noted.

“The increasing number of deaths from opioid overdose is alarming,” CDC Director Tom Frieden said in a statement. “The opioid epidemic is devastating American families and communities.”

The increased availability of heroin, its relatively low price compared to prescription opioids, and high purity appear to be factors in the increase in heroin use, overdoses, and deaths, the CDC said.

Overall, drug overdose deaths have increased 137 percent since 2000. Opioid overdose deaths rose 200 percent during that period. The CDC noted almost half a million people in the United States have died from drug overdoses since 2000.

The most commonly prescribed opioid pain relievers, such as oxycodone and hydrocodone, continue to be involved in more overdose deaths than any other opioid type, the CDC said. These deaths rose by 9 percent.

The CDC recommended steps to prevent overdose deaths. These include providing health care professionals with safer guidelines for prescribing opioids; expanding access to evidence-based substance use disorder treatment, including medication-assisted treatment; expanding access and use of the opioid overdose antidote naloxone; and improving communication between state and local public health agencies, medical examiners and coroners, and law enforcement agencies to detect and respond to illicit opioid overdose outbreaks.