Drugs caused a record number of deaths in Greater Manchester last year - with cocaine and prescription drugs increasingly the cause.
And one expert fears next year's figures could be even higher due to the stresses caused by the COVID-19 pandemic.
There have been significant rises in Wigan, Oldham, and Bury. Overall the number has increased by 17 per cent in the region in the last six years.
There were 268 deaths related to drug poisoning in the area in 2019 - the highest number since records began in 1993.
An addiction charity called the announcement a sad day and said such deaths were “preventable”.
Numbers were up 12 per cent in a year from 239 deaths in 2018, according to statistics released by the Office for National Statistics.
Nationally, deaths are most likley to be caused to heroin and morphine, but 2019 saw a drop in such deaths.
Deaths involving cocaine have risen rapidly in recent years, but there have also been increases due to cannabis and prescription drugs, such as anti-anxiety drugs, antidepressants and painkillers.
Of the 268 deaths due to drug poisoning in Greater Manchester last year, 196 were due to drug misuse - a category that only relates to illegal drugs. That was also the highest total since 1993.
The area saw 158 deaths between 2017 and 2019, a rate of 11.9 per 100,000 people - 1.7 times higher than the England rate of 7.1 deaths per 100,000 people.
It also had the highest rate of drug misuse deaths at 9.1 per 100,000, almost double the England rate of 4.7 per 100,000.
Laura Bunt, Deputy CEO at drug, alcohol and mental health charity With You (We Are With You, formerly Addaction), said: “This is a really sad day. Every drug-related death is preventable, and each death has a huge impact on families and communities, continuing to be felt years down the line.
“We know that people who use drugs problematically but aren’t in treatment are most likely to die of a drug-related cause. The government's proposed new addiction strategy represents an opportunity to get more people the support they need.
“It’s also clear that cocaine use has increased exponentially in the last decade, with both crack and powder becoming increasingly available and affordable, yet many people remain unaware of the potential harms.
"We need much better education early on in schools and throughout the population on how to use drugs in the safest way possible and what support is out there.”
She said it should also be recognised that problematic drug use is often a reaction to people’s surroundings - including homelessness, mental health and a lack of economic opportunities - something likely to be exacerbated by the Covid-19 crisis, making it more important than ever that the Government commits to addressing inequalities.
New analysis by deprivation shows that, in the last decade, rates of drug poisoning deaths have been higher in the most deprived areas of England and Wales.
A break down of the drugs-related deaths in the region shows sharp increases in some boroughs.
| 2017-19 | 2016-18 | 2015-17 | 2014-16 | 2013-15 | 2012-14 | 2011-13 | |
| Bolton | 76 | 67 | 70 | 66 | 64 | 48 | 62 |
| Bury | 58 | 60 | 41 | 41 | 35 | 35 | 27 |
| Manchester | 158 | 146 | 151 | 148 | 143 | 136 | 127 |
| Oldham | 68 | 59 | 60 | 63 | 60 | 56 | 38 |
| Rochdale | 68 | 68 | 65 | 71 | 58 | 59 | 46 |
| Salford | 70 | 66 | 72 | 55 | 46 | 41 | 59 |
| Stockport | 52 | 51 | 53 | 57 | 61 | 60 | 59 |
| Tameside | 64 | 48 | 50 | 47 | 54 | 49 | 55 |
| Trafford | 42 | 30 | 26 | 37 | 39 | 39 | 30 |
| Wigan | 89 | 81 | 80 | 84 | 76 | 60 | 48 |
| Greater Manchester (Met County) | 745 | 676 | 668 | 669 | 636 | 583 | 551 |
Nuno Albuquerque, Group Treatment Lead for drug addiction treatment firm UKAT, said: "The drug death mortality rates across Greater Manchester are only worsening.
"In eight years, particular boroughs like Wigan, Oldham, and Bury, have seen significant rises in drug-related deaths.
"We must remember that these aren't just numbers; they're someone's mother, father, child or friend. We can't stress enough the value of investing in the treatment of addiction.
"We urge the councils of Greater Manchester to come together for the greater good and to make a significant investment in their 2021 budgets to avoid more loss of life, because unfortunately, we foresee next year's figures to tip off the scale after such a difficult 2020 for everyone, especially the most vulnerable."
