As my colleague Josh Katz has reported, this death toll is more than the peak yearly death totals from H.I.V., car crashes or gun deaths.

It’s not clear whether the opioid epidemic has reached its peak. Despite the efforts of policymakers and medical professionals, some of the factors contributing to the rising overdose rate have proved difficult to contain.

“Because it’s a drug epidemic as opposed to an infectious disease epidemic like Zika, the response is slower,” said Dan Ciccarone, a professor of family and community medicine at the University of California, San Francisco, who studies heroin markets. “Because of the forces of stigma, the population is reluctant to seek care. I wouldn’t expect a rapid downturn; I would expect a slow, smooth downturn.”