The drug-death data announced by the state Monday tell what’s become a familiar story. Year by year, they chart fatal overdoses rising precipitously in New Hampshire, starting in 2013, before dipping in 2018.

But over the course of eight pages, Monday’s report from the N.H. Office of the Chief Medical Examiner offers a glimpse at the circumstances behind the statistics.

Of the 471 people confirmed to have died of drug overdoses last year — the vast majority from opioids — about 70 percent (328 people) were male, whereas 30 percent (143) were female.

Last year’s deadliest month was July, with 56 people dying during that 31-day period alone.

Although most drug deaths in 2018 were accidents, about 7 percent were deemed suicides. These deaths were most common among people aged 50 to 59. Accidental fatal overdoses were most prevalent among people in their 30s.

Also include in last year’s numbers are what officials describe as the “undetermined overdose death” of a toddler.

“The awareness [of substance use] has improved to allow us to actually be having these conversations,” said Shorey Dow, assistant vice president for strategic quality optimization for Phoenix House New England, “but we still have a lot to do related to substance use.”

The data also breaks down where 2018’s fatal overdoses happened.

Seventeen were in Keene, and 32 were in Cheshire County, ranking as the fifth-highest city and county for fatal overdoses in the state.

Of the deaths confirmed for 2018, 421 were caused by opioids; 386 of them by fentanyl used either by itself or with another drug.

Methamphetamine was involved in 22 drug deaths and cocaine in 65, and in most of these cases, opioids were also used. Alcohol was the cause of two overdose deaths, the data state, and contributed to 52 more.

“With the fentanyl getting into everything, those overdoses being opioid-related isn’t surprising,” said Jocelyn Goldblatt, executive director of the Keene Serenity Center.

So far this year, a total of 240 drug deaths had been confirmed statewide as of last month — 213 of them from opioids — with a determination of the cause of another 72 deaths pending toxicology testing.

At least four fatal overdoses have happened in Keene in 2019, according to October’s data from the MMedical Examiner’s Office.

The Elm City’s statistics were included with those of 20 other Granite State communities ranking at the top for confirmed drug deaths in 2019. Keene stood roughly center, with the same number of fatal overdoses as Hudson, Hampton and Somersworth.

“We got to keep talking about [substance use] and educating individuals,” Dow said. “The stigma is still there and still real.”

Those seeking recovery resources in Cheshire County can visit the The Doorway at 640 Marlboro Road in Keene (the Curran Building on Route 101) Monday through Friday, from 8 a.m. to 5 p.m., or seek support through the state’s 24/7 hotline at 211.

To access the National Suicide Prevention Lifeline, call 1-800-273-8255. For the local Samaritans’ hotline, call 357-5505 or 1-866-457-2910.

Olivia Belanger can be reached at 352-1234, extension 1439, or Follow her on Twitter @OBelangerKS.