Public-health officials said the increase is from cheaper and deadlier heroin flooding into New England. They expect the trend to continue as budget cuts lead to the elimination of treatment programs.

"We have a clear indication that we have a heroin epidemic in the state of Massachusetts, including Boston," said Deborah Klein Walker, assistant commissioner of the Massachusetts Department of Public Health.

The report found an increase in women and white men dying from drug overdoses or drug-related suicides.

"We fear but expect that drug-related deaths will dramatically increase in 2003, and we're already seeing some indication of that," said John M. Auerbach, executive director of the Boston Public Health Commission.

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