MASSACHUSETTS — State health officials say Massachusetts saw its biggest year-over-year drop in opioid overdose deaths in two decades last year, although more than 2,100 residents still died due to an overdose in 2023.

Massachusetts opioid overdose deaths increased every year between 2019 and 2022, reaching an all-time high of 2,357 in 2022. An estimated 2,125 died in 2023, and deaths over the first three months of 2024 were trending lower than in previous years, the state Department of Public Health said Wednesday.

State officials attributed the reduction to increased investments in treatment programs and housing, the distribution of nearly 200,000 naloxone overdose kits and increasing access to medications to treat opioid-use disorder. The state has focused its efforts especially on people living in rural areas and in communities of color.

The reduction in deaths comes amid the ongoing surge of fentanyl use, and the combination of fentanyl with xylazine — a tranquilizer whose sedating effects can’t be reversed by anti-overdose medications like naloxone.

According to state data, many large communities like Pittsfield, Brockton, Cambridge, Lynn and Lawrence saw big reductions in overdose deaths. Worcester, the state’s second-largest city, saw a decrease between 2022 and 2023, but the number of deaths in 2023 was still the second-highest on record dating back to 2016. Boston’s overdose deaths rose from 353 in 2022 to 377 in 2023, according to state data.

RIZE Massachusetts, a Boston-based nonprofit working to reduce overdose deaths, said the reduction is a positive step, but that more work needs to be done to further reduce deaths.

“Any decrease in fatal overdoses is positive, but we are still losing far too many people — with persistently alarming rates among people of color and in our rural communities — given the knowledge and resources we have at our disposal to save lives,” the nonprofit said in a news release. “In partnership with the state, we are broadening our efforts to address the overdose crisis and increasing access to opioid settlement funds. We must continue to champion effective, equitable interventions and advocate for new measures to achieve a sustained downward trend in the crisis.”