FRANKFORT, Ky. — Since 2011, a year when Kentucky was flooded with 371 million doses of opioid painkillers, state officials have cracked down on pain clinics, sued pharmaceutical companies, and limited how many pills doctors can prescribe.

The result is nearly 100 million fewer opioid prescriptions in 2017 — and an 11.5 percent increase in drug overdose deaths.

Those are the sobering findings of a new report from the Kentucky Office of Drug Control Policy in a state on the front lines of the nation’s opioid epidemic. The report says 1,565 people died from drug overdoses in 2017, a 40 percent increase in the past five years.

Deaths attributed to prescription painkillers and heroin are declining. But other drugs have taken their place. Fentanyl, a synthetic opioid, accounted for more than half of all the deaths. And methamphetamine has made a comeback.

Nationally, opioids accounted for more than 42,000 deaths in 2016. States with the highest rates of drug overdose deaths that year were West Virginia, Ohio, New Hampshire, Pennsylvania, and Kentucky, according to the Centers for Disease Control and Prevention.

Every year, Kentucky lawmakers have been passing more laws designed to address the opioid problem. They have increased penalties for heroin dealers. They have diverted more money to drug treatment programs. And they limited patients to a three-day supply of prescription painkillers.

Antidrug advocates celebrate those changes, but their celebration is tempered once a year when the new numbers come out detailing how many more people have died.