Fentanyl killed 18,335 people in the US in 2016—the most of any drug, making the synthetic opioid the deadliest drug in America. Health officials announced the new ranking of overdose deaths from 2016, the most recent year for which data is available, on Wednesday. It's fentanyl's first time atop the list, which had heroin in the No. 1 spot from 2012 to 2015, USA Today reports. Oxycodone held the top spot in 2011. Fentanyl has experienced a disturbingly fast rise, causing just 4% of overdose deaths in 2011—but 29% in 2016. On average, the rate of fentanyl OD deaths increased by 113% per year from 2013 to 2016. Of note, as the Huffington Post reports, is the fact that most OD deaths involved multiple drugs; of the fatal ODs involving fentanyl or heroin, 70% involved at least one other drug as well, and about 40% of cocaine deaths also involved fentanyl. Read on for the top 10 deadliest drugs in the US: