PORTLAND, Ore. (AP) — Fentanyl and methamphetamine drove a record number of homeless deaths last year in Oregon’s Multnomah County, home to Portland, according to an annual report released by regional officials Wednesday.

At least 315 homeless people died in 2022 in the Portland area, the report found. More than half of the fatalities — 123 — were from drug overdoses. Methamphetamine contributed to 85% of overdose deaths, and fentanyl contributed to 74%.

Kaia Sand, executive director of Street Roots, a newspaper that covers issues related to homelessness, has worked on the annual report for years. In the report, she wrote that this year’s edition “demonstrates the devastating impact of fentanyl.”

“The first year I worked on this report — 2016 — fentanyl was not associated with any deaths,” she wrote. “In 2020, four deaths were tracked to fentanyl, and by 2021, that number rose to 36 deaths. This year, the number skyrocketed to 91 deaths.”

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The figures underlie the increased risk of death facing people who live outside, and it comes as homelessness in the U.S. this year jumped a dramatic 12% to its highest reported level.

The mortality risk for people experiencing homelessness compared with the general county population was nearly six times higher for all causes of death, the report found. For drug overdoses and homicide, it was 37 times higher and 32 times higher, respectively.

Homeless people, many of whom live near roadways, were also nearly 45 times more likely to die from a transportation-related injury than the general county population, according to the report. Fourteen people died of such a cause last year.

Among them was Angela Boyd, who was the victim of a hit-and-run in southeast Portland. Her brother, Jake Ausmes, attended Wednesday’s news conference unveiling the report to pay her homage.

“It’s awful,” he said, adding that he hopes new developments in the case will help it get “as much exposure as possible.” He said his family intends to offer a $2,500 reward to find the person responsible.

Violence also contributed homeless deaths — about a quarter of all people who died by homicide in Portland in 2022 were homeless, according to the report.

Twenty-five homeless people died by homicide in 2022, accounting for 8% of homeless fatalities. The majority were caused by firearms, the report said.

Additionally, the number of suicides — 17 — more than doubled from 2021.

For the first time, this year’s report included hospital deaths in addition to data from the county medical examiner. That contributed, in part, to the sizable 63% increase in homeless deaths compared with 2021, when at least 193 homeless people died.

But county officials said that homeless deaths would have still broken a new record this year even based solely on county medical examiner figures. The report cites 249 homeless deaths recorded by the medical examiner in 2022 and 66 deaths recorded by hospitals.

More than 5,000 people were experiencing homelessness in the county in 2022, according to that year’s federal count.

The most recent federal numbers show that, nationwide, more than 650,000 people were homeless in January 2023, an increase of about 70,650 from a year earlier, as soaring rents and a decline in coronavirus pandemic assistance combined to put housing out of reach for more Americans, federal officials said.

The latest estimate indicates that people becoming homeless for the first time were behind much of the increase.