A report the state Department of Mental Health and Addiction Services released last week shows signs of a continuing opioid crisis, but officials said there are some bright spots.

The annual report, which analyzes the department’s mental health and substance abuse clients and admissions, found 2,138 more people entered into a DMHAS substance abuse program in fiscal year 2016 than in the previous year.

Heroin again topped the list of substance abuse clients’ drugs of choice, and for the second straight year also topped that list for all DMHAS clients.

“I think it’s clear from our data that more people are using,” DMHAS Director of Quality Jim Siemianowski said. “We’ve seen this over a five-year period.”

However, he said, the increase in those claiming heroin or another opioid as their drug of choice was less in fiscal year 2016 than in years prior, possibly signaling that the problem is leveling off.

“We’re cautiously evaluating that,” he said.

Siemianowski also said it’s encouraging that more people are seeking treatment.

“Certainly one of our goals for people experiencing problems with opioids is to get them into treatment, and get them into treatment that’s considered gold standard,” he said.

Over the last five years, Siemianowski said, there’s been a close to 40 percent increase in the number of people taking part in methadone maintenance programs operating in the state.

The programs fall under the umbrella of medication-assisted treatment, in which behavioral therapy and medications are combined to treat substance use disorders. Such treatment “is considered the evidence-based way of treating people,” Siemianowski said.

He said the programs have been able to expand because of grants and the fact that insurances and Medicaid pay for the cost of methadone maintenance.

Locally, New London had the highest rate of DMHAS substance abuse clients, at 284.41 per 10,000 population, according to the report. Norwich had the highest number of such clients, with 943.

According to a different DMHAS spreadsheet, New London also had the highest rate of people receiving opioid treatment, whether from DMHAS or a private provider. Its 331 patients in fiscal year 2016 equate to a rate of 121.79 per 10,000 population.

Speaking by phone Wednesday, New London Human Services Director Jeanne Milstein said officials from all disciplines are working overtime to address the opioid crisis in the city.

“When the mayor ran, he absolutely recognized the need,” Milstein said, referring to Mayor Michael Passero. “Part of the reason my position was created was to look at the numbers and come up with ways we can do more prevention.”

Since she was hired nearly a year ago, Milstein has worked with law enforcement, health, court, government and other officials to analyze things such as access to and cost of treatment.

Right now, she said, the city continues to advocate for a requirement that sober houses be certified. It’s working to institute a program modeled after one in Bridgeport that would send addicts who are not dealers to treatment rather than prison. City officials are looking at ways to make inmates’ transitions back to life in the city smoother.

Milstein has been working with Lawrence + Memorial Hospital to establish a recovery coach program, too. Through the program, each person who ends up in the hospital because of an overdose would be paired with someone who could direct them into a recovery program and stay in touch with them.

The city also remains on track to open a recovery community center, where people can go for meetings or other support, in the spring.

“I credit the mayor for his leadership and vision on this,” Milstein said. “He understood the need and wanted to get right on it.”

But without a “deep, collaborative, cooperative” partnership with individuals and organizations throughout New London, she said, the initiatives wouldn’t be possible.

“We’ve got to keep the momentum going — and we are,” she said. “Everybody is in this together.”

Siemianowski said it’s not unusual for cities to see higher rates of DMHAS clients — in part because there’s typically greater access to illicit drugs there — but he emphasized that the problem is not just an urban one.

Indeed, the majority of southeastern Connecticut towns saw an increase in the number of people being treated for opioid addiction from 2012 to 2016. In Montville, a town of just more than 19,000, that increase was 83 percent. In 15,000-population Ledyard, it was about 58 percent.

“We have to be vigilant in all towns across the state,” Siemianowski said.

People who want help for opioid abuse can call 1 (800) 563-4086 to find a walk-in assessment center in their area.

l.boyle@theday.com