New figures from the ONS (Office of National Statistics) show there were 4,859 deaths related to drug poisoning registered in 2021 - a rate of 84.4 deaths per million people.
This is the ninth consecutive annual rise, up 6.2% from the previous year.
It is also the highest number since records began more than a quarter of a century ago in 1993.
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There were 21 deaths recorded in Milton Keynes last year, 22 in 2020 and 24 in 2019, as compared to just 7 in 2015 and 6 in 2014.
However around half of the deaths registered in 2021 will have occurred in previous years due to death registration delays.
The ONS said the overall rising trend over the past decade has been driven primarily by deaths involving opiates, but also those involving other substances such as cocaine.
In the last year there have been “significant” rises from 2020 in deaths involving cocaine, methadone and new psychoactive substances.
The ONS said possible explanations for the rise could be that there is an ageing cohort of drug users experiencing the effects of long-term use and becoming more susceptible to a fatal overdose.
New trends, which involve taking specific drugs, such as benzodiazepines, alongside heroin and morphine, may increase the overdose risk.
The ONS figures cover drug abuse and dependence, fatal accidents, suicides and complications involving controlled and non-controlled drugs, prescription and over-the-counter medications.
The figures show that the rates of drug-related deaths have risen 81.1% since 2012, when there were 46.6 deaths per million people.
Of the deaths registered last year, 3,809 were due to accidental poisoning, while there were 927 instances of intentional self-poisoning.
Some 119 deaths arose from mental and behavioural disorders as a result of drug use, and four deaths followed assault by drugs, medicaments and biological substances.
Some 840 deaths involved cocaine, which was up 8.1% from 2020, and more than seven times the number recorded a decade ago (112 deaths in 2011).
There were also 663 deaths involving methadone registered in 2021, a 28.5% rise from the previous year (516 deaths).
A total of 258 deaths involving new psychoactive substances were also registered, this being up 88.3% from the previous year (137 deaths).
People in the North East were more than three times more likely to die due to drug misuse than people in the East (104.1 deaths per million versus 27.4 deaths per million).
They were also more than three times more likely to die from drug poisoning than people in London (163.4 deaths per million versus 47.6 deaths per million).
And rates of drug misuse deaths also continued to be high among Generation X, who were born between the late 1960s and early 1980s.
Dr David Bremner, group medical director and consultant psychiatrist in addictions at the charity, said: “If these were cancer deaths increasing at this rate, we would expect action at a certain pace that I believe we should expect the same for persons with addiction.”
A Government spokesman said: “Our landmark drug strategy will help rebuild drug treatment and recovery services to better support people through recovery, as well as tackling the criminal supply chains which fuel illegal drug markets.”