The Health Research Board (HRB) said the number of fatal heroin overdoses in 2013 was one third more than that recorded in 2012, jumping from 64 to 86.
Also, there were separate warnings from a drugs charity that heroin deaths would increase further, as heroin from a bumper crop of opium in 2013 only began hitting the streets this year.
The HRB’s National Drug-Related Deaths Index 2013 report shows that 679 people died from drugs, directly or indirectly, in that year.
The deaths resulted from poisonings (overdoses), as well as trauma (such as hanging), and medical causes (such as cardiac arrest or respiratory failure).
The toll for 2013 is the highest number of deaths since the index began in 2004, when there were just 432 deaths.
The 679 deaths comprised of 387 poisonings and 292 non-poisonings (trauma and medical deaths). There were 297 non-poisoning deaths in 2012 and 165 in 2004.
Suzi Lyons, report co-author with Ena Lynn, said it was the first increase in heroin deaths since 2009, and a 34% rise on 2012 figures.
She said two out of every five heroin victims were not alone at the time and that half were injecting.
The report showed that 21% of those who died from injecting heroin were in homeless accommodation, while 17% were in a public place.
Ms Lyons said “there is an opportunity there for prevention”.
She said strategies included access to treatment, overdose prevention and training and, for problematic users, medically-supervised injecting centres.
Speaking at the launch, Drugs Strategy Minister Aodhán Ó Ríordáin said the figures showed that “heroin is not an old problem”.
He said that the Government was making efforts, including funding a Nalxone demonstration project. The antidote to heroin has been given to 600 patients. He said he believed it had already saved lives.
The minister of state said the continuing rise in the total number of drug deaths was “frightening” and he noted that alcohol continued to be implicated in many overdoses, being linked with 137 deaths in 2013 (35% of all poisonings).
The report shows that benzodiazepines — legal tranquillisers — were involved in 41% of poisonings, a 24% rise on 2012.
Almost all of these deaths involved other drugs, mainly opiates (heroin or methadone) or alcohol.
Mr Ó Ríordáin said the report found 60% of traumatic deaths involved people with a history of mental illness.
There was also an increase in hangings, from 53 in 2010 to 74 in 2013 (75 in 2012).
Mr Ó Ríordáin said that the Government launched the Connecting For Life programme earlier this year, which aimed to reduce suicide over the next five years.
Tony Duffin, of the Ana Liffey Project, said that he was “concerned” at the rise in heroin deaths and said it had probably worsened since 2013, as produce from a bumper crop of opium in Afghanistan in that year would not have hit Ireland until 2015: “I would think we will see deaths from heroin increase as we go forward.”