RICHMOND, Va. (WRIC) -- A preliminary report by the Virginia Department of Health (VDH) lists Richmond as one of several localities in Virginia with the highest rate of all deadly drug overdoses in 2023. According to VDH's Fatal Drug Overdose Quarterly Report for the second quarter, Richmond was listed as a locality with the highest rate of all deadly drug overdoses in 2023, with a rate between 104.5 and 129.5. Other localities included Petersburg and Hopewell. According to the report, in 2023, the most common combination of substances causing deadly overdoses was cocaine and fentanyl, representing 34.2% of all overdose deaths. Richmond, Petersburg and Hopewell had the highest rate of deadly fentanyl overdoses in Virginia, as well as the highest rate of cocaine overdoses in 2023, according to the report. In 2023, preliminary numbers indicated that fentanyl was involved in 76.3% of all drug overdose deaths, according to the report. However, the preliminary number of deadly fentanyl overdoses in 2023 decreased by 2.6% when compared to 2022. It is important to note that the quarterly report contains the most recent number of drug-related deaths in Virginia for the previous year. The numbers represented in the report are preliminary and subject to change, according to VDH. To view VDH's Fatal Drug Overdose Quarterly Report for the second quarter, go here.