Figures from the Northern Ireland Statistics and Research Agency (Nisra) showed almost three quarters of drug-related deaths in 2021 were men.
The total is down slightly from 218 in 2020, but is more than double the death toll a decade ago in 2011, when the total was 102.
In relation to all deaths recorded in Northern Ireland in 2021, drug-related deaths accounted for 1.2% of the total.
Men accounted for 156 of the recorded deaths.
Of the registered deaths, 66 were in the 25-34 age group and a further 51 in the 35-44 age group.
The majority (82.1%) of all drug-related deaths in 2021 were classified as substance abuse deaths.
This means that the underlying cause is drug intoxication, substance abuse, or drug addiction, or if one of the substances covered under the Misuse of Drugs Act is involved.
Nisra said more than two-thirds of drug-related deaths in 2021 involved two or more drugs.
Every year since 2011, more than half of drug-related deaths have been attributed to an opioid.
In 2021, 126 drug-related deaths had an opioid mentioned on the death certificate.
Heroin and morphine were the most commonly reported opioids in 2021, linked to 39 drug-related deaths, down from a 2020 peak of 55.
The second most common drug on death certificates was benzodiazepines, which accounted for more than half of drug-related deaths.
Diazepam was implicated in 25.5% of all drug-related deaths in 2021.
Pregabalin-related drug-related deaths have steadily increased since the first statistical mention in 2013. The annual number of deaths related to this controlled substance rose from one in 2013 to a peak of 77 in 2019, but fell slightly to 71 in 2021.
The number of drug-related deaths related to cocaine fell slightly from 36 in 2020 to 32 in 2021.
The proportion of all drug-related deaths in which alcohol was also mentioned on the death certificate increased from 30 in 2020 to 46 in 2021.
The statistics also indicate that there are significantly more drug-related deaths in deprived areas in Northern Ireland.
Nisra said that in 2021, the 20% of Northern Ireland’s most deprived areas recorded five times as many drug-related deaths as the 20% of least deprived areas.
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