A new study finds 156,000 Americans died from drugs, alcohol or suicide in 2019 — more than ever before, according to U.S. News & World Report.

The findings come from Trust for America’s Health, a nonprofit that works on preventing poor health outcomes, and the Well Being Trust, a national foundation with a focus on mental health.

Deaths related to the use of synthetic opioids, including fentanyl, were up 16% in 2019, while deaths from cocaine increased 8%. Deaths from psychostimulants, such as Ecstasy and methamphetamine, rose 28%.

“The most important key takeaway here is we are dying earlier from preventable causes than we ever have before,” said Dr. Ben Miller, chief strategy officer of Well Being Trust. “The reason we are dying is what we call deaths of despair. And these are deaths of drugs, alcohol and suicide. We continue to go in the wrong direction with trends.”

The researchers looked at data gathered before the pandemic hit. They said the pandemic caused a great deal of financial, emotional and physical stress, which likely increased the rates of substance use.