More than 93,000 people in the United States died from a drug overdose in 2020, an increase of almost 30% from the previous year, The Washington Post reports.

Opioid-related overdose deaths reached 69,710 last year, up from 50,963 in 2019, according to the National Center for Health Statistics. Many of those deaths involved fentanyl.

According to Nora Volkow, head of the National Institute on Drug Abuse, 70% of cocaine overdose deaths and 50% of methamphetamine overdose deaths also involved fentanyl. In many cases, people are not aware that the substances they use are laced with fentanyl. She noted that most of the deaths involve multiple substances.

“The pandemic has led to increased substance use across the board, as people have sought to manage stress, isolation, boredom, anxiety, depression, unemployment, relationship and child care issues, and housing instability,” said Kimberly Sue, medical director of the National Harm Reduction Coalition, an advocacy group that tries to prevent overdose deaths. Sue noted access to anti-addiction medication such as buprenorphine and methadone was limited during the pandemic, as was access to the opioid overdose antidote naloxone.