Over the last decade, doctors prescribed 44% fewer opioids, yet opioid overdoses continued to rise, a new report from the American Medical Association (AMA) finds.

The report evaluated opioid prescriptions and overdoses between 2011 and 2020, The Hill reports. The decrease in prescriptions during that time coincided with a rise in doctors using prescription drug monitoring programs. These electronic databases track controlled substance prescriptions and help identify patients who may be receiving multiple prescriptions from multiple prescribers. Doctors used these programs more than 910 million times in 2020, compared with 750 million times in 2019 and 61.5 million times in 2014.

More than 93,000 Americans died from overdoses in 2020, including 69,000 from opioid overdoses, according to the Centers for Disease Control and Prevention. This number represented an almost 30% increase in overall fatal overdoses from the previous year. During the pandemic, every state experienced an increase in opioid overdoses, the report found.