Suicide deaths involving heavy alcohol use rose significantly among women between 2003 and 2018, according to a new study.

The new study was supported by the National Institute on Alcohol Abuse and Alcoholism. It used data from the National Violent Death Reporting System, which included 115,202 suicides by men and women ages 18 and up between 2003 and 2018. The researchers evaluated suicides among people with a blood alcohol concentration (BAC) of 0.08 g/dL or greater, which were considered alcohol-involved.

They found the proportion of suicides involving a BAC greater than or equal to that level significantly grew each year for women of all age groups. The biggest increase was among women over 65. Only middle-aged men had a significant annual rise in alcohol-involved suicides.

The findings suggest alcohol use may have been a core driver in the accelerated rise in suicide among U.S. women, the researchers wrote. They called for more education and awareness of this relationship, as well as improved screening and intervention strategies.