The rate of alcohol-induced deaths increased 26% in the United States in the first year of the pandemic, a new government report finds.

The increase was the highest in at least 40 years, according to study lead author Merianne Spencer of the Centers for Disease Control and Prevention (CDC).

The agency found the increases in rates from 2019 to 2020 were driven largely by deaths from alcoholic liver disease and mental and behavioral disorders due to use of alcohol. The rate of deaths from alcoholic liver disease increased 23% from 2019 to 2020 and 33% for mental and behavioral disorders due to use of alcohol.

Marissa Esser, who leads the CDC’s alcohol program, told CBS News one possible reason alcohol-related deaths have increased since the pandemic may be that people with alcohol-related illnesses may have had more trouble getting medical care.