After a small decline in 2018, drug overdose deaths have been on the climb since last year and the pandemic might make things worse.

Preliminary data from the Centers for Disease Control and Prevention (CDC) show drug overdose deaths are on the rise once again in the United States. There were just over 70,000 deaths in 2019, the CDC reports. That represents a 4.9% increase from a year before and those numbers could continue to climb, according to the Drug Policy Alliance.

“While the increase in overdose deaths in the U.S. in 2019 is devastating, it is not at all surprising, and there is reason to believe that these deaths will continue to climb in 2020 as a result of the COVID-19 pandemic, which has increased isolation, disrupted the drug supply and reduced access to harm reduction and treatment supports,” said Sheila Vakharia, Deputy Director of the Department of Research and Academic Engagement for the Drug Policy Alliance.

Overdose deaths saw a small decline in 2018, the first such decrease since 1990. Lawmakers, including President Donald Trump, celebrated the drop at the time. This was a mistake, Vakharia said, as a closer scrutinization of the data indicated the U.S. had achieved a hollow victory.

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“Last year, as legislators tried to do a victory lap over a 4.5% decrease in overdose deaths from the year prior, we warned that the data did not account for the fact that there were states where overdoses continued to climb, nor did data make clear the racial and other demographic discrepancies or the troubling increases in stimulant overdoses in recent years,” she said. “This is still true today.”

Since 1990, more than 700,000 people have died due to drug overdoses. This has mostly been driven by the opioid epidemic and the 2019 data reveals not much has changed. Of the 70,980 people who died from drug overdoses last year, 50,042 involved opioids.

Another recent CDC report found that 6.6% of women had used opioid pain killers while pregnant last year. One in five women admitted to misusing the opioids, the authors reported, and they suggested improved screening for opioid misuse and treatment of opioid use disorder in pregnant patients.

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Harm reduction strategies across the United States is vital right now, Vakharia added. The COVID-19 pandemic has disrupted many ways of life, with a disorientation effect on communities hit hardest by increase drug overdose deaths. All of which has revealed the health inequities of the system, according to Vakharia.

“More than ever, it is essential that we double-down on overdose prevention approaches that work, as outlined by DPA’s COVID-19 policy recommendations, said Vakharia, “including improving substance use disorder treatment and increased access to harm reduction services — such as keeping loosened regulations for methadone and buprenorphine in place, allowing overdose prevention sites to legally open and allocating federal funding towards syringe exchange and naloxone access.”