Drug overdose deaths are on the rise across all genders, demographics and geographic areas, according to a new CDC report.

A total of 63,632 Americans died of a drug overdose in 2016 — a 21.5% increase over the 2015 total, according to the report. The researchers attribute this sharp uptick in deaths to the fatalities involving potent synthetic opioids such as fentanyl, which doubled in 2016.

The report drew on data from 31 states, plus Washington, D.C. Of these, 21 saw increases in synthetic opioid overdose deaths, and 10 saw those rates double. New Hampshire, West Virginia and Massachusetts were particularly hard-hit by synthetic opioids, the report says.

Get our Health Newsletter. Sign up to receive the latest health and science news, plus answers to wellness questions and expert tips. Please enter a valid email address. Sign Up Now Check the box if you do not wish to receive promotional offers via email from TIME. You can unsubscribe at any time. By signing up you are agreeing to our Terms of Use and Privacy Policy . This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply. Thank you! For your security, we've sent a confirmation email to the address you entered. Click the link to confirm your subscription and begin receiving our newsletters. If you don't get the confirmation within 10 minutes, please check your spam folder.

From 2015-2016, deaths related to cocaine, psychostimulants, heroin and prescription opioids rose by 52.4%, 33.3%, 19.5% and 10.6%, respectively. But the report notes that these drugs are often laced with fentanyl as well, which likely contributes to skyrocketing casualty rates.

While nearly every demographic experienced an increase in drug overdose death rates, the report says men between ages 25 and 44 saw the most drastic increase.

Substance abuse, particularly related to opioids, has become one of the most pressing public health issues in the U.S., leading President Donald Trump to declare it a public health emergency in October. Drug overdose deaths have even chipped away at the U.S. lifespan, according to September report.

Write to Jamie Ducharme at jamie.ducharme@time.com.