NEW YORK (AP) More than 107,000 Americans died of drug overdoses last year, setting another tragic record in the nations escalating overdose epidemic, the Centers for Disease Control and Prevention estimated Wednesday.

The provisional 2021 total translates to roughly one U.S. overdose death every 5 minutes. It marked a 15% increase from the previous record, set the year before. The CDC reviews death certificates and then makes an estimate to account for delayed and incomplete reporting.

Dr. Nora Volkow, director of the National Institute on Drug Abuse, called the the latest numbers truly staggering.

U.S. overdose deaths have risen most years for more than two decades. The increase began in the 1990s with overdoses involving opioid painkillers , followed by waves of deaths led by other opioids like heroin and most recently illicit fentanyl.

Last year, overdoses involving fentanyl and other synthetic opioids surpassed 71,000, up 23% from the year before. There also was a 23% increase in deaths involving cocaine and a 34% increase in deaths involving meth and other stimulants.