The number of Americans who died due to alcohol-related causes skyrocketed in the first year of the COVID-19 pandemic, according to the results of a new study.

Alcohol-related deaths rose roughly 25% from 2019 to 2020, according to a March 18 study conducted by researchers at the National Institute on Alcohol Abuse and Alcoholism and published in The Journal of the American Medical Association.

“Deaths involving alcohol reflect hidden tolls of the pandemic,” the study’s authors noted. “Increased drinking to cope with pandemic-related stressors, shifting alcohol policies, and disrupted treatment access are all possible contributing factors.”