PROVIDENCE, R.I. (AP) — The number of accidental drug overdose deaths in Rhode Island is on the rise, and the coronavirus pandemic could be partially to blame, state health officials say.

There were 233 accidental drug overdose deaths in the first seven months of this year, compared to 185 during the same period last year, the state Department of Health said in a statement Wednesday.

While all drug fatal overdoses increased 26%, opioid-involved fatal overdoses increased 33%.

The 40 fatal drug overdoses in July was the highest single-month total since the state started tracking the data in 2014.

Although the increase started before the pandemic, “the stressors and isolation of the COVID-19 pandemic are believed to be factors,” the agency said.

Other possible factors include the use of more than one drug at a time, counterfeit pills, and fentanyl mixed with other drugs.

“The increased potency of drugs combined with the challenges of COVID-19 have stressed an already fragile system,” Kathryn Power, director of the Department of Behavioral Healthcare, Developmental Disabilities & Hospitals, said. “These challenges might have led people who were in recovery to relapse. In other cases, people who use drugs occasionally, like cocaine, might have succumbed to an overdose by not knowing fentanyl was present.”

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