The average life expectancy in the United States has once again dropped after peaking in 2014. Experts say that drug overdoses are the reason why, but could there be other factors that come into play as well?

According to the latest official numbers, as reported by BuzzFeed News, the average baby born in the US in 2017 can expect to live 78.6 years, a slight drop from the previous year’s estimate of 78.7 years. The new numbers were released on Thursday by the National Center for Health Statistics. More than 72,000 Americans overdosed on drugs and died as a result so far in 2018.

Heart disease and cancer still remain by far the leading cause of the 2.8 million US deaths last year, followed by accidental injuries, a category dominated by fatal drug overdoses. “Pretty grim,” Regina LaBelle of the O’Neill Institute for National and Global Health Law at Georgetown University told BuzzFeed News. “Another year of decreased life expectancy is a wake-up call that this epidemic is far from over.”

In particular, death rates from fentanyl and its analogs, which now show up in illicit heroin and cocaine as well, rose 45% from 2016 to 2017, contributing to more than 20,000 deaths. Those numbers are estimated to have grown to more than 30,000 yearly deaths in preliminary data from the CDC.

But suicide rates are also on the rise, increasing 33% from 1999 to 2017. The rate was 1.8 times higher in rural counties compared to city ones, the report found. According to the Washington Post, increases in suicide rates were seen across age, gender, race, and ethnicity, according to a report released Thursday by the Centers for Disease Control and Prevention. In more than half of all deaths in 27 states, the people had no known mental health condition when they ended their lives. Nearly 45,000 suicides occurred in the United States in 2016, which is more than twice the number of homicides, making it the 10th-leading cause of death. Among people ages 15 to 34, suicide is the second-leading cause of death.

“The data are disturbing,” said Anne Schuchat, the CDC’s principal deputy director. “The widespread nature of the increase, in every state but one, really suggests that this is a national problem hitting most communities.”