For the 11th consecutive year, U.S. drug overdose deaths increased, mostly by opioids—illegal heroin or painkillers by prescription, health officials say.

An analysis from the Centers for Disease Control and Prevention in Atlanta found 38,329 people died of a drug overdose in the United States in 2010, up from 37,004 deaths in 2009.

This continued the steady rise in overdose deaths seen over the past 11 years, starting with 16,849 deaths in 1999.

In 2010, nearly 60 percent, or 22,134 fatal overdoses, involved pharmaceutical drugs. Opioid analgesics, such as oxycodone, hydrocodone, and methadone, were involved in about 3-of-4 pharmaceutical overdose deaths, confirming the predominant role opioid analgesics play in overdose deaths.

The researchers analyzed data from CDC’s National Center for Health Statistics 2010 multiple cause-of-death file, based on death certificates.

The researchers found drugs often prescribed for mental health conditions were involved in a significant number of pharmaceutical overdose deaths. Benzodiazepines—anti-anxiety drugs—were involved in nearly 30 percent of these deaths; antidepressants in 18 percent and anti-psychotic drugs at 6 percent. Deaths involving more than one drug or drug class are counted multiple times and therefore are not mutually exclusive.

“Patients with mental health or substance use disorders are at increased risk for non-medical use and overdose from prescription painkillers as well as being prescribed high doses of these drugs,” Dr. Tom Frieden said in a statement.

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United Press International