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Sixty Oregonians ended their lives last year by taking a lethal drug dose prescribed under the Death with Dignity Act, state officials have reported. That’s the highest annual total in the 11-year history of the law—11 more than in 2007. Deaths from a drug prescribed under the Oregon law now account for two of every 1,000 deaths in Oregon.

In all, 401 terminally ill Oregonians have died this way since 1997, when Oregon made it legal for a doctor to prescribe a lethal drug dose to a terminally ill patient who makes the request orally and in writing.