In 2012, St. Louis County in Missouri used a grant from the Department of Homeland Security to buy a refrigerated trailer that can hold more than 20 human bodies. The trailer was intended for use after a terrorist attack or natural disaster, and the county is fortunate that the money spent to buy it was wasted. Until now, when the compressor in the already-full morgue went out.

Why was the morgue full? The St. Louis Post-Dispatch explains that an increase in drug overdose deaths have the county morgue operating at its limits, and the medical examiner thinks that she may have to find a permanent place to stash the trailer and keep it running as extra space for when there’s more than two dozen people in the morgue.

Like in the rest of the country, illegal imports of fentanyl and other powerful synthetic opioids have made an existing nationwide heroin problem worse. In 2016, the St. Louis County medical examiner dealt with twice as many fatal overdoses as in 2010.

“It used to be, every few days there would be a drug overdose,” the medical examiner told the Post-Dispatch. She’s been working there since the mid-’70s. “Now almost every day, now maybe half of the deaths are drug overdoses.”

The increase in deaths that have to be investigated means a shortage of forensic pathologists across the country. Different municipalities are finding their own ways to deal with this.

When someone’s death is clearly due to a drug overdose, the office of the medical examiner doesn’t perform a full autopsy: They perform toxicology tests and an external exam, but the office doesn’t have the staff to perform autopsies on everyone.

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