In early March, West Virginia passed an ugly milestone: A state program designed to provide money for burial assistance for needy families ran out of funds nearly four months before the end of the fiscal year.

This is the fifth year in a row that money for the program ran out. The main cause? Increased deaths resulting from the worst opioid epidemic in any state in the United States. Deaths from drug overdoses in the state climbed to nearly three times the national average in 2015.

But West Virginia isn’t alone. The opioid epidemic has reached such proportions in Ohio that the coroner for Stark County, where the city of Canton is located, had to ask the state Emergency Management Agency for a cold storage trailer — the kind used at disaster scenes — to store the overflow of bodies from the morgue.