Last year, it was refrigerated trucks. Now, it’s “temporary storage” in funeral homes. The Coroner’s Office in Montgomery County, Ohio, has been so overwhelmed by the death toll of the raging opioid epidemic that it has had to turn to makeshift morgues to keep up.

“We’re running at full capacity,” Kenneth Betz, director of the coroner’s office, told The New York Times in a phone interview. “We’ve never experienced this volume of accidental drug overdoses in our history. We now call funeral homes immediately," he said.

So far in 2017—just 33 days into the year—the Coroner’s Office has already handled 163 accidental overdose deaths. That’s more than half the yearly totals of overdose deaths from 2015 and 2016. In fact, in the last decade the number of yearly overdose deaths has quadrupled in Ohio and surpassed deaths from car crashes.

And the state is not alone—in fact, it may not even be the worst off. West Virginia had the highest rate of drug overdose deaths in 2015, reaching 41.5 per 100,000, according to the CDC. Ohio came in tied for third with Kentucky, at 29.9 per 100,000. New Hampshire was second with 34.3 per 100,000.

Those deaths and the increases are driven by widespread addiction to opioid pain killers.

The rest of the country, too, has seen dramatic impacts of the epidemic, particularly in the northeast and some in the south. The CDC reports that 91 people a day die from an opioid overdose in the US.

“This increase from year to year—I’ve never seen anything like this,” Betz said. “The drug problem we have is absolutely phenomenal.”