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Whenever New Hampshire’s medical examiners suspect someone died of a drug overdose, they autopsy the body. Or at least, they used to.

Thanks to the nation’s out-of-control opioid epidemic, the state’s Office of the Chief Medical Examiner can’t completely autopsy every body anymore. It’s been getting too many.

Now, if the medical examiners aren’t sure if drugs were involved or if the case could go to trial, they perform a full autopsy. Otherwise, they send samples for a toxicology report — and cross their fingers that the tests come back positive for drugs. But there are no second chances; the body will have likely been buried or cremated by the time they get the results. Thankfully, the tests have come back positive for drugs every time. So far.

“We’re not entirely comfortable with this. We are left with this reality,” said Thomas Andrew, who recently retired as New Hampshire’s former chief medical examiner but has had to keep working because he had too many open cases to leave outright. “We haven’t been burned by anything yet, but that doesn’t mean it couldn’t happen today.”

With more than 64,000 fatal overdoses expected in the United States this year, New Hampshire is far from the only state where medical examiners are scrambling to keep up with a surge of bodies.

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