The surge in deaths from opioids like heroin, fentanyl and prescription painkillers has overwhelmed Maryland pathologists, and put them at risk of losing their accreditation because they are exceeding the number of autopsies they are allowed to conduct each year.

During the past four years, medical examiners in the state have performed roughly 100 more autopsies each compared to 2010, according to the Baltimore Sun. Employees have worked extra hours to get the work done, and national accreditors worry that the quality of the results could fall if workers don’t have enough time to perform an autopsy or if they cannot do so in a timely manner.