Many of us are afraid to call 911 when someone we know ODs. You may have had a bad experience with cops or paramedics, or heard horror stories from others. But if you don’t know how to do rescue breathing and/or CPR (or don’t want to), and you don’t have naloxone or Narcan, calling 911 may be the only way to save the person’s life.

Here are a few tips, some suggested by paramedics, some by other users, that can help you get you through this stressful situation with a minimum of grief. Some of the suggestions appearing below may seem obvious upon first glance. But after conducting focus groups on heroin and overdose it’s become apparent to me that a public discussion on these topics can both reduce the risk of get busted for those who choose to intervene at an OD and help save lives–which is, of course, the object here. Remember, though, every locale has its own protocols. Just because San Francisco rarely dispatches the police doesn’t mean that it works that way in your suburban community. In fact, in both Chicago and New York, police are usually dispatched to overdose calls.

The call…

• Lots of noise in the background, or yelling and screaming, can cause the dispatcher to send the cops along for crowd control. Be as calm as possible (which I realize is often difficult given what’s happening–but try anyway) and before you speak to the dispatcher tell anyone else in the room to be quiet.

• Be clear and concise. Tell the dispatcher someone has stopped breathing. That’s enough to get the paramedics zipping through the streets.

• If you’re calling from a location that’s been the scene of prior calls for ODs, the dispatcher will often know this. Most 911 systems–especially ones in big cities–are computerized and keep records of these kinds of things. (They may keep records of calls where paramedics run into trouble, too.) If they ask you if it’s an overdose, don’t lie; it might make them more suspicious. You can say you think the person took something, but you’re not sure exactly what it was.

• If they’re asking too many questions, you can always say you’re alone with the person and you have to get back to doing rescue breathing. Just make sure you’ve given them the address, phone number–if there is one–and instructions on how to get into the building. (If you’re squatting, send someone out to the street to wait, if you can.)

You have warrants, absolutely cannot stay and no one else is around…

• You can still call 911, using any of the above tips that are relevant. If you’re on the street or in a park, calling from a pay phone is pretty anonymous.
• If you can do so without hurting your friend, drag him into the street, or the building doorway, if inside; the easier it is for the paramedics to get to him, the better.

• Keep up the rescue breathing for as long as possible. It will give your friend extra time. Stick around until you hear the sirens close by.
• If it’s happened on the street, or you brought your friend outside, before you leave, try to get a passerby to help.
• If you can’t move your friend, you can stay until you hear the sirens get really close, then split. Just make sure help can get to your friend: leave the door open, put a note up, etc. A final suggestion: if it’s not your place and there’s a fire escape or back door, you can always wait until the last minute and duck out the back way.

While you’re waiting…

• Continue rescue breathing.
• If for some reason you can’t do rescue breathing, try to wake up your friend–shaking by the shoulders, yelling his name, etc.
• If your friend wakes up, and you’re really afraid of the police coming, you can cancel the 911 call. Because a person can go out again after waking up, it’s a important to take your friend to the emergency room. This way, if he ODs again he can get proper medical care.
• Another suggestion, which may already be standard practice for many of you: hide your shit, especially anything that might have residue–like cookers, cottons, empty bags, etc.–before anyone comes. And coming up with a uniform story in advance may save you from getting caught in any lies to police or paramedics; I once went to jail because my friend told the cops stuff that contradicted what I said.

When help arrives…

• If it’s just paramedics: The paramedics don’t care what someone has taken; they’re there to help. With paramedics, saving lives is a point of pride. Give them as much info as possible: what the person took, whether they were already on anything else, any medical conditions you know about, etc. (You can always say you just got there, but the guy who just left told you what happened.)

• If the cops come too: Generally paramedics are pretty smart and can figure out what’s happening medically on their own. Sometimes, though, when a person is really overdosed, or has taken drug combinations, it’s not as obvious. Even if you have to pull the paramedic to the side to inform them of the substances taken, this can make a difference in the outcome-especially if more than one drug is involved! The key here is to remain calm, not have any attitude, be polite and be as honest as you can without getting yourself into trouble.

In the end, if you save a life, it will be worth it.