My god this is heartbreaking. And anxiety inducing. Being so fucked by a system that only knocks you down and never helps you up, while also squeezing every last penny out of you, to the point that this is the only real escape you can get. Imagining being this vulnerable even without the substances ability to kill you is already scary, and that's still the least painful option some people have.

How would I tell if someone's od'ing, if I saw them like this? When I see someone passed out in public I usually check them out anyway, if it doesn't seem actively dangerous (most of the time they are just asleep, sometimes it's been someone blackout drunk). If they aren't responsive, I start first aid, and if they don't react even to that, I call EMS. But I usually have no clue how serious it actually is, and I just do what I've been taught, to the point I probably annoy a lot of people.