Donna Cain was doing her rounds in the Belmont Public Library one night in early April when it happened.

The library research assistant knocked on a locked bathroom door, following protocol, and called out, "Library staff, the library is closing."

No response.

She has a soft voice, so she tried again, speaking louder this time.

Still nothing.

That's when she knew something was wrong. She raced to the library's front desk to grab the bathroom key and then came back and unlocked the door to find a man on his knees, bent over on the floor. A needle lay beside him.

Cain called 911 from her library-issued cell phone and kept speaking to the gently snoring man, trying to talk him out of his stupor, to no avail.

It seemed like it took forever for emergency services to arrive, she said – time tends to pass slowly in emergencies. It was really only about five minutes, though, before the paramedics got to the library and could revive the man.

This scene is all too common, as librarians across the country have become one of the unexpected leaders at the forefront of the battle against the opioid crisis. While opioid overdoses aren't as common at Portland libraries – happening at a rate of about one suspected overdose per year – they are beginning to happen more frequently.

In June, the Multnomah County Library system will start rolling out naloxone, in the form of nasal spray, at five of its locations – Belmont, Central, Holgate, Hollywood and Midland. They are also training staff how to administer the opioid overdose-reversing drug so they will know what to do in case they have less time than Cain did to save someone's life.

In the current system for dealing with overdoses, there is one person who acts as a point of contact at each library branch. They know what to look for, often checking the bathrooms for people lingering. There's a rule against sleeping in the library, as it can be hard to tell if someone's napping or unconscious. If library personnel can't wake someone up, they know what they have to do.

Up until now, they have depended on paramedics to respond to drug overdoses. Most overdoses have been concentrated in Central Library, by far Portland's most-frequented library. Emergency service response times are generally pretty fast downtown, said Dave Ratliff, the county's neighborhood libraries director who worked at Central for 14 years.

But the opioid epidemic has spread, increasingly affecting vulnerable populations across the area.

There have been three suspected overdoses at Multnomah County libraries since February 2017. And response times throughout the county vary, Ratliff said. Sometimes it takes paramedics longer to get to libraries farther away from the city's center.

"If someone's not breathing, three or four minutes makes a big difference," he said.

Maintenance crews and librarians regularly find needles lying in the grass and on sidewalks surrounding libraries, Director of Libraries Vailey Oehlke said. To help people dispose of syringes more safely, the library has installed sharps containers in most bathrooms.

Drug use is prohibited in libraries, but staff can't always control if people use drugs outside, where people sometimes sit or sleep for the night.

Libraries are one of the most public places in every city, making them appealing to homeless and addicted people looking for warmth and shelter.

"What happens in our community happens in our buildings," Oehlke said.

Libraries' fundamental job in any community is to ensure equal access to information for all, but often, securing that access requires more than just stocking bookshelves and preparing for children's story hour.

So many serious issues affecting the community walk into library doors each day that Multnomah County has joined other larger cities in hiring social workers to help visitors of Central Library access a wide array resources.

Oehlke said that in one social worker's first year, she saw more than 1,100 people, helping them with everything from mental health access to getting new pairs of shoes.

And while Portland libraries naturally have more overdoses because of the city's higher population, opioid overdoses have also hit rural counties hard.

Library directors in two counties in Oregon with high rates of opioid overdose deaths – Lincoln and Clatsop Counties – said they were happy enough with ambulance response times in their smaller cities that they didn't feel like they need naloxone on site.

Jackson County Library staff members, however, have started to discuss possibly purchasing naloxone for librarians to use, assistant director Laura Kimberly said. The library has had three suspected overdoses in the past five years, she said, but she feels like drug use has escalated.

"You can definitely tell there's been a change in the last few years," Kimberly said.

Oregon isn't the only state having this conversation. Librarians across the country are constantly debating about which services libraries should provide. The American Libraries Association writes on its website that "it is crucial that libraries recognize their role in enabling poor people to participate fully in a democratic society."

But how far should libraries go? Should administering naloxone be part of a librarian's job description?

"It's a perfect example of how time and time again, the government turns to libraries to step up and fill in," Jeremy Johannesen, executive director of the New York Library Association, told the New York Times in February. He pointed out that libraries distributed tax forms and had assisted with enrollment for the Affordable Care Act.

Salt Lake County Library recently started distributing free naloxone kits on site, and cities like Denver and San Francisco are also training librarians how to use the drug. Last fall, a representative from New York even introduced the Lifesaving Librarians Act to congress, a bill that would help make naloxone kits more affordable for libraries.

Oehlke said she understood other libraries have different needs and resources, and sometimes it might not make sense to keep naloxone on site. For Multnomah County, though, she said the opioid epidemic was a problem serious enough that it's everyone's job to step in and help where they can.

"We're not afraid of this conversation," she said. "This is our reality."

Ratliff said he figured that if people were going to overdose somewhere, he's glad it's where someone could help them.

After thinking about her experience that day in early April, Cain said she was glad the library would make naloxone available to managers. If she had found someone closer to death, she might not have been able to get them help in time.

Still, she thinks back to when she first started working for Multnomah County Library 26 years ago, and how different her perception of the job was.

When most librarians start their careers, they don't picture themselves standing in a bathroom doorway, talking to an unconscious man having an overdose. But many find themselves there.

"None of us in library work, when we got started, signed up for this kind of thing," Cain said.