Most people wouldn’t hesitate to call 911 if a loved one was having a heart attack. During those moments of panic and fear, it’s comforting to reach for the phone where a calm voice on the other end assures us help is on the way.

Unfortunately, when it comes to America’s fastest growing public health crisis, drug overdose, calling for help is not always a viable option. Because many, though not all, overdoses involve illicit substances or mis-used prescription medications, seeking help can result in the arrest of both caller and victim for possession of drugs and paraphernalia. Studies show that fewer than half of overdose witnesses call 911 for fear of legal repercussions, and those who do often pay the price behind bars. Many choose not to seek help, hoping the victim will recover without aid. It’s a dangerous game of Russian roulette, one with tens of thousands of casualties annually.

Drug overdose now claims 36,000 lives a year in the United States (more than car accidents and murder combined), and people are beginning to recognize the implications of a dilemma in which the risk of a friend’s death must be weighed against the instinct for self-preservation. In response, 12 states and the District of Columbia have enacted 911 Good Samaritan laws, legislation that grants limited immunity from some drug crimes to people who experience an overdose or call for help. New Mexico blazed the first trail in 2007, followed by a swift succession of laws passed in California, Colorado, Connecticut, Florida, Illinois, Massachusetts, New York, Rhode Island, and Washington. The laws vary in terms of immunities, but the message is the same: saving lives is more important than making arrests.

This year nearly a dozen more states introduced bills; legislation in North Carolina, New Jersey and Vermont emerged victorious, while other bills were strangled by partisan bickering (Missouri, Mississippi and North Dakota), killed in committee (New Hampshire and West Virginia), or simply ran out of time (Hawaii and Texas). Maine’s bill was vetoed by the Governor.

Although the demise of many promising bills is unfortunate, proponents of 911 Good Samaritan laws have collected valuable lessons for future advocacy; namely, build a strong coalition, be ready when the legislative session starts, be strategic about choosing a sponsor, know your opposition and be present at legislative hearings and committees.

Perhaps no state demonstrated strong coalition-building more than New Jersey. Roseanne Scotti, state director of the New Jersey division of the Drug Policy Alliance, headed the efforts to pass a 911 Good Samaritan law in her state. Before introducing a bill in January 2012, Scotti and her team built up a large coalition of drug treatment providers, overdose prevention groups, public health organizations, law enforcement, medical providers, and parents who had lost children to a drug overdose. Each of these groups played a critical role in educating legislators, whether to reassure them that a 911 Good Samaritan bill would not encourage drug use, to demonstrate law enforcement support, or to provide heartbreaking stories of personal loss and a plea that other families be spared such pain. With broad bipartisan support, the bill rolled smoothly through the legislature to the governor’s desk, where it was promptly vetoed.

“We were shocked at Governor Christie’s veto,” says Roseanne Scotti. “He’d never voiced opposition before. He said something about not wanting to give a free pass to drug dealers, but that’s not what this bill is about.”

Disappointed but determined to press on, the coalition launched campaigns in local municipalities urging the governor to reconsider and begged the legislature to override the veto. Over the next few months, letters poured into the capital pleading for a change of heart and parents flooded the state house, passing out red roses with the names of their lost children to stunned legislators.

In the spring of 2013 their work finally paid off. Clearly chastised, Governor Christie selected another overdose-related bill that awaited signature, crossed out a few lines, and wrote in the 911 Good Samaritan language with a pen. He signed the bill into law at a well-publicized event surrounded by tearful parents and even rocker Bon Jovi, whose daughter recently survived a drug overdose.

“We succeeded because we had a strong coalition of affected families,” says Roseanne Scotti. “At the end of the day it’s about enabling legislators to understand the issue at a human level. The parents were saying, my child might be alive if we’d had this bill, but we can still save someone else’s child."

Coalition-building is integral to successful advocacy, but so is being ready when the legislative session starts. Though session lengths vary state to state, most last only a few months, so advocates who aren’t prepared early with coalition members, sponsors and a clear message might run out of time. Such was the case in Texas.

Texas native Joy Strickland, who founded Mothers Against Teen Violence, has pushed for drug policy reform ever since the tragic murder of her son in 1994. She backs 911 Good Samaritan laws as sound policy that “treats addiction as a public health problem, not a criminal one.” Joy helped build a small coalition of medical experts and affected families who worked to create professional fact sheets for distribution at the General Assembly, to practice an “elevator speech” for those quick encounters with busy legislators, and to prepare for potential opposition to the bill. As it turned out, the bill’s only foe was time. On May 9, Joy stayed up late listening to the Texas General Assembly debate bill after bill, praying they would get to hers before the midnight deadline caused all remaining bills to expire. But the clock ran out.

“We did so many things right, but we didn’t have enough time,” says Strickland. “Now that we have a bill that has gone through the process, we will be in a position to get it pre-filed next session so that is has a better chance of making it to the floor for a debate and vote.”

In addition to introducing bills early, another component of successful advocacy is to be strategic about choosing a bill sponsor or champion. A valuable lesson about sponsorship was learned in North Carolina, a state with a Republican supermajority.

“We knew that the bill sponsor would be important,” explains Robert Childs, executive director of the North Carolina Harm Reduction Coalition. “Here in the South, reputation is critical. We had a lot of progressive allies in the legislature who would have been happy to introduce this bill, but we needed someone with a strong conservative voting record to reassure the other representatives that this was not a liberal bill.”

Advocates recruited one of the more conservative senators in the legislature to introduce the bill, and consequently, it sailed through the General Assembly with little opposition. Leilani Attilio, a nurse and two-deployment veteran who advocated for the bill, recalls, “Sometimes all the legislators asked about was the sponsor. Once I told them, their faces relaxed, and they said they would support the bill.”

North Carolina’s 911 Good Samaritan bill was the first to become law in 2013, and remains the only bill in the nation to pass with an all-Republican sponsorship.

Having a strategic sponsor can relieve negative reactions to a bill, but it’s still important to know the opposition and prepare a response. Opposition can take many forms; law enforcement might push for officers’ rights to make arrests at their discretion, trial lawyers may balk at the elimination of evidence obtained at the scene of an overdose, and legislators might show concern about encouraging drug use or “letting bad guys off the hook.” In most cases the life-saving argument trumps opposition, especially when delivered by a devastated parent who has lost a child, and expert testimony by law enforcement officers, treatment providers and the medical community can assuage most legislators’ fears.

The final piece of advice for aspiring advocates is to be present at legislative hearings and committees. Committee meetings can get out of hand if legislators misinterpret the bill, fear-monger or spin off into weird hypotheticals, so having a knowledgeable advocate present to keep the discussion on point is a huge asset.

Tom Dalton and Grace Keller of Howard Center Safe Recovery in Vermont made sure to show up for every hearing on the 911 Good Samaritan bill in their state.

“We coordinated experts to testify when needed and brought in people with real world experience to tell their overdose stories,” says Grace Keller. “As they spoke you could visibly see legislators change their perspectives and understand 911 Good Samaritan laws at a deeper level.”

Vermont’s bill passed the legislature with broad support and was signed into law on June 5, 2013.

Thanks to strong advocacy efforts, three states have adopted 911 Good Samaritan laws so far this year, but much remains to be done, and not just in the 37 states that have yet to pass overdose prevention laws. Tom Dalton of Vermont points out that it’s important even for successful states to continue to advocate for broader protections for people who call 911. As the drug overdose epidemic worsens and more lives are claimed each year, 911 Good Samaritan laws may prove an integral part of efforts to turn back the tide of deaths. 2013 has been a good year for overdose prevention. Next year can be even better.