Addressing Inequitable Opioid Overdose Deaths in Indiana Black Communities
reduction in overdose deaths in target zip codes*
doses of naloxone (Narcan™) passed out in target zip codes
(from October 2022 – September 2025)
current MACRO-B coalition members
Multi-Sector And Multi-Level Community-Driven Approaches to Remove Structural Racism and Overdose Deaths in Black Indianapolis Communities, or MACRO-B, started as an academic initiative to identify racial barriers to fair and compassionate responses to the opioid crisis and has grown into a crucial community-driven coalition, focused on harm reduction in Indiana’s most affected areas.
The initiative focused on four Black-dominant inner-city Indianapolis communities (46202, 46205, 46208, 46218) with disproportionate rates of Black overdose deaths.
How This Project
Came to Be
Between statewide naloxone (Narcan™) distribution data and data on opioid overdose-related deaths in Indiana, a trend emerged highlighting the disparity between overdose deaths and lifesaving resources and education in Black communities. The MACRO-B project is a three-year program with three phases headed by a coalition of grassroots community partners. The program involves surveys and interviews, identifying policies and practices contributing to Black overdose deaths, destigmatization, educational programming, and improving access to resources like naloxone (Narcan™) and fentanyl testing strips.
Exceeding Harm Reduction Goals
There was an initial goal of a 25% reduction in Black overdose deaths within these designated ZIP codes by September 2025. We exceeded that goal by the end of 2023 with a 26.9% reduction and are continuing the work to address the key issues with the support of the community.
reduction in Black overdose deaths in target zip codes
updated: September 2025
Why Do
Inequalities Exist?
Our research sought to answer this question through one-on-one interviews, focus groups, and large-scale community surveys. We found that many residents did not know that naloxone (Narcan™) was available in their communities or were afraid to carry it for fear of repercussions from racial prejudice stemming from stigmas surrounding law enforcement. You can view our research findings on the Our Work page.
What is the MACRO-B Coalition?
The MACRO-B coalition includes Black community members who are overdose survivors or family members of fatal overdoses and representatives from law enforcement, local emergency medical services, fire departments, as well as decision-makers at local and state governments and local and state-level legislators.
MACRO-B Education Sessions
One of the initial objectives of our project was to provide monthly educational programming for the four zip codes of focus to address substance use disorder, addiction, misinformation, stigma, Good Samaritan Laws, and the provision and use of naloxone (Narcan™). We have since expanded that to all of Marion County.
This training is meant to serve all residents, but with a focus on Black residents. Every person can be trained to be a bystander, respond to an overdose, and potentially save a life by carrying and administering naloxone (Narcan™). We have held open-to-public trainings as well as trainings affiliated with specific organizations, including community organizations, social service organizations, churches, and others. We pass out harm reduction supplies and provide harm reduction education at each training.
Open discussion around stigma and misinformation creates an environment where individuals feel safe to talk about addiction, seek treatment, and have conversations that otherwise may not have happened.
MACRO-B Funding and Foundations
MACRO-B was launched in October 2022 with a foundation in two key frameworks: the Citizen Health Care Model (CHCM) and the Community Coalition Action Theory (CCAT). These models emphasize the importance of community involvement in enhancing public health outcomes. The project was supported by the U.S. Department of Health and Human Services, Office of Minority Health, under Grant Number CPIMP221346 for three years from October 2022 to September 2025. This funding was awarded to Dr. Dong-Chul Seo, Full Professor at the Indiana University School of Public Health-Bloomington, to reduce disparate burden of opioid overdose deaths in the Black Indianapolis communities.