What is the Purpose Behind MACRO-B?
MACRO-B, or Multi-Sector And Multi-Level Community-Driven Approaches to Remove Structural Racism and Overdose Deaths in Black Indianapolis Communities, started after identifying an alarming number of Black opioid overdose deaths in several Marion County ZIP codes – 46202, 46205, 46208, and 46218. The high amount of opioid overdose deaths and the limited number of naloxone (Narcan™) requests in these areas led the MACRO-B team on a mission to uncover the ‘why’ behind these trends and develop lasting programs to reverse them.
The MACRO-B Coalition
Together, the MACRO-B team launched a multi-year research initiative led by a joint Coalition consisting of Black community members who are overdose survivors or family members of fatal overdoses, first responders, politicians, and government representatives. This Coalition meets monthly to identify barriers from structural racism that must be addressed to reduce overdose deaths in Black Indianapolis communities.
There are Four Main Components to Achieving This Goal:
Identify policies and practices that contribute to higher overdose rates in Black communities.
Identify structural barriers that contribute to higher overdose rates in Black communities.
Educate residents to reduce the stigma and misinformation surrounding substance use disorder and overdoses.
Provide naloxone (Narcan™) and naloxone administration training to members of these underserved communities.
MACRO-B Goals
One of MACRO-B’s initial goals was to reduce the rate of opioid overdose deaths in the designated ZIP codes by 25% within three years. We achieved this goal in one year with a 26.9% reduction by the end of 2023; our progress grew to a 45% reduction by the end of 2024 and we will continue to build on our success.
Overdose Education & Naloxone Access
The project’s primary short-term goals center on promoting overdose education and naloxone (Narcan™) distribution. This involves addressing the lack of publicity and improving social marketing efforts to increase awareness of overdose issues and community educational outreach.
First Responders & Good Samaritan Law
There is also the issue of a lack of awareness of Good Samaritan Law (Aaron’s Law), which protects people who contact first responders in the event of an overdose. This point speaks directly to the misinformation and stigma surrounding overdose, naloxone (Narcan™) use, and mistrust of law enforcement when it comes to contacting first responders for assistance.
Harm Reduction Through Legislation
MACRO-B’s long-term goals focus on amending laws to safeguard against opioid overdose deaths and create an environment that supports those seeking help. This involves clarifying the verbiage of legislation regarding fentanyl test strips so there is no fear of potential repercussions with possessions and addressing the fear of legal consequences stemming from racial discrimination in drug-related arrests.
MACRO-B Progress Timeline
We have held Coalition meetings, town halls, interviews, and focus groups with community members, conducted large-scale community surveys, and conducted community education sessions on substance use stigma/misperceptions and naloxone administration training.
In 2025, the MACRO-B Project partnered with Mental Health America of Indiana to provide scholarships and peer recovery support training to 14 Indianapolis residents.
You can see a more detailed view of the MACRO-B timeline in the graphic below:
Town Hall 1
Building community consensus on the direction of the MACRO-B project and solutions moving forward.
Town Hall 2
Building community consensus on the direction of the MACRO-B project and solutions moving forward.
Community Survey 2
Community survey in our target zip codes (and some comparison zip codes across the state) of over 500 people to measure levels of community overdose knowledge, attitudes, discrimination, and stigma. This survey will be conducted toward the end of the project to determine how much knowledge, attitudes, discrimination, and stigma have changed as a result of our efforts.
Coalition Meetings (ongoing)
The MACRO-B Coalition meets monthly to determine what policies, practices, and community conditions contribute to inequitable overdose prevention and response and to build action plans to address these inequities.
Education Sessions (ongoing)
We provide monthly educational programming in the target zip codes to address substance use/addiction misinformation, stigma, Good Samaritan Law, and how to use naloxone. At these education sessions, we also pass out naloxone and other harm reduction supplies to equip individuals and bystanders to respond to the overdose crisis in their community.
One-on-One Interviews (completed)
50 in-depth interviews with community members in the target zip codes to understand what community conditions, physical barriers, and attitudinal barriers limit access to substance use-related health care.
Focus Groups (completed)
3 focus groups with community members in the target zip codes to understand community conditions, physical barriers, and attitudinal barriers that limit access to substance use-related health care.
Community Survey 1 (completed)
Community survey in our target zip codes (and some comparison zip codes across the state) of over 500 people to measure levels of community overdose knowledge, attitudes, discrimination, and stigma. This was conducted at the beginning of the project to serve as a baseline.
Town Hall 1 (completed)
Introducing the community to the MACRO-B Project and the issue (higher overdose rates in Black Indianapolis communities)
Town Hall 2 (completed)
Getting feedback from the community on the MACRO-B project and potential solutions to the higher overdose rates.