Removing Inequitable Access Barriers and Improving Intervention Techniques in Black Communities

Our way of honoring Black History Month this year is to further our efforts to support increased opioid overdose prevention and intervention resources in the Indianapolis Black community. Racial disparities and systemic inequitable access have long limited opioid overdose prevention among Black people. 

MACRO-B (the Multi-Sector and Multi-Level Community-Driven Approaches to Remove Structural Racism and Overdose Deaths in Black Indianapolis Communities Coalition), works to explore how racism intersects with opioid overdose prevention efforts and alternative approaches for preventing overdose fatalities in Black Communities in Indianapolis. MACRO-B is the product of the partnership between Overdose Lifeline and Indiana University and will continue to evolve over the next few years as more evidence is gathered from Black voices. 

By addressing the structural racism inherent in these local infrastructures and the effects it has on Black communities, MACRO-B is tackling the problem head-on to drive positive change. Enacting change first requires acknowledgment of the real issues, and MACRO-B’s work shines a light on structural racism so that real progress can be made. 

Fighting an Uphill Battle Toward Progress

In the United States, the war on drugs continues to cast a long shadow over the Black community. Decades of discriminatory policies have led to disproportionate rates of incarceration and systemic disenfranchisement among Black individuals, stemming from unequal enforcement of drug laws and limited access to lifesaving intervention techniques and resources. While strides have been made to address these injustices, the legacy of the war on drugs persists, particularly concerning substance use disorders (SUD) and naloxone distribution.

Despite increased awareness and efforts to combat substance misuse, resources for SUD treatment often fail to adequately reach Black communities. This disparity reflects systemic issues, including limited access to healthcare, socioeconomic barriers, and stigma surrounding mental health in these communities. Consequently, Black individuals facing SUD are less likely to receive the support and treatment they need, perpetuating cycles of addiction, incarceration, and overdose deaths.

Promoting Intervention Resources Like Naloxone

Naloxone, a life-saving medication used to reverse opioid overdoses, is another critical tool in addressing the opioid crisis. However, its distribution and training programs remain insufficient in Black communities. Limited access to naloxone exacerbates the risk of overdose deaths, particularly among Black populations who may face higher rates of opioid misuse. Improving naloxone distribution requires targeted efforts to increase access, awareness, and education within Black communities, empowering individuals to intervene effectively in overdose situations.

To enhance naloxone distribution and training in Black communities, several strategies must be implemented. First, policymakers must allocate resources specifically to these communities, ensuring that naloxone is readily available through healthcare providers, community organizations, and harm reduction programs. Additionally, culturally competent education and outreach initiatives should be developed to destigmatize SUD and harm reduction, addressing unique barriers faced by Black individuals.

Black Communities in Action to Stop Inaction

Community organizations play a vital role in addressing the opioid crisis and supporting those affected by SUD, including in Black communities. While some organizations have made commendable efforts, more comprehensive and sustained initiatives are needed to combat the opioid epidemic equitably. This includes advocating for policy changes, expanding access to treatment and harm reduction services, and fostering community partnerships to amplify impact and reach Black populations. There needs to be more work done to address perceptions of mistrust, fear, and stigmatization related to law enforcement and first responders around an overdose event, as this lowers motivation to use intervention techniques for fear of harassment liability. There also needs to be more work exploring the intersectionality of substance use-related stigma and race-related stigma, as this connection is vital to increase intervention prevention effectiveness.

Addressing racial disparities in SUD treatment and naloxone distribution requires a multifaceted approach that acknowledges historical injustices and systemic racism. By prioritizing equity, increasing resources, and engaging with affected communities, we can work towards a more just and effective response to the public health opioid crisis that uplifts all individuals, regardless of race or background.

Getting Involved With MACRO-B

MACRO-B is continuing its research into these complex topics with the goal in mind of bridging the gap between lifesaving resources and knowledge and the Black community of Indianapolis. The team has been hard at work conducting multiple rounds of interviews and gathering invaluable research to help build intentional strategies. Other current plans involve creating townhall meetings, where community members can congregate and discuss these issues. The continued growth of community involvement is of the utmost importance, so the MACRO-B team strongly encourages people to help promote and attend these townhalls when they are scheduled. 

Please contact Ms. Charlotte Crabtree at to learn more about the initiative and how you can get involved. 

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