A three-year, community-driven push anchored at Indiana University is being credited with a dramatic drop in overdose deaths among Black residents in parts of Indianapolis. The MACRO-B coalition, a partnership of neighborhood organizers, first responders and public health groups, reports roughly a 45 percent decline in opioid fatalities in its target ZIP codes over two years. Organizers point to culturally tailored outreach, frequent town halls and wider access to overdose-reversal tools as key ingredients in the turnaround.
The initiative zeroed in on four inner-city ZIP codes — 46202, 46205, 46208 and 46218 — and set an initial goal of cutting overdose deaths among Black residents by 25 percent over three years. Project leaders say they hit that benchmark in the first year and “already achieved a 45 percent decrease in mortalities within two years,” according to WFYI.
How MACRO-B Reached People
Instead of relying on flyers and press releases, the coalition leaned into face-to-face contact: door-to-door outreach, focus groups, peer educators and public events that presented naloxone and testing tools in culturally familiar terms. Overdose Lifeline reports that MACRO-B distributed about 81,000 naloxone kits in the target ZIP codes between fall 2022 and the end of 2024. The effort was steered by a monthly coalition of community members, first responders and service providers who helped refine messaging and tactics as they went.
Policy Shifts Made It Easier To Hand Out Tools
Project partners also credit a key legal change with removing a stubborn barrier to getting supplies into people’s hands. Legislative records on LegiScan show that House Bill 1167, enacted as Public Law 53 in 2025, exempts items marketed to detect drugs or controlled substances from Indiana’s paraphernalia statutes. Advocates say that tweak made it far simpler to legally distribute fentanyl and xylazine testing supplies.
Organizers stress that the project was never just about handing out gear. Outreach staff say training sessions walked through proper naloxone administration, the science of addiction and how to confront stigma, with the goal of getting neighbors not only to carry reversal kits but to feel willing and prepared to use them on friends and family, according to materials from Overdose Lifeline.
Origins And Oversight
The work took shape after Indiana University public health researchers secured federal funding in 2022. The U.S. Department of Health and Human Services’ Office of Minority Health awarded a grant to a team led by Professor Dong-Chul Seo, according to Indiana University. IU described MACRO-B as both a research project and an intervention, designed to probe how structural racism, mistrust and service gaps have fueled higher overdose rates in specific Black neighborhoods.
What Happens Next
Project leaders say the mix of street-level outreach, large-scale naloxone distribution and clearer legal footing helped convince state officials to back a wider rollout. After the Marion County pilot, state funding began supporting expansion of the model to counties including Allen, Lake, Vanderburgh, St. Joseph/Elkhart and Delaware, according to WFYI.
Local public health workers and coroner’s staff at recent town halls describe their reaction as cautious optimism rather than a victory lap. Outreach workers say more residents now call for help and pick up naloxone, while coroners and community organizers repeatedly emphasize that building and maintaining trust — not just flooding neighborhoods with kits — is the harder, longer-term job. Community leaders argue the early results show that targeted, culturally competent harm reduction can shift outcomes in places where traditional outreach has not broken through, a case they continue to make at public meetings covered by local outlets.
