“There's no real urgency when it comes to us”: Critical discourse analysis of Black communities' lived experience with opioid overdose response in Indianapolis area

This study aims to examine how Black communities construct their discourses about opioid overdose response from lived experiences in the Indianapolis area. We randomly selected and analyzed 20 out of 50 interviews as data saturation was reached. Our analysis was informed by critical discourse analysis (CDA) and intersectionality as an overarching framework for the interpretation process. Each interview lasted about 60 min and consisted of ten open-ended questions. Participants were Black residents over 18 years old, who lived in four zip code areas in Indianapolis that had the highest rates of opioid overdose deaths in the city. The interviews revealed complex ways in which Black communities in Indianapolis navigated the opioid overdose crisis. The discourses on opioid overdose response are shaped by the intersectionality of various factors, including institutionalized racism, social discrimination, and fear of mistreatment. Moreover, the normalization of inadequate opioid overdose response is exacerbated by the stereotypes on Black communities, lack of access to resources and information, and historical mistrust in healthcare and law enforcement bodies. Our findings indicate that future intervention to reduce overdose deaths in the Black communities should move away from isolated approaches to holistic ones. These should encompass various intersecting factors, including structural racism, stigma of drug use, fear of mistreatment, lack of resources, and mistrust of law enforcement.