“We Playin’ Chess But You Give Me a Checker Piece”: A Portrait of Structural Racism Ingrained in Overdose Good Samaritan Laws Through Semi-Structured Interviews

By centering the experiences of minoritized community members, this study explores how Good Samaritan laws (GSLs) impact health behaviors related to opioid overdose response. Most states have GSLs that address overdose response. However, their scope can perpetuate structural racism by extending inequitable protection through rigid requirements and exclusions. In this paper, we look at Indiana's GSL, Aaron's Law, and consider how its limitations impact Black Indianapolis residents. We analyzed 50 semi-structured one-on-one interviews with Black residents of four urban Indianapolis zip code areas. We engaged the Health Belief Model using directed qualitative content analysis to consider participants' evaluation of perceived benefits and barriers as they relate to calling 911 following an opioid overdose. We explore participants' feelings about calling 911 and interacting with law enforcement, and their understanding of Aaron's Law and its practical application in their neighborhoods. We demonstrate structural racism's presence in the impressions and applications of policies and highlight how addressing them can improve health outcomes in minoritized communities. Finally, we make recommendations for GSLs nationwide that address the impact of structural racism on overdose fatalities and strengthen their protections, making laypeople more likely to call 911 after an overdose.