According to the Center for Disease Control and Prevention (CDC), 115 Americans die every day from an opioid overdose, and the rate of OD deaths is five times what it was 20 years ago. This crisis disproportionally affects rural areas of the U.S. where philanthropic attention has been historically low. In this piece which originally ran in 2017, Stephanie Fuerstner Gillis, Strategy Advisor for Giving Compass and Senior Advisor at the Raikes Foundation, discusses the severe shortcomings of the Drug Abuse Resistance Education program (DARE) — and how funders can truly make an impact in this area.
The Center for High Impact Philanthropy (CHIP) lists four strategies for lifting the burden of substance use disorders, including improving access to evidence-based treatment and funding innovation for prevention. In the latter case, CHIP recommends proven programs such as the Harm Reduction Coalition, which advances support for clean needle distribution and the overdose-reversal drug naloxone nationwide. At the community level, Prevention Point Pittsburgh and Prevention Point Philadelphia are nonprofits that provide health empowerment services to drug injection users.
My colleagues at Giving Compass know that my blood boils when I think about well-intentioned generosity that is wasted on organizations that are ineffective. In 2016, Attorney General Jeff Sessions put the Drug Abuse Resistance Education (DARE) back in the news, and that’s not good news.
The AG spoke at DARE’s annual training conference in 2017, where he noted that, “DARE is …the best remembered anti-drug program today … We know it worked before and we can make it work again.” Unfortunately, he’s got it wrong. What we know from research and evidence is that DARE did NOT work, and in some cases, it actually did harm.
Two tales related to drugs: Both lack substantial evidence
Both DARE and opioids as painkillers are examples of interventions that scaled with little or no research on their impact. Opioids were embraced and spread as low-risk treatment options for pain based largely on a small study of 38 patients who got very low doses, and a five-sentence letter to the editor published in The New England Journal of Medicine. The letter shared the results of an analysis of roughly 12,000 patients who were given small doses of opioids by physicians in hospitals and concluded that few of these patients experienced addiction. It was used to justify prescribing these drugs to patients, sending them home with bottles of pills, where doses could not be regulated. Thus, nearly 183,000 people (and counting) in the U.S. have died from overdoses related to these drugs, and this country is in the midst of an addiction crisis of epic proportions.
The story of DARE is best captured in this piece. Chances are, at some point in your life, someone has asked you to contribute to DARE (or will). If you search for DARE on Giving Compass, you’ll see that DARE America reports close to $6 million in annual revenue. The program still runs in nearly 85 percent of public schools across this country, which is a travesty. It’s not just the frustration or waste of giving to something that doesn’t work that is problematic; it’s also the opportunity cost. There are so many high-performing, top quality organizations, and programs that struggle to scale (see GiveWell for examples of great organizations you can support with confidence).
How do you know the organizations you are giving to are effective?
- LEARN: Ask the organizations you support to show you the evidence and also search for evidence by yourself. Strong organizations are strong because they are committed to delivering on outcomes and will be able to explain to you the research they do to understand their effectiveness. Not every nonprofit can or should invest in costly evaluation research, but every one of them should be able to explain to you the connection between the work they are doing and the evidence that their work will lead to impact (if they do it well). Then, they should be able to show you that they measure the quality of their own work.
- CONNECT: Join a giving circle. If you have some time and want to learn about philanthropy while giving, consider joining a giving circle or collaborative. This is a great way to meet others who care about the same things or places you do, while also learning together.
- TAKE ACTION: Feel free to be a free rider. If you don’t have the time to learn about the organization, or don’t feel comfortable assessing the quality of an organization’s work, there is no shame in being a “free-rider” and piggybacking on someone else’s due diligence. Consider pooling your money in a fund managed by someone with expertise in the area you care about who is sourcing and doing proper due diligence on quality opportunities on that issue. We feature issue funds on Giving Compass (a few are up and we’re adding more soon). You also can look to a funder you admire and trust, to see where they are giving. If it is a foundation, these data are often shared on the foundation’s website. You also can go to Guidestar or Charity Navigator and look at the foundation’s 990-PF tax return — inside the return, you can see each and every grant it awarded.
There are many examples of things that have been scaled without evidence, but DARE has become the poster-child, for a good reason. Follow three simple steps when guiding your journey — learn, connect, take action — and you will avoid organizations that, like DARE, were created with a noble goal but failed to deliver on the promise.
Original contribution by Stephanie Fuerstner Gillis, Strategy Advisor for Giving Compass and Senior Advisor for the Impact-Driven Philanthropy Initiative at the Raikes Foundation.
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