GiveBetter x SF

End Overdose

Conditional whole-organization value of a $100,000 unrestricted gift

Research time: ~18 min on GPT-5.6 Sol Medium
  • Research — organization and evidence review.
  • Modeling — cost-effectiveness analysis.
  • Historical estimate for research done before time tracking.

Published: September 8, 2026.

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Summary

What do they do? A national general gift supports training, naloxone, test strips, public awareness, chapter and school activity. The whole-gift model quantifies only additional rescue survival while retaining all spending. Historical output counts do not establish deaths averted. More

Why this approach interests us

  • End Overdose supplies overdose-response training and naloxone, with verified SF event delivery and Bay chapters. Timely administration can avert opioid-overdose death.

Our main reservations

  • Low-risk recipients, other kit carriers, EMS and public supply can make added kits substitutive. Complete marginal costs, encounter rates, funding additionality and resident shares are not measured.

What do you get for your dollar?

Our conditional central estimate is $1.52 million per 10 US QALYs, $21.7 million for Bay residents and $76.0 million for SF residents. The favorable joint case reaches $10,238 nationally, $68,255 Bay and $204,764 SF; it is a demanding sensitivity, not a measured offer or confidence bound. Inspect formulas, inputs and sources.

central donor cost / 10 qalys
$76.0M SF / $21.7M Bay / $1.52M US — Same $100,000 gift: 0.0131657 SF, 0.0460801 Bay and 0.658287 US QALYs. Bay includes SF; geographic totals are nested and never additive.
whole-gift boundary
$100,000 once — 75% rescue-training allocation and 25% other portfolio work with unquantified health. Both are retained in the gift numerator; allocation is judgmental.
recipient
End Overdose · EIN 83-0696963 — 2024 organization-filed Form 990 identifies END OVERDOSE, EIN and endoverdose.net. This is primary filing identity verification, not a current IRS eligibility audit.
central gross resource envelope
$115,000 — Includes $15,000 hypothetical unpaid delivery inputs. Gross package resources, not net incremental societal cost; downstream medical spending and displacement omitted.

1. What do they do?

A national general gift supports training, naloxone, test strips, public awareness, chapter and school activity. The whole-gift model quantifies only additional rescue survival while retaining all spending. Historical output counts do not establish deaths averted.

Allocate and cost the whole gift

Central $75,000 pays $50 per offered training-plus-twin-pack package. Staff, noncompletion, delivery, shipping and relevant administration are already costed.

Reach a qualifying overdose opportunity

Count only the first qualifying opportunity within one year, then remove overlapping witnesses and repeatedly rescued people across the funded cohort.

Add rescue beyond usual care

Conditional extra timely administration includes training completion, kit carriage and functioning supply beyond bystanders/EMS. Funding additionality separately addresses replacement financing.

Count finite survival gains

Count conditional mortality reduction, then finite discounted survival/utility. Two doses are one kit, not two independent lives; no national mortality trend credit.

Scope of this review. Only US-resident health is modeled. SF delivery and chapter locations do not establish beneficiary residence or next-dollar shares. Remove overlapping stock, scenes, rescued people and causal credit across End Overdose, SFAF, DOPE and FentCheck.

2. Monitoring and information sharing

19 Massachusetts communities, 2002–2009

Walley et al., BMJ 2013 controlled interrupted time series. Mortality rate ratios .73 and .54 at two implementation intensities versus none; 2,912 cumulative trainees and 327 reported rescues.

Our assessment. Primary abstract inspected; full article inaccessible. Observational older community context does not estimate current EO low-risk recipients' annual use or marginal lives saved.

Rhode Island naloxone distribution scenarios

Zang et al., JAMA Network Open 2024 decision model. 50,000 added kits annually modeled to reduce mortality 6.3% or 8.8% depending allocation.

Our assessment. Simulation, not trial or EO causal measurement. Witnessing opportunities constrain additional benefit in supplied settings; no per-kit effect imported.

National trainees and events, including SF Portola

Official program, chapter directory and historical quarterly report. Summer 2024 reports 71,733 doses and 44,952 trainees; Portola 1,814 doses. Official directory lists Bay Area/SF and UC Berkeley.

Our assessment. July–September quarterly figures, not annual totals, unique residents or rescues. Full historical PDF retrieval inherited from documented primary inspection; chapter directory freshly checked.

END OVERDOSE, EIN 83-0696963

Organization-filed 2024 Form 990 reproduced from IRS data. Header links legal filing name, EIN and endoverdose.net. 2024 revenue $956,733; expenses $970,440.

Our assessment. Direct compressed retrieval inspected primary header and Parts I/III/IX. Historical functional program classification does not validate marginal rescue share; no model values recalibrated.

3. Qualitative assessment

End Overdose supplies overdose-response training and naloxone, with verified SF event delivery and Bay chapters. Timely administration can avert opioid-overdose death.

Key reservations

  • Marginal recipient exposure, unique additional rescues, complete fulfillment cost and residence shares remain unmeasured.
  • Primary filing identity and official giving route are verified; checkout entity disclosure and SF-restricted terms are not independently readable.
  • Core marginal allocation differs from historical program-accounting categories; unquantified benefits retain all gift costs.
  • $19 is a California procurement benchmark, not a nationwide EO invoice. Public stock availability and unpaid input prices are assumptions.
  • National death trends and historical training/dose totals establish no extra donor causal health.
  • Cross-organization price gaps are not measured comparative effectiveness. Our central encounter/rescue assumptions imply one added death averted per20,000 offered packages, versus roughly one survival-equivalent per1,000 differently defined Remedy bundles. Audience targeting can justify different priors, but does not establish that twentyfold gap; units and survival tails also differ.

Benefits not included in our estimate

  • Other prevention and public-awareness work
  • Fentanyl test-strip benefit
  • Chapter and school spillovers beyond counted rescues
  • Nonfatal morbidity prevented
  • Welfare and medical savings

4. What do you get for your dollar?

Additional unique-person rescues, not doses counted as lives

Central offers are hypothetical deliverable counts, not capacity promises. One-year encounter and rescue probabilities are explicit low-confidence analyst priors. Survival begins after rescue at the end of year 1 and is finite.

A better life is our comparison unit of 10 additional quality-adjusted life years (QALYs), potentially spread across people. These are uncertain estimates, not measured returns or verified donation offers.

How we calculate the estimate

Whole-gift rescue bridge: Offers = gift × rescue allocation / complete package cash. Avoided deaths = offers × one-year encounter × unique-person factor × extra timely administration × conditional mortality difference × funding additionality. QALYs = deaths × sum(k=1..T)[utility × (1−annual mortality)^k / 1.03^k] / 1.03 − implementation-scaled shared harm − independent donor harm.
Central: 1,500 offers × .005 × .5 × .2 × .2 × .5 = .075 avoided deaths; 9.040 finite QALYs at rescue per death yields .658287 US QALYs at gift.

Model inputs and assumptions
Rescue allocation / offered-package cash
75% / $50 (range: 50–85% / $35–$100). Central $19 twin-pack plus $31 complete operations. CalRx price applies to California; nationwide transfer is a judgment. Beneficiary shipping revenue assumed absent/waived. Analyst judgment; external drug benchmark.
First qualifying opportunity within one year
0.5% (range: 0.1–5%). Broad youth/general audience central; favorable assumes better targeting. Historical trainees and reported rescues do not measure EO's next cohort. Unmeasured analyst prior.
Unique rescued-person factor
50% (range: 25–80%). Deduplicate multiple carriers at one scene and repeated rescued people across the funded cohort, not merely kit/rescuer IDs. Bookkeeping judgment.
Extra timely administration / conditional mortality difference
20% / 20% (range: 5–30% / 5–30%). First includes completion, kit availability and carriage beyond ordinary rescue. Second is absolute survival advantage for that additional administration, retaining alternative care. No second adherence factor. Unmeasured analyst priors.
Funding additionality
50% (range: 0–80%). Whether gift adds delivery rather than replacing funding. Separate from clinical alternatives; no verified marginal tranche. Analyst judgment.
Utility / competing mortality / survival years
0.75 / 4% yearly / 30 years (range: 0.65–0.85 / 2–8% / 15–40 years; separate 10-year stress). 3% discount, rescue at end of year 1. Central 9.040 QALYs at rescue is mathematical, not an observed EO life expectancy or utility. Finite survival judgment.
SF / other Bay beneficiary-residence share
2% / 5% (range: 0.5–5% / 2–10%; separate zero-SF stress). Bay includes SF. All remaining health assumed other US. Portola dose share and chapter counts do not establish these shares. Unmeasured allocation prior.
Unpaid inputs per offered package
$10 (range: $5–$25). Medication is paid in main cash case. Separate hypothetical donated stock removes $19 cash and adds stock once to gross resources; does not establish available public stock. Gross resource judgment.
Independent donor harm diagnostic
Zero in central (range: 0.1 present-valued US QALY loss with zero additionality). Independent gift harm survives zero activity. Shared implementation harm would scale with funding additionality. Signed geography uses same shares here; differently localized harm requires separate partition. Hypothetical stress, not observed harm.

Same $100,000 gift in every scenario

  • central: SF donor: $75,954,757/10 QALYs. US/Bay/SF QALYs: 0.658286619 / 0.0460800634 / 0.0131657324. US donor $1,519,095; Bay donor $21,701,359 per 10 QALYs. Gross resource envelope $115,000; US/Bay/SF resource prices $1,746,959 / $24,956,563 / $87,347,970 per 10 QALYs.
  • favorable: SF donor: $204,764/10 QALYs. US/Bay/SF QALYs: 97.6735188 / 14.6510278 / 4.88367594. US donor $10,238; Bay donor $68,255 per 10 QALYs. Gross resource envelope $112,143; US/Bay/SF resource prices $11,481 / $76,543 / $229,628 per 10 QALYs.
  • pessimistic: SF donor: $1,485,568,356,857/10 QALYs. US/Bay/SF QALYs: 0.000134628608 / 0.0000033657152 / 6.7314304e-7. US donor $7,427,841,784; Bay donor $297,113,671,371 per 10 QALYs. Gross resource envelope $112,500; US/Bay/SF resource prices $8,356,322,007 / $334,252,880,293 / $1,671,264,401,464 per 10 QALYs.
  • no funding additionality: SF donor: No finite positive ratio/10 QALYs. US/Bay/SF QALYs: 0 / 0 / 0. US donor No finite positive ratio; Bay donor No finite positive ratio per 10 QALYs. Gross resource envelope $115,000; US/Bay/SF resource prices No finite positive ratio / No finite positive ratio / No finite positive ratio per 10 QALYs.
  • no incremental rescue: SF donor: No finite positive ratio/10 QALYs. US/Bay/SF QALYs: 0 / 0 / 0. US donor No finite positive ratio; Bay donor No finite positive ratio per 10 QALYs. Gross resource envelope $115,000; US/Bay/SF resource prices No finite positive ratio / No finite positive ratio / No finite positive ratio per 10 QALYs.
  • donor harm: SF donor: No finite positive ratio/10 QALYs. US/Bay/SF QALYs: -0.1 / -0.007 / -0.002. US donor No finite positive ratio; Bay donor No finite positive ratio per 10 QALYs. Gross resource envelope $115,000; US/Bay/SF resource prices No finite positive ratio / No finite positive ratio / No finite positive ratio per 10 QALYs.
  • short survival: SF donor: $132,117,523/10 QALYs. US/Bay/SF QALYs: 0.378450935 / 0.0264915654 / 0.00756901869. US donor $2,642,350; Bay donor $37,747,864 per 10 QALYs. Gross resource envelope $115,000; US/Bay/SF resource prices $3,038,703 / $43,410,043 / $151,935,151 per 10 QALYs.
  • no sf health: SF donor: No finite positive ratio/10 QALYs. US/Bay/SF QALYs: 0.658286619 / 0.032914331 / 0. US donor $1,519,095; Bay donor $30,381,903 per 10 QALYs. Gross resource envelope $115,000; US/Bay/SF resource prices $1,746,959 / $34,939,188 / No finite positive ratio per 10 QALYs.
  • donated stock sensitivity: SF donor: $47,091,949/10 QALYs. US/Bay/SF QALYs: 1.06175261 / 0.0743226828 / 0.0212350522. US donor $941,839; Bay donor $13,454,843 per 10 QALYs. Gross resource envelope $170,161; US/Bay/SF resource prices $1,602,645 / $22,894,934 / $80,132,268 per 10 QALYs.

Uncertainty. Joint scenarios are not confidence intervals. Central priors are not an empirically calibrated expected value. Favorable national/Bay prices must not substitute for the SF ranking. At other central assumptions a national $100K/10 QALY threshold requires over 7.6% one-year encounter probability versus 0.5% central; even 100% would not reach central Bay/SF thresholds. Null/harm cases retain cost and have no finite positive ratio.

5. Funding and previous grants

Accepted conditional research, not a demonstrated high-value SF donation. No verified marginal recipient cohort, additional rescue rate or SF-restricted offer.

Fresh official Solution→Donate link resolves to the listed campaign URL. Its JavaScript landing page exposes no readable entity/EIN or checkout terms to the web reader; CUA reports no browser available. Exact checkout identity is therefore unverified independently of official route linkage and primary filing identity. No SF restriction, current matching offer, funding queue or supply gap established. Existing free kits, NDP medication, other organizations, venue medics and EMS form the baseline.

This review does not establish a verified marginal funding offer or a complete history of grants.

Donate

Opens the organization’s giving page. A general donation may not fund the specific activity modeled here; confirm allocation with the recipient.

6. Sources

  1. 2024 Form 990, submitted March 25, 2025. End Overdose; IRS-released Form 990 reproduced by ProPublica. Primary organization-filed return, not a secondary profile summary; Header identifies name, EIN and website. Historical national accounting and reported output do not identify marginal donor allocation or health. No model input recalibrated from filing.. Published: March 25, 2025 submission; retrieved: September 8, 2026; direct compressed HTTP retrieval inspected header, Part I, Part III and Part IX.
  2. Our Solution. End Overdose. Official program description. Published: Undated; retrieved: September 8, 2026.
  3. Chapters. End Overdose. Official chapter directory. Published: Undated; retrieved: September 8, 2026.
  4. Summer 2024 Impact Report, July–September. End Overdose. Organization-authored quarterly report. Published: October 1, 2024; retrieved: September 8, 2026.
  5. Naloxone Kit. End Overdose. Official product page. Published: Undated; retrieved: September 8, 2026.
  6. Naloxone Kit (CA residents). End Overdose. Official California product page. Published: Undated; retrieved: September 8, 2026.
  7. Donate to End Overdose. End Overdose. Official linked giving route. Published: Undated; retrieved: September 8, 2026.
  8. CalRx Naloxone Savings. State of California, CalRx. Official procurement price. Published: Price effective January 1, 2026; retrieved: September 8, 2026.
  9. Get Naloxone. State of California, CalRx. Official procurement eligibility. Published: Undated; retrieved: September 8, 2026.
  10. Naloxone Distribution Project FAQ. California Department of Health Care Services. Official public program. Published: Current page includes April 2026 supply update; retrieved: September 8, 2026.
  11. Opioid overdose rates and implementation of overdose education and nasal naloxone distribution in Massachusetts. Walley et al., BMJ; PubMed primary abstract. Controlled interrupted time-series study. Published: January 30, 2013; retrieved: September 8, 2026.
  12. Evaluation of Strategies to Enhance Community-Based Naloxone Distribution Supported by an Opioid Settlement. Zang et al., JAMA Network Open. Primary decision-analytic simulation. Published: May 30, 2024; retrieved: September 8, 2026.
  13. Lifesaving Naloxone. US Centers for Disease Control and Prevention. Official public-health explanation. Published: June 11, 2025; retrieved: September 8, 2026.
  14. SF Hep B Free–Bay Area. Community Initiatives. Sponsor-run giving page. Published: Undated; retrieved: September 8, 2026.
  15. Donate. NCAPDA. Official giving/program page. Published: Undated; retrieved: September 8, 2026.

Annual expenses: years and sources

Average annual expenses (three consecutive fiscal years): Not available. Organization size is separate from the modeled cost-effectiveness of a donation.

End Overdose

Three years of organization-level expenses have not yet been verified for this report. No other organization or fiscal sponsor budget has been substituted.