GiveBetter x New York City

New Jersey Harm Reduction Coalition

Whole recipient; conditional community overdose-prevention health

Research time: 4 min on GPT-6 Astra Light
  • Research — reviewed programs, finances and impact evidence.

Updated: 2026-09-14

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Summary

What do they do? NJHRC delivers harm-reduction supplies, education and support in New Brunswick and across New Jersey. It also advocates for drug-policy changes and community leadership. The estimate prices a conditional overdose-prevention component against the full recipient's cost and attributes only a judgment-based share to MSA residents.

Why we’re interested in this organization:

  • Direct delivery prioritizes people likely to encounter overdose.

  • Current originals identify government and donated resources rather than ignoring them.

  • A unique-person survival model avoids repeated lifetime credit for repeat rescues.

Our main reservations:

  • Annual unique reach and beneficiary geography were not verified.

  • Public supply and alternative providers could replace much of the marginal gift.

  • Historical accounts contain unresolved comparative differences, and policy and infection benefits are unpriced.

What do you get for your dollar? $10.5M per better life: ten additional quality-adjusted life years in New York City. Whole annual NJHRC recognized expense, including donated supplies, charged to a conditional finite overdose-survival component for MSA residents. Service allocation, unique reach, rescue additionality and funding response are judgment priors; wider clinical, infection and policy effects remain unpriced. Not measured whole-portfolio return or a proven lower bound..

Whole-recipient resources -> unique high-risk person-years reached through community delivery -> additional timely opioid rescue -> one-year mortality hazard difference -> finite survival-adjusted QALYs.

1. What do they do?

The recipient is NJHRC, EIN 85-4099652, not National Harm Reduction Coalition or NEXT Distro. Ordinary support covers delivery, community education, research and advocacy. New Brunswick outreach is local to the MSA, but mail and community distribution operate statewide. Portfolio Gift destination

2. Monitoring and information sharing

The state identifies NJHRC as serving Middlesex and statewide jurisdictions. Published state totals combine many centers and cannot become NJHRC counts. This review did not verify a current annual NJHRC count of unique people reached, rescue events or beneficiary residence. The numerical model therefore uses an explicitly assumed resource-to-person bridge, not a disguised activity observation. State report

Before upgrading confidence, obtain deduplicated distribution/refill data, onward recipient residence, current donated-stock and public-contract terms, and the extra delivery supported by flexible funds. Recipients can rescue someone else; mailing ZIP alone is not necessarily the beneficiary's residence.

3. Qualitative assessment

Targeted community access has a plausible causal advantage when pharmacy or emergency access is too late. The Massachusetts interrupted time-series evaluation supports the mechanism but is observational and predates today's drug supply and broad naloxone availability. The contemporary HEALing cluster trial found no statistically significant primary mortality reduction from a bundled community scale-up; its rate ratio was 0.91 with a 0.76–1.09 interval. Neither study supplies NJHRC's marginal rescue rate. Earlier evaluation Randomized counterevidence

Current NJHRC material addresses medetomidine and related risks, showing why naloxone supply alone is not the entire response. No separate infection-prevention or policy mortality benefit is added to this component. Current work

4. What do you get for your dollar?

The conditional partial-health estimate is about $10.5 million per 10 MSA QALYs. This is not the complete portfolio return or a lower bound.

The central resource bridge allocates 50% of annual recipient capacity to community overdose prevention and assumes $1,000 per unique risk-person year: approximately 1063 people. Neither number is a verified service allocation or actual annual reach. They are explicit planning priors given the absence of recipient-level outcome data. The encounter rate is 0.1 per person-year, additional timely rescue is 30%, and avoided mortality hazard per incremental encounter is 0.1. This yields a 0.003 annual hazard reduction for one year, before the 25% ordinary-gift response.

Baseline mortality hazard is 0.08 per year (about 7.69% annual death risk), and utility is 0.7; both are judgments. After the first year, both groups face the same mortality hazard; any survival difference is followed for at most ten years with 3% discounting. Repeat overdose is therefore not awarded another lifetime. A 65% MSA share applies only to the modeled beneficiaries and is deliberately uncertain, with 40% and 80% alternatives. No full New Jersey or CSA denominator is substituted.

Wide positive alternatives vary delivery efficiency, rescue opportunity, substitution, funding and duration. Zero and net harm remain possible. A 25% added-resource case changes cost only, testing omitted partner and volunteer inputs without pretending those resources produce more beneficiaries.

Model, assumptions and sensitivity

Full annual gross recognized recipient cost, including $396,000 in-kind supplies. Only community overdose-prevention health is priced; infection, care-linkage and policy benefits are not a complete portfolio estimate.

g=.65 is an explicit weak-confidence prior for the modeled statewide beneficiaries' MSA residence. Middlesex is included; Atlantic, Camden, Mercer and other non-MSA counties are excluded. Neither headquarters nor all New Jersey is counted as MSA.

U=C*f/k; delta=e*t*l; dlog=ln(1+d); F(v,t)=(1-exp(-v*t))/v; H=U*u*[F(m-delta+dlog,1)-F(m+dlog,1)+(exp(-(m-delta))-exp(-m))*exp(-dlog)*F(m+dlog,T-1)]; Qall=b*H-h; QMSA=g*Qall. Cost sensitivities change numerator only. The encounter-level mortality input l is mapped linearly into a hazard decrement delta=e*t*l as an approximation, not an exact probability-to-hazard identity.

C
2125515 USD annual gross expense (observed). FY2024 Part IX including in-kind supplies; no separately netted event/rental/inventory expense. [return2024] [noncash2024]
f
0.5 assumed overdose-delivery capacity fraction (judgment). Scenario assumption, not an NJHRC or external study estimate. [work] [state] [walley] [heal]
k
1000 USD allocated resources per unique risk-person year (judgment). No verified annual unique NJHRC count; $1,000 is an explicit capacity prior, not a measured per-client cost or drug price. [work] [state] [walley] [heal]
e
0.1 potential rescue encounters per risk-person year (judgment). Scenario assumption, not an NJHRC or external study estimate. [work] [state] [walley] [heal]
t
0.3 incremental timely rescue fraction versus alternatives (judgment). Scenario assumption, not an NJHRC or external study estimate. [work] [state] [walley] [heal]
l
0.1 mortality hazard reduction per incremental rescue encounter (judgment). Scenario assumption, not an NJHRC or external study estimate. [work] [state] [walley] [heal]
b
0.25 ordinary funding response (judgment). Scenario assumption, not an NJHRC or external study estimate. [work] [state] [walley] [heal]
m
0.08 annual baseline all-cause mortality hazard (judgment). Scenario assumption, not an NJHRC or external study estimate. [work] [state] [walley] [heal]
u
0.7 health utility (judgment). Scenario assumption, not an NJHRC or external study estimate. [work] [state] [walley] [heal]
T
10 maximum survival horizon years (judgment). Scenario assumption, not an NJHRC or external study estimate. [work] [state] [walley] [heal]
g
0.65 MSA beneficiary fraction (judgment). Statewide delivery and Middlesex operations observed, but residence distribution unknown; .65 is not a measured population allocation. [work] [state] [walley] [heal]
h
0 net adverse QALYs (judgment). Scenario assumption, not an NJHRC or external study estimate. [work] [state] [walley] [heal]
d
0.03 annual discount (judgment). Scenario assumption, not an NJHRC or external study estimate. [work] [state] [walley] [heal]

Conditional overdose-prevention component: Cost: $2.1M; New York City QALYs: 2.0315566945555563; all-population QALYs: 3.125471837777779. {"C":2125515,"f":0.5,"k":1000,"e":0.1,"t":0.3,"l":0.1,"b":0.25,"m":0.08,"u":0.7,"T":10,"g":0.65,"h":0,"d":0.03,"numeratorCostUSD":2125515}

Sparse additional reach and extensive substitution: Cost: $2.1M; New York City QALYs: 0.006012943846244851; all-population QALYs: 0.015032359615612126. {"C":2125515,"f":0.5,"k":2500,"e":0.03,"t":0.1,"l":0.05,"b":0.1,"m":0.08,"u":0.7,"T":5,"g":0.4,"h":0,"d":0.03,"numeratorCostUSD":2125515}

Efficient targeted delivery and meaningful rescue gap: Cost: $2.1M; New York City QALYs: 61.8775790171856; all-population QALYs: 77.346973771482. {"C":2125515,"f":0.5,"k":500,"e":0.2,"t":0.5,"l":0.15,"b":0.5,"m":0.08,"u":0.7,"T":15,"g":0.8,"h":0,"d":0.03,"numeratorCostUSD":2125515}

Complete ordinary-gift replacement: Cost: $2.1M; New York City QALYs: 0; all-population QALYs: 0. {"C":2125515,"f":0.5,"k":1000,"e":0.1,"t":0.3,"l":0.1,"b":0,"m":0.08,"u":0.7,"T":10,"g":0.65,"h":0,"d":0.03,"numeratorCostUSD":2125515}

No incremental rescue with service-related burden: Cost: $2.1M; New York City QALYs: -0.065; all-population QALYs: -0.1. {"C":2125515,"f":0.5,"k":1000,"e":0.1,"t":0,"l":0.1,"b":0.25,"m":0.08,"u":0.7,"T":10,"g":0.65,"h":0.1,"d":0.03,"numeratorCostUSD":2125515}

Added partner and volunteer resources: Cost: $2.7M; New York City QALYs: 2.0315566945555563; all-population QALYs: 3.125471837777779. {"C":2125515,"f":0.5,"k":1000,"e":0.1,"t":0.3,"l":0.1,"b":0.25,"m":0.08,"u":0.7,"T":10,"g":0.65,"h":0,"d":0.03,"numeratorCostUSD":2656893.75}

Counterfactual: State naloxone procurement, pharmacy access, other community distributors and emergency response continue. t credits only additional timely rescue beyond those alternatives. An ordinary gift does not buy all donated stock anew.

Attribution: f allocates an assumed capacity share, k turns that share into unique risk-person years, e*t*l gives a one-year mortality hazard difference, and b applies funding response once. No separately multiplied repeat-rescue lifetime or national affiliate credit.

All delivery reach and causal factors are explicit uncalibrated judgments. Finite survival, recurrence after year one, wide alternatives, zero and adverse cases are included. Partial health price must not be represented as full portfolio ranking.

Sensitivity

  • Sparse additional reach and extensive substitution: 3,534,899,135 USD per 10 MSA QALYs. Scenario assumptions are judgments, not statistical confidence limits.
  • Efficient targeted delivery and meaningful rescue gap: 343,503 USD per 10 MSA QALYs. Scenario assumptions are judgments, not statistical confidence limits.
  • Complete ordinary-gift replacement: no finite positive-benefit price. Scenario assumptions are judgments, not statistical confidence limits.
  • No incremental rescue with service-related burden: no finite positive-benefit price. Scenario assumptions are judgments, not statistical confidence limits.
  • Added partner and volunteer resources: 13,078,118 USD per 10 MSA QALYs. Scenario assumptions are judgments, not statistical confidence limits.

Unresolved inputs

  • Verified annual unique NJHRC risk-person reach and resource allocation.
  • Residence of rescued beneficiaries, not only package destinations.
  • Current donated-stock/public funding replacement and effective rescue counterfactual.
  • FY2023 comparative and FY2022 noncash reconciliation; audit total-resource reconciliation.

5. Funding and previous grants

FY 2024 Form 990 gross expense is $2,125,515, including $396,000 of donated supplies already in Part IX; adding the same stock again would double count it. The return reports $1,750,800 government grants, $262,236 net assets, $18,178 cash and $188,366 grants receivable. These historical figures do not establish a current cash gap. Event, rental and inventory cost lines are blank. Although the return indicates an audit, its Schedule D reconciliation is blank, so this is not independently verified audited total-resource expense. Original FY 2024 return

Original FY 2023 expense is $2,128,588, but FY 2024's comparative column shows $2,136,736: an unresolved $8,148 difference. Original FY 2022 expense is $746,927; its Schedule M medical donation value of $164,196 differs from Part VIII noncash revenue of $138,616. Both historical years are marked noncomparable, with no synthetic three-year average. All three returns use accrual accounting. FY 2023 original FY 2022 noncash disclosure

New Jersey's public naloxone programs already supply pharmacies and eligible community agencies. An ordinary gift may improve distribution or flexible services, but should not be assumed to purchase incremental medicine or reverse every reported overdose. Public baseline

Expense appendix: FY 2024 functional expense is $1,824,131 program, $267,124 management/general and $34,260 fundraising, totaling $2,125,515. In-kind supplies of $396,000 are already within program expense. Earlier original reporting discrepancies remain unresolved; no verified comparable three-year mean is supplied.

Annual expenses

Organization-level spending, including programs, administration and fundraising. The research list averages three comparable, consecutive full fiscal years when available.

  • FY 2022: $747K; New Jersey Harm Reduction Coalition, EIN85-4099652, 12-month period, Original accrual Form 990 gross recognized expense; in-kind supplies retained once, no separate event/rental/COGS. Historical reconciliation limitations disclosed.. Source
  • FY 2023: $2.1M; New Jersey Harm Reduction Coalition, EIN85-4099652, 12-month period, Original accrual Form 990 gross recognized expense; in-kind supplies retained once, no separate event/rental/COGS. Historical reconciliation limitations disclosed.. Source
  • FY 2024: $2.1M; New Jersey Harm Reduction Coalition, EIN85-4099652, 12-month period, Original accrual Form 990 gross recognized expense; in-kind supplies retained once, no separate event/rental/COGS. Historical reconciliation limitations disclosed.. Source

6. Sources

  1. FY2022 original Form 990. NJHRC / IRS. Published: not stated; retrieved: 2026-09-14.
  2. FY2022 original noncash disclosure. NJHRC / IRS. Published: not stated; retrieved: 2026-09-14.
  3. FY2023 original Form 990. NJHRC / IRS. Published: not stated; retrieved: 2026-09-14.
  4. FY2023 original noncash disclosure. NJHRC / IRS. Published: not stated; retrieved: 2026-09-14.
  5. FY2024 original Form 990. NJHRC / IRS. Published: not stated; retrieved: 2026-09-14.
  6. FY2024 original noncash disclosure. NJHRC / IRS. Published: not stated; retrieved: 2026-09-14.
  7. Current delivery and advocacy portfolio. NJHRC. Published: not stated; retrieved: 2026-09-14.
  8. Current naloxone access and prioritization. NJHRC. Published: not stated; retrieved: 2026-09-14.
  9. Current drug-supply response. NJHRC. Published: 2026-04-28; retrieved: 2026-09-14.
  10. Original 2022–2024 state harm-reduction report. New Jersey Department of Health. Published: not stated; retrieved: 2026-09-14.
  11. Free public naloxone distribution baseline. New Jersey Department of Human Services. Published: 2024-09-13; retrieved: 2026-09-14.
  12. Community naloxone interrupted time-series evaluation. Walley et al., BMJ. Published: 2013-01-30; retrieved: 2026-09-14.
  13. Randomized contemporary community scale-up trial. HEALing Communities Study Consortium, NEJM. Published: 2024-06-16; retrieved: 2026-09-14.
  14. Official ordinary-gift destination. NJHRC. Published: not stated; retrieved: 2026-09-14.