Appendix

Appendix:
How We Develop
Our Guidance

Broad evidence base, targeted focus on social impact

Looking for evidence-based solutions
To identify high-impact philanthropic opportunities, our multi-disciplinary team accesses the best available
information from three sources: rigorous academic research, informed opinion, and field experience. From all
three sources, we seek an empirical understanding of where the unmet needs are, what practices address
these needs well, what social impact these practices generate, and how much change costs. By tapping all three
sources, we leverage the strengths of each, while mitigating their weaknesses. Where all three sources point to
the same practice or model, we see a high-impact opportunity.

SOURCES OF INFORMATION
Field Experience

Field Experience

Practictioner and beneficiary insights

Performance assessments
In-depth case studies
Informed Opinion
Stakeholder input

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Expert opinion
Policy analyses

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Inf

Most-Promising
Approaches

Academic Research
Randomized controlled trials and
quasi-experimental studies
Modeled analyses (e.g., costeffectiveness)

Sources reviewed
We reviewed over 300 sources and interviewed over 70 experts in academia, policy, philanthropy, health
systems, care provision, and more. Our collaboration with the Treatment Research Institute (TRI) is of particular
note. TRI is a leading center for substance use disorder research, and TRI staff members served as expert
resources throughout the project.

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Lifting the Burden of Addiction: Philanthropic opportunities to address substance use disorders in the United States

Criteria for inclusion of opportunities in this report

After conducting our initial scan of the three circles of evidence noted above, we generate a list of potential
philanthropic opportunities to highlight. We then analyze each approach to determine how it stacks up against
our four criteria:
Strength of evidence: Is there a body of evidence supporting the link between the approach and the targeted
social impact? Does that evidence come from each of the three circles. How does the strength of evidence for
this approach compare with the evidence for other approaches aiming to achieve the same outcomes?
Expert recommendation: Do experts across the three circles of evidence (including those whose expertise
comes from lived experience) see potential for social impact as a result of this approach?
Potential for impact: If the approach is successful, how many people will experience a positive change in their
lives, and how meaningful will that change be? Does this approach have the potential to demonstrate a more
powerful or efficient way to get to positive impact? If it is not successful, is there potential for negative impact
(as compared with the negative impact of doing nothing)?
Philanthropic on-ramp: Are there ways in which philanthropic support could create high impact? Are there
credible implementers who could put this approach into practice? Is it clear where funds could be donated to
implement this approach? Is it redundant given government programs or market forces?
We seek to highlight opportunities with: strong evidence of a link to the target impact; expert and constituent
support; potential for meaningful and potentially game-changing impact; minimal potential for negative impact;
and the ability to leverage philanthropic funding. Within opportunities that approach those benchmarks, we
analyze and present costs and impacts, facilitating appropriate comparisons and clarifying trade-offs.
As with all of the Centers work, this report summarizes evidence drawn from a range of sources, including
academic research, policy experts, and practitioners in the field. As we present a range of opportunities to serve
different populations or target different levers for change, some options may have stronger evidence from one
dimension than from another. For example, since health service interventions can be replicated and studied in
different settings, the academic evidence base in health services is sometimes deeper than the evidence base in
policy change. However, since a single policy change can affect large populations for an extended period of time,
those interventions can be extremely cost-effectiveif they are successful.

Appendix: How We Develop Our Guidance

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