“There is a gap between the effectiveness of medication for those struggling with alcohol use disorder and the frequency with which it’s prescribed,” Oar founder and CEO Jonathan Hunt-Glassman tells Verywell Mind, “so we started Oar to be an approachable place to get treatment.”
The Shift to Online Treatment
According to a 2019 survey from the Substance Abuse and Mental Health Services Administration, around 20 million teenagers and adults in the United States have a substance use disorder. So-called “virtual rehab” lets people connect with a secure platform to seek advice and support, and access various treatment options. “Telehealth has greatly expanded because of the pandemic, and this has allowed many more people access to physicians who are knowledgeable about treating alcohol problems,” says John C. Umhau, MD, MPH, CPE, addiction medicine specialist and director of AlcoholRecoveryMedicine.com. Additionally, the increased confidentiality of telemedicine has removed a significant barrier to getting care for many people with alcohol use disorder (AUD). “The frequent follow-up visits often required are much less burdensome with telemedicine compared to an in-person appointment,” Dr. Umhau explains. “The result is that patients keep their appointments more often and therefore are more likely to succeed in their efforts to recover from AUD.”
Telehealth for Addiction
Oar, which joins other virtual platforms like Lionrock Recovery and Quit Genius, will initially focus on medication-assisted treatment—specifically, naltrexone—for moderate to severe AUD. “For my entire adult life, I struggled with alcohol use. The real turning point for me was when a nurse practitioner encouraged me to meet with an addiction medicine specialist,” says Hunt-Glassman. That specialist, he says, did two things that were new to his experience of recovery—accept his goal of moderation, and suggest medication. “For some portion of the folks who find themselves in that situation, an option like telemedicine that’s so private and convenient may be a more approachable place to start." To get started with Oar, users complete an online assessment which is then reviewed within 24 hours by Oar’s licensed clinicians. The next step is a personalized treatment plan, which may or may not include medication. If deemed medically appropriate, a licensed medical professional will prescribe the FDA-approved medication naltrexone, which can be delivered by mail conveniently and discreetly as part of a subscription plan. If customers have any concerns or questions, they can connect and chat with their clinician through secure messaging in their Oar patient portal at any time.
Naltrexone For Alcohol Use Disorder
Research shows that less than 10% of people with AUD actually receive treatment. Hunt-Glassman notes that the standard message he’d always received—“You need to quit”—never worked for him. “I had a problem for so long, sought treatment in so many places, and I really hadn’t heard about this option. Naltrexone had a pretty transformational effect in my life,” he says. This is where Hunt-Glassman hopes Oar will make a difference, by delivering an effective medication to the people who need it. “Alcohol remains a massive public health problem, but it doesn’t get the press that opiates do because we don’t have an alcohol overdose epidemic,” says Joshua D. Lee, MD, Oar’s chief clinical advisor. “Globally, alcohol is a much bigger problem and there’s been a lack of knowledge and inertia,” he adds. Lee and Hunt-Glassman see this gap as an opportunity to increase access to addiction medication as part of a common treatment plan. “Naltrexone works by blocking the effect of endorphins, the natural opioids normally released by drinking,” says Dr. Umhau. As a result, the pleasure from drinking alcohol is reduced, people will drink more slowly, and have an easier time stopping when they want to. “For those who want to quit drinking for good, naltrexone can reduce the risk of relapse,” Dr. Umhau adds. “It also works well for people with a certain genetic background—those who have a strong family history of alcoholism.” There are many reasons why physicians relatively seldom prescribe naltrexone, explains Dr. Umhau. For starters, many of them are simply unaware of the ways in which medications can reduce alcohol consumption and craving. Plus, many physicians don’t have experience treating alcohol use disorder and lack the confidence in their ability to help these patients. In some cases, they may have prescribed naltrexone, but because they do not understand how to use it, they seldom see success and are then hesitant to use it in the future. “One of our struggles, professionally, is just to educate med students and working physicians about addiction—that they can treat it,” says Dr. Lee, “The more we treat addiction like other chronic medical problems, there will be less stigma, and patients will be more interested in treatment.” “Some physicians are under the impression that the only acceptable goal for the person with AUD is to stop drinking and embrace a lifetime of abstinence, and that attending Alcoholics Anonymous is the treatment,” adds Dr. Umhau. “They may think the disease is incurable when they see a relapse. However, a more appropriate way to think about the problem is to think of it as a chronic disease, like diabetes or hypertension, which must be managed but never fully goes away.” “What we’re hearing from our customers is there’s no one barrier that’s universal. For some, it’s awareness. They just never knew this was an option,” Hunt-Glassman says. “Others have tried to seek it out from a primary care physician and feel failed by them. Others are concerned about talking about it because they have a privacy concern.” As the founder of Oar, Hunt-Glassman says that understanding these barriers, and finding ways to break them down, has been one of the most fulfilling parts of this journey toward safe, effective, and convenient treatment for addiction. Disclosure: Oar was launched by Newco, an incubator for entrepreneurial enterprises owned by IAC, Verywell’s parent company.
