Ophelia (YC W20) – At-home recovery for opioid addiction

Hi HN,

My name is Zack, and I'm the cofounder of Ophelia (https://meetophelia.com). We help people quit opioids without going to rehab. We offer online doctor's visits, medication for withdrawal and cravings, and long-term support for recovery.

There’s a treatment for opioid addiction that works, and it’s low-cost, discreet, and convenient. It’s called medication-assisted treatment (or MAT), it reduces mortality by more than 5x [1], and it resembles treatment for anxiety or depression: medication and therapy. Yet 80% of the 3 million Americans addicted to opioids are not getting it. You can read more about MAT at [2] [3] [4].

I decided to work on this problem after my girlfriend died of an overdose last year. She wanted to quit, but she was afraid of losing her job and her privacy, and she found it easier to get this medication from a drug dealer than a doctor or rehab. The rest of the story is too sad to articulate, and I don’t want this post to be about her. It’s about all of the people just like her, struggling to get help today. This is why we started Ophelia: to lower the barriers to proven, lifesaving treatment.

Most Americans struggling with opioids have jobs, families, and privacy concerns that make rehab an impossible option. They want to quit, but they’re afraid of withdrawal, and the medication that helps is too hard to get: doctors need a special waiver to prescribe it, which only 5% of them have [5], so most people are buying it on the black market. Yet, drug dealers aren’t doctors, and the statistics support it: every 11 minutes, another American dies of an opioid overdose – now the #1 cause of death for Americans under 50.

As it turns out, rehab is not just unnecessary: the data shows it rarely works anyway [6] [7]. Without medication, 90% of people relapse in the first 3 months: yet, 2/3rds of rehabs don’t offer medication, and most don’t even employ doctors! Thus: 80% of people avoid getting help, and the rest succumb to pseudoscience that does nothing to address their problem.

Ophelia’s mission is to replace drug dealers with doctors, without any loss of privacy or convenience. We make MAT discreet, convenient, and affordable for anyone who needs help but can’t or won’t go to rehab.

Our medical directors are two of the best addiction specialists in the world (Dr. Adam Bisaga and Dr. Arthur Robin Williams, both Columbia Professors and NIH-funded research scientists), and we’re now treating patients in Philadelphia and New York, through a combined in-person and telemedicine approach.

There's a problem, though: we're restricted by regulations from letting people know that this treatment is available. Both Facebook and Google require a third-party certification before allowing us to use their platforms, and many sites like Reddit don't allow any advertising for addiction treatment at all.

We would love your help figuring out how to get past this bottleneck.

The other big problem is the stigma around addiction, which stops most people from sharing success stories about MAT, so its efficacy is underappreciated. If you know anyone who is personally struggling with this issue, please make sure they know about MAT. It can literally save their life.

If you have thoughts about how we can solve these problems, I would be grateful for your help: any ideas to increase awareness of MAT, or any stories you can share that may help us better understand the needs of our patients. Thank you!

[1] Effects of medication-assisted treatment among opioid users https://www.ncbi.nlm.nih.gov/pubmed/29934549

[2] Medication-Assisted Treatment (MAT) https://www.samhsa.gov/medication-assisted-treatment

[3] Information about Medication-Assisted Treatment (MAT) https://www.fda.gov/drugs/information-drug-class/information...

[4] We have a solution for the opioid epidemic. It’s dramatically underused. https://www.vox.com/policy-and-politics/2019/12/17/18292021/...

[5] America’s Healthcare System is Making the Opioid Crisis Worse https://www.theatlantic.com/health/archive/2018/11/why-heroi...

[6] Lapse and relapse following inpatient treatment of opiate dependence. https://www.ncbi.nlm.nih.gov/pubmed/20669601

[7] Does Rehab Work as a Treatment for Alcoholism and Other Addictions? https://www.scientificamerican.com/article/does-rehab-work/

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