
Launch HN: Ophelia (YC W20) – At-home recovery for opioid addiction - ZackGray
Hi HN,<p>My name is Zack, and I&#x27;m the cofounder of Ophelia (<a href="https:&#x2F;&#x2F;meetophelia.com" rel="nofollow">https:&#x2F;&#x2F;meetophelia.com</a>). We help people quit opioids without going to rehab. We offer online doctor&#x27;s visits, medication for withdrawal and cravings, and long-term support for recovery.<p>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].<p>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.<p>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.<p>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&#x2F;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.<p>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.<p>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.<p>There&#x27;s a problem, though: we&#x27;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&#x27;t allow any advertising for addiction treatment at all.<p>We would love your help figuring out how to get past this bottleneck.<p>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.<p>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!<p>[1] Effects of medication-assisted treatment among opioid users <a href="https:&#x2F;&#x2F;www.ncbi.nlm.nih.gov&#x2F;pubmed&#x2F;29934549" rel="nofollow">https:&#x2F;&#x2F;www.ncbi.nlm.nih.gov&#x2F;pubmed&#x2F;29934549</a><p>[2] Medication-Assisted Treatment (MAT) <a href="https:&#x2F;&#x2F;www.samhsa.gov&#x2F;medication-assisted-treatment" rel="nofollow">https:&#x2F;&#x2F;www.samhsa.gov&#x2F;medication-assisted-treatment</a><p>[3] Information about Medication-Assisted Treatment (MAT) <a href="https:&#x2F;&#x2F;www.fda.gov&#x2F;drugs&#x2F;information-drug-class&#x2F;information-about-medication-assisted-treatment-mat" rel="nofollow">https:&#x2F;&#x2F;www.fda.gov&#x2F;drugs&#x2F;information-drug-class&#x2F;information...</a><p>[4] We have a solution for the opioid epidemic. It’s dramatically underused. <a href="https:&#x2F;&#x2F;www.vox.com&#x2F;policy-and-politics&#x2F;2019&#x2F;12&#x2F;17&#x2F;18292021&#x2F;opioid-epidemic-methadone-buprenorphine-naltrexone-drug-rehab" rel="nofollow">https:&#x2F;&#x2F;www.vox.com&#x2F;policy-and-politics&#x2F;2019&#x2F;12&#x2F;17&#x2F;18292021&#x2F;...</a><p>[5] America’s Healthcare System is Making the Opioid Crisis Worse <a href="https:&#x2F;&#x2F;www.theatlantic.com&#x2F;health&#x2F;archive&#x2F;2018&#x2F;11&#x2F;why-heroin-and-fentanyl-addicts-cant-get-treatment&#x2F;576118&#x2F;" rel="nofollow">https:&#x2F;&#x2F;www.theatlantic.com&#x2F;health&#x2F;archive&#x2F;2018&#x2F;11&#x2F;why-heroi...</a><p>[6] Lapse and relapse following inpatient treatment of opiate dependence. <a href="https:&#x2F;&#x2F;www.ncbi.nlm.nih.gov&#x2F;pubmed&#x2F;20669601" rel="nofollow">https:&#x2F;&#x2F;www.ncbi.nlm.nih.gov&#x2F;pubmed&#x2F;20669601</a><p>[7] Does Rehab Work as a Treatment for Alcoholism and Other Addictions? <a href="https:&#x2F;&#x2F;www.scientificamerican.com&#x2F;article&#x2F;does-rehab-work&#x2F;" rel="nofollow">https:&#x2F;&#x2F;www.scientificamerican.com&#x2F;article&#x2F;does-rehab-work&#x2F;</a>
======
celingEff4TW
Burner account here. I've been on MAT for years, during which I've gone to
grad school, worked, and otherwise lived a normal and productive life. A
couple of points/observations.

1) I think an online advertising growth strategy will be hard, or really any
strategy that strictly involves spending X in advertising for the recruitment
of Y in revenue spend. However, people that use drugs talk to each other about
where to get drugs and treatment (surprising, I know), and I would build your
marketing strategy around word of mouth and patient to patient referrals.
Initially reaching these communities are hard, but I would really think about
how well the product can be optimized for patient -> uninitiated patient
referrals, similar to "growth loops"

That said, I've worked in a start up with a similar premise, hire domain
experts to give advice to customers during a life transition, and watched it
fall down as the operations shook apart and the acquisition cost was very
high. It's hard to get both the operations to stay great during the scale out,
and keep the the marketing channels diverse enough so when you tap one out,
another 5 are in different stages of life.

2) When assessing this product for my own use, the thoughts I had where: 2.1
Is this available in my area? How far would I have to travel initially? 2.2 Do
they drug test me like my current place? 2.3 How frequently do I met the
doc/what's the script duration? 2.4 What is expected of me to stay in MAT?

Basically, I have a provider, but with more up front information, might be
willing to switch. However, the website and FAQ are pretty sparse, and I
really don't feel like picking up the phone to talk to someone (flatmates, ya
know?), so I feel like that's kind of a blocker.

Good luck!

~~~
ZackGray
This is incredible feedback, thank you. I’m happy to hear that MAT has helped.
Here’s some color:

1\. We need to be licensed in each state in which we operate, which limits our
reach.

2\. Our lawyers tell us that a “referral program” is illegal. Sounds stupid to
me.

3\. I think you’re right about the phone call. What would you recommend
instead? We have the text prompt up top, but it’s not the main call to action.

You seem like a great person to get to know. Email me if you’re interested in
chatting more. I appreciate it.

~~~
burnaway
Try to uncover more angles to the "referral". Is it illegal because they
receive compensation/cut? If yes, build it around "being the hero" for people
not directly affected but have huge stake or motivation to help addicts (like
some in this thread) - try and reach people on the edge of communities most
affected by it - for example, distribute a "qualifier questionnaire" physical
leaflet which gives people free consultation and 30% off list price on
treatment. Your "Withdrawal Heroes" would get a pack and they could drop some
off in relevant places in their communities or give to people directly - they
probably know what places to hit better than you could identify effectively.
The value for them is helping others; this might be your better bet anyways
compared to referral $$ incentive anyways. Next step is to use people in
recovery who used your system for similar little bets and more - giving talks,
spreading the word in communities as part-time employees for example (some
sort of "ambassadorship" for the lack of a better word). ps. I'm in Europe and
only following opioid news from the distance, just want to add keep it up and
good luck with the project, more stuff like this is needed happy to brainstorm
or invest some more time in coming up with ideas pro bono just let me know

------
davecyen
Sorry to hear about the loss of your girlfriend. This is an amazing way to
honor her life, and important work you're doing to help solve a painful
problem for millions of people. I've lost a family member to this disease, and
have friends who have as well. I'm going to share this with someone I know who
is also battling opioid addiction today. Thank you for building this.

~~~
ZackGray
I'm so sorry to hear that, but I really appreciate your words of support, and
I hope whoever you know who is struggling is doing OK. The biggest barrier to
accessing treatment is just the lack of awareness that it exists. Please reach
out if you want to chat or want more information as they consider options.

------
30d100n
Hello Zack! Thank you so much for working in this space. I am a recovered
opiate addict, who benefited from medication-assisted treatment a few years
ago. I have come a long way from being homeless and living on the street in
Austin, Texas for 2 years. I am now a good father and husband, and I have a
pretty damn good job too. It was truly a life and death struggle, against HUGE
odds, and I'm definitely one of the lucky ones.

You're correct that this is a tough space. I've been in and out of the
"recovery community" for a couple of decades, and I think you may have only
scratched the surface of how complex this market is. I would love to chat. I
think I may have some good ideas for breaking through those barriers you're
facing. I've created this burner to respond (re:stigma)and I've also created a
burner email. Hit me up at the mail service of proton with the name
"30days1000nights"

------
orangefarm
I’ve got nothing useful to add except saying that I find it inspiring that you
were able to turn a personal loss into entrepreneurial energy for positive
change.

Good luck to you guys. I’m certain that your endeavors would make her proud.

~~~
ZackGray
I really appreciate that - and it's useful to me! Thank you.

------
Cyberdog
> 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.

When you say "regulations" here, do you mean government law, or just the rules
of online services as in your examples?

To advertise to addicts, go where the addicts are; bulletin boards in halfway
houses, homeless shelters, probation/parole offices, and clinics that offer
court-mandated treatment programs. Granted, these are the places where the
most down-on-their-luck addicts will be, but perhaps they will be more open to
change than the "successful" ones. That said, you might have some luck
targeting those types on web forums for drug addicts and experimenters - some
of these use their own in-house ad systems rather than something like AdSense
for obvious reasons.

(If it sounds like I might know some things about where you can find drug
addicts… well…)

I wish you nothing but the best of luck with your project.

~~~
mattangriffel
While there are some regulations (both state and federal) around what we can
and can't say publicly, most of our obstacles so far have been the policies of
sites like Facebook, Google, Reddit and the like. Many of them have gotten
into trouble before with scammy rehab programs preying on vulnerable
populations, so they've made it incredibly difficult for startups like us who
have something new to offer to even get the word out. We're working on it, but
it's still hard.

I agree with you about getting the word out in a grassroots way, and we've
definitely been to some of the hardest-hit areas out there. The problem is
that 80% of opioid users aren't currently seeking treatment and are just like
you and me, but living with a secret problem. Those are the people we want to
reach and let them know there are options for them.

~~~
projektfu
Maybe see if you can partner with a national pharmacy to put flyers in opioid
prescription bags. Not sure of the pros and cons but it would really get the
message out.

~~~
Cyberdog
If you can get a pharmacy on board with the idea of encouraging their
customers to stop buying their products, sure, but most of the worst ope
addicts aren't getting their pills from pharmacies…

~~~
projektfu
Don’t be so cynical. I sell drugs in my practice. I don’t want any addicts
buying them.

I think the current opioid problem in the US _is_ a prescription opioid
problem.

------
whiddershins
Reach out to Scott Adams. He is passionate about this topic and signal boosts
startups he believes in.

With that in mind, also look in to podcast ads, or doing interviews wherever
interviews are done, as there is enough human interest to make that possible.

~~~
mritchie712
podcasts are a great idea, I'm sure there are a several big ones dealing with
addiction.

------
tonydiv
Hi, Tony here, Flower Co W19

I'm really keen on what you're working on. It's fantastic. I am a big believer
in what you're doing.

I have some marketing ideas for you. I work in cannabis so I face all these
same challenges of closed tech platforms.

Email is in profile, let's talk

~~~
ZackGray
Thanks Tony, your support means a lot. I will email you to continue this
conversation. Looking forward to hearing more.

------
goatsi
>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.

Those limitations were added as a response to real abusive and harmful
practices [0]. Just changing the advertising rules hasn't solved the problem,
now almost any drug related search has had the results SEOed into complete
uselessness by rehab companies. The answers they give to basic questions (what
doses are harmful, is it safe to mix these substances) are usually misleading
and sometimes explicitly false in order to maximize their conversion rates.

[0] [https://www.theverge.com/2017/9/7/16257412/rehabs-near-me-
go...](https://www.theverge.com/2017/9/7/16257412/rehabs-near-me-google-
search-scam-florida-treatment-centers)

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

Can you restructure the strategy so that the business can operate with a low
(initial) growth rate ? You might find success by partnering with regional
public health officials, who would sponsor or subsidize real world
advertisement.

I live in Europe and last time I was in NY the subway was full of public
health billboards encouraging people to carry naxalone.

Maybe you can convince one official or non profit somewhere to subsidize those
billboards for you. You're not only solving a personal problem for the
addicted, your solving a societal problem. I imagine that if you can show
efficacy in one or two pilot regions, you'll have an easy time partnering with
other ones / raising money (maybe non vc) / funding acquisition yourself.

My $0.02, hope it helps and good luck, nice to see startups doing important
things.

~~~
mattangriffel
Appreciate these thoughts talolard. I like the idea of partnering with local
governments and non-profits, and would welcome any introductions or
suggestions there. As you mentioned, most would want to see efficacy in a few
pilot regions first, which is what we're currently working on.

~~~
petra
You're working on proving your process.

Do you have enough patients to do that ?

If you do, why do you seek growth? Isn't it better, in the long term, to prove
yourself, build a stable foundation and a good reputation among clinicians and
than scale ?

------
mwseibel
I am really excited for this startup. Opioid crisis needs to be addressed and
I think this is one of the many steps that can help the people/families who
are suffering.

------
prostheticvamp
As a pain specialist, I ask you to strongly incorporate one more element:

Make it ridiculously easy for the patient to put your docs in touch with
(other docs). At some point they will land in the hospital, and ONLY having
your doc talk to the attending on the other hand will save them from under
treatment and withdrawal.

~~~
ZackGray
This is great feedback. I would love to talk more about this. If you’re open
to it, send me an email at zack@meetophelia.com.

------
gsjbjt
Have you seen this? Not sure if it's helpful for your regulatory problem,
perhaps you could reach out this guy:

[https://onezero.medium.com/900-000-americans-tell-google-
the...](https://onezero.medium.com/900-000-americans-tell-google-they-want-to-
try-buy-or-quit-heroin-every-year-48f725ee5db9)

~~~
mattangriffel
Wow this is great. No I hadn't seen this but I'll definitely be reaching out
to him. Thanks!

------
cturitzin
Congrats on the launch Zack!

Possible G and FB have gotten faster and better with their detection of health
specific ads, but up until about a year ago, one temporary workaround (while
waiting for legitscripts) was to create an Instapage or Leadpages landing page
with a subdomain (eg. lp.meetophelia.com) and direct ads there.

~~~
ZackGray
Thanks! That's definitely a good suggestion, but there's always the risk they
disapprove of something like this and then reject our certification - which
would make it not worth it.

------
primitivesuave
Thank you for building this. I lost my best friend, someone I'd known since I
was 2 years old. It is painful to learn that MAT could have saved him, but
also uplifting to think of the people who will be saved by this.

With that said, I work in healthcare and want to warn you about the HIPAA
implications of using Google Analytics (which is not HIPAA compliant nor
covered under a Google BAA) on your scheduling form for consultations. This
can connect PII to a health condition in Google's system by means of a Google
universal identifier.

I am the CTO at a healthcare startup and sincerely wish you the best in this
venture, and will gladly/freely offer any knowledge I have to you - let me
know if you'd like me to elaborate by email.

~~~
mattangriffel
Thanks for the tip, would love to chat further if you want to shoot me an
email at mattan@meetophelia.com

------
VvR-Ox
Please do not feel offended by my words but I would never ever use a service
like this.

The question in most cases in my opinion is not "will there be a data breach?"
but when it will occur. Leaving this kind of data on some servers of some
company just opens the door for patients to be extorted etc. in the future.

I like the idea of apps and computers helping us with problems like that but
in our world services and devices are just not trustworthy enough for my
taste.

Maybe a desktop app on a device that has no internet connection would be a
reasonable alternative.

I wish you good luck with your business though and keep my fingers crossed
that somehow your data remains secure.

------
pedalpete
I think this TED Talk did a great job of describing why this is such a huge
issue, and how people get into the state of addiction
[https://www.ted.com/talks/travis_rieder_the_agony_of_opioid_...](https://www.ted.com/talks/travis_rieder_the_agony_of_opioid_withdrawal_and_what_doctors_should_tell_patients_about_it?language=en)

What you're doing is incredibly inspiring. I have a friend who ha to kick
their morphine addiction alone when the medical system wouldn't support
anything other than continued medication.

I can only assume your girlfriends name was Ophelia. What an incredible
tribute to her memory.

------
peteretep
When I was trying to kick a Doctor-originated benzo habit, I spent a lot of
time on a community forum called BenzoBuddies, and it was a life-line for me
and many other users. There's got to be a glut of opiate-focused boards? I
think if you can establish legitimacy with them, building a direct advertising
relationship with them might help?

------
Ourotica
We're in a similar place in terms of restrictions on promotion -- we can't
advertise on any of the major platforms, at all, ever.

One thing that has worked for us is directly reaching out to community groups
or (and I hate that I'm about to use this word) influencers. I'm sure there
are plenty of sober / in-recovery people out there with large followings
and/or community connections who believe in your cause.

It can be tough, because people who dive bomb into a community for the sake of
self-promotion are gross and deserve to be shunned, but there's a balance
there where you're actively participating, and helping, and also telling
people about the thing you're doing to help.

------
dangus
I’m going to get needlessly harsh here.

Is this a for-profit company?

Do you think for-profit companies should be able to advertise medical
products? Because in my view they shouldn’t, full stop.

So you’re up here telling us that one of your challenges is that you can’t
advertise anywhere, and to that I say “good.”

Perhaps you and your 81% white male team/advisors (with zero female/minority
people with executive level decision making ability) could answer to some of
that.

My condolences to your girlfriend, but this isn’t an issue that a web CRUD
platform is going to solve and seeing it laid out in typical Silicon Valley
marketing copy is kind of sickening. It reminds me of some of those less than
stellar web therapy platforms that seem like another way to Uber-ize the
professional therapy workforce into poverty.

------
junkthrowaway
I'm glad you're working on this. I was given opiates as a child and not
getting shot at, beaten, living outside in a northern winter, doing things
that make me horribly ashamed today, could make me quit but Suboxone got me
living a regular-ass life in about a year.

It's been 6 years since I last had any dope, I've achieved so many of the
goals I thought I had abandoned. I still use the subs though, I've tried
kicking and I just can't seem to function even coming off a near homeopathic
dose.

For anyone still in it though it's amazing how fast stopping drugs can improve
your life. Someone out there would be happy if you could even put a few days
together, tried treatment again, or just called.

------
rancar2
Hi Zack and the Ophelia, congrats on the launch! It's great to see others
tackling important problems in the healthcare space. I'd love to see if there
is a way for my team at CareDash to help out. We are a data-driven health tech
startup (the fastest growing doctor review site in the US), and we are very
fortunate to have a scale to impact lives positively. Feel free to get in
touch with me at rcarlton(at)caredash.com.

------
themmes
In the Netherlands anyone can get drugs tested for free and anonymously. I
believe this is a very important point of contact for health officials.

------
irscott
Which medication(s) are you using? My personal experience with both Suboxone
and methadone were absolutely horrible and made my getting clean 10x worse.

~~~
mattangriffel
We're primarily focused on medication-assisted treatment with Suboxone. Sorry
to hear about your experience irscott, it's certainly not the right solution
for everyone.

------
staticautomatic
It's not clear from your post what you're implying when you say you're
restricted by regulations. Are you saying they are regulations you're unable
to comply with? Why?

It's also not clear what the relationship is, if any, between those
regulations and third-party certification. Likewise, is third-party
certification something you're unable to comply with? Why?

~~~
mattangriffel
Oof, where to begin. There are regulations around what states we're allowed to
operate in, what kinds of clinicians are able to see patients, how we have to
treat patient data, and what the clinical protocols have to look like.

In terms of regulations restricting what we can say publicly, besides FDA
regulations around medical claims we're allowed to make, our biggest obstacle
is that many of the common channels available to startups for building
awareness are restricted or blocked entirely. Facebook and Google, for
example, both require LegitScript
([https://legitscript.com/](https://legitscript.com/)) certification. We're in
the process of going through that and it may take several months. That's also
a requirement for us to be able to do payment processing through services like
Stripe, since we qualify as a "high-risk business" since we do both
telemedicine and addiction-recovery services.

But even when we do have those certifications, Google, Facebook, Reddit, and
many other sites have a blanket ban against targeting users who are part of
addiction and addiction-recovery groups.

It's not that we can't comply with any of these regulations (and in fact,
we're working on many of them as we speak), but many of them are really
onerous and time consuming for a startup given the stage that we're at.

------
Barrin92
>There's a problem, though: we're restricted by regulations from letting
people know that this treatment is available.

On this, do you have yourself published research on how effective your
particular application of this treatment is, how many patients stick with it,
or anything else along those lines?

~~~
ZackGray
This is a great question. Our medical directors have published a lot of
research on this protocol (MAT). If you're interested, I recommend this book
by Dr. Bisaga: [https://www.amazon.com/Overcoming-Opioid-Addiction-
Authorita...](https://www.amazon.com/Overcoming-Opioid-Addiction-
Authoritative-Therapists/dp/1615194584)

More generally: MAT is very well researched, vetted, and accepted by the
medical community. Our innovation is in the delivery of this treatment,
through ways that make it easier to opt into and stick with. MAT has
historical adherence rates of 60-70% (same as diabetes and depression), but
often people drop out because they grow tired of visiting a clinic regularly
for group therapy, just to get their medication refilled. We think we can
increase adherence rates by making MAT less of a burden to people,
particularly as they enter into the later stages of treatment.

------
ryneandal
Have you considered using kratom to assist with weaning or helping with
withdrawl symptoms?

~~~
mattangriffel
Mattan here (co-founder of Ophelia). We're certainly considering any options
that are scientifically backed and evidence-based. Medication-Assisted
Treatment (MAT) is the standard in the medical community among addiction
specialists and it's proven to be the most effective solution.

Kratom is certainly one of the solutions that people trying to overcome opioid
addiction are resorting to, but it's unclear whether it's effective — not
enough studies have been performed, and it's not an FDA-approved treatment for
opioid use disorder. There's also some evidence to suggest that kratom
actually leads to more health problems than it solves [1].

[1] [https://www.mayoclinic.org/diseases-
conditions/prescription-...](https://www.mayoclinic.org/diseases-
conditions/prescription-drug-abuse/in-depth/kratom-opioid-
withdrawal/art-20402170)

~~~
ryneandal
Yeah, I see the issue with relying solely on anecdote.

Re: safety of kratom itself: AKA
([https://www.americankratom.org/](https://www.americankratom.org/)) has had
independent physicians look into each reported death involving kratom in the
US, and all have involved various other substances of abuse, none have been
exclusively cause by kratom.

When taking powdered leaf itself, OD is pretty much impossible since you end
up vomiting. There are many extracts and such on the market, but most people I
know partake of (including myself) are wary about strength and clarity of said
extracts.

I'd love to see more of a push for some legitimate research, I think it's
something that could be very effective in this space. Good luck with licensing
and I'll be sure to share the service with ones I know are currently trying to
kick opiods.

~~~
ZackGray
Thanks for your thoughts. I'm interested to see how kratom fits into the
longer-term solution. An issue right now is that its formulation is not
standard, so there are different brands with different concentrations, which
makes it difficult to "prescribe" as medicne. Another problem is that it's
sold at smoke shops along with vape pens and paraphernalia, so people who
aren't already using opioids are trying it out of curiosity and becoming
accidentally dependent.

~~~
stallmanite
Are you implying that you think kratom should not be available otc? If so
you’re completely going against your mission of helping people get off
opiates. I can add to the pile of anecdotes that I personally know 10-15
people who’ve used kratom to kick serious years-long addictions to oxycontin.

------
robertjm221
Hi, I have over a decade of experience working with addiction treatment
centers and getting around these type of issues. The problem is the
certification, I'd be happy to provide some guidance.

~~~
mattangriffel
That would be great! Mind shooting me an email at mattan@meetophelia.com?

------
ely947
Could you explain more by what you mean by Facebook requires a third party
certification? What type of third-party certification and why are you having
trouble getting this certification?

~~~
mattangriffel
Facebook and Google both require LegitScript
([https://legitscript.com/](https://legitscript.com/)) certification. We're in
the process of going through that and we're told it may take several months.

------
ArtDev
This is great work!

I really like the site design and snappy fast pages too.

~~~
ZackGray
Thanks so much. The brand design is really important to me, so I am glad that
it resonates with you.

------
ArtWomb
I think about this short doc from a decade ago all the time

Last Minutes With ODEN

[https://vimeo.com/8191217](https://vimeo.com/8191217)

Best of Luck ;)

~~~
mattangriffel
Wow. That's beautiful, thanks for sharing.

------
batesy
I just wanted to chime in and say that this is incredibly inspiring and I hope
it takes off.

------
whb07
ibogaine ? theres strong anecdotal evidence for this and while it isn't
possible in the US, there are many countries in the world besides the US. Have
you looked into this?

~~~
mattangriffel
Yes! MAPS has conducted and collected some really great research around
psychedelics and their use in the treatment of things like PTSD and addiction.
Specifically, Ibogaine Therapy has shown some real promise around drug
addiction [1].

Unfortunately, it's going to be quite a while before any psychedelics are FDA-
approved. Right now, MDMA and Psilocybin are both in FDA trials (Phase 3 and
Phase 2, respectively) but I think Ibogaine is still quite a ways out.

Interestingly, in terms of your comment about Ibogaine's use outside of the
US: other countries besides the US (and Canada) have not really seen quite the
same problem in terms of opioid addiction as we have here in the US. This is
mostly due to American pharmaceutical companies historically having been
really successful at convincing US doctors to prescribe opioid-based pain
medication [2], and due to the fact that pain was added as a 5th vital sign in
2001 by the Joint Commission [3]. That isn't to say that other countries
haven't had problems with opioid addiction, but it hasn't generally been at
nearly the scale of the problem in the US, and other countries have had
varying rates of success with solutions that haven't been possible in the US
thus far.

[1] [https://maps.org/research/ibogaine-
therapy](https://maps.org/research/ibogaine-therapy)

[2] There's a really great John Oliver segment about this
[https://www.youtube.com/watch?v=-qCKR6wy94U](https://www.youtube.com/watch?v=-qCKR6wy94U)

[3]
[https://www.medpagetoday.com/publichealthpolicy/publichealth...](https://www.medpagetoday.com/publichealthpolicy/publichealth/57336)

------
ficklepickle
Former IV opiate addict here. Medication is great and important for breaking
the physical addiction. But it does nothing to resolve the mental health
issues that led to the dependence in the first place.

Buprenorphine helped me get into a state where I could deal with my mental
health issues with a professional. But until I began to deal with the mental
stuff, I was still very unwell. Addiction is transitive, it pops up in new and
unexpected ways.

Discontinuation of use is only a small aspect of recovery. Don't get me wrong,
I think what you are doing is great. Access to medication is definitely an
issue in the USA. But in Canada, we have easy access to addiction doctors in
urban areas, and we haven't ended addiction yet.

A big part of the problem is general ignorance. Most people still think
addiction is a moral issue. Shame and guilt are fuel for addiction. So hiding
away and getting help in secret compounds the problem both for the individual
and society at large. When people start to see that it affects many people
close to them, that is when the stigma is destroyed.

You wouldn't say you are too busy to get treatment for any other life-
threatening condition.

All treatment centers are not alike. Some are downright harmful. There is a
heady mix of science, mysticism, greed and benevolence. There can be benefits:
removal from environmental stressors, reduces shame by showing you are not
alone, learning about the neuroscience of addiction, bonding with people over
a common struggle, a chance to feel good about yourself.

The human mind loves to simplify things. Oversimplify and your model does not
reflect reality.

Recovery from addiction and underlying mental health issues is not a simple
process. It requires a multifaceted approach, strong personal support and
constant honest self-evaluation. It requires letting go of shame and guilt. It
also requires, of course, discontinuation of use and withdrawal management.

I could go on and on about my experiences and what they have taught me. One
day I might write it down. I want nothing more than to make the road a bit
easier for others. I have spent thousands of hours trying to distill what I
have learned into some sort of essential truths. I haven't got there yet.

I'm going to have to stop myself there. To anyone out there interested, my
email is in my profile. To anybody struggling out there right now: Be kind to
yourself. Find your own path and make your own honest definition of success. I
found keeping track of days of abstinence to be actively harmful. It resulted
in more severe and longer relapses. So I stopped counting. Some said this was
bad, but they were wrong because it worked for me. I identified that the shame
and guilt of "losing" all those days was more harmful than motivating. It's
been a long journey, I couldn't have done it without the support of family. I
wouldn't change a thing though because I finally like myself.

Addiction is a symptom. Treat the symptom while working to address the
underlying causes.

Thank you for your work.

------
brianprovost
Might want to reword this sentence in the FAQ under "Who do I see on the first
visit?":

"It is the law, the first visit be in person."

~~~
mattangriffel
Fixed! Thanks for catching that Brian.

~~~
brianprovost
You are welcome!

------
phemartin
Link: meetophelia.com

~~~
dang
Added above now. Thanks!

