Addressing Alcohol Use Disorder with Jonathan Hunt-Glassman

george grombacher 0:02
Jonathan Glassman is the CEO of or health. They’re an organization providing medically assisted treatment for alcohol use disorder. Welcome, Jonathan. Thanks for having me. excited to have you on. Tell us a bit about your personal lives more about your work and why you do what you do.

Jonathan Hunt-Glassman 0:21
Well, I spent my whole career in healthcare as a product manager as a strategist as a consultant. But what we do at our health is really the combination of that professional background and some aspects that are much more from my personal life, specifically that I’ve struggled with alcohol misuse, pretty much my entire adult life, what started as binge drinking in high school and college became a pattern of drinking to black out in my 20s. And then as I saw peers start to put excessive alcohol use behind them. The opposite was happening for me, I was having multi day binges, and starting to experience the physical and mental health symptoms of withdrawal on the back end of those. And it was no secret to me over those 15 years or so that I had a drinking problem. So I sought treatment and a lot of the places that first come to mind for any of us, Alcoholics Anonymous, individual psychotherapy, the emergency room without a lot of planning, and pretty much always heard of the same thing, which was you need to stop drinking and start going to meetings. And I gave that a shot. But it didn’t click for me, what was much more of a turning point was connecting with a primary care physician who had some experience treating addiction issues. And he did two things that felt brand new to me, accepted my goal of moderation, rather than lifelong sobriety, and suggest prescription medication as a tool in the toolkit to achieve that goal. Those two things were great for me. And I haven’t looked back personally. But it also opened my eyes to how much work we have to do for the 29 million people in the United States who have alcohol use disorder in terms of providing them with the same range of effective evidence based options. And so that’s our health, we help people get connected to a clinician who can prescribe safe, effective FDA approved medication that can help them drink less or quit. So

george grombacher 2:34
how, how old were you when, when when you started the company?

Jonathan Hunt-Glassman 2:40
It was about? We’ve had we started in January 2021. I’m 39 now so I guess 37?

george grombacher 2:47
Okay, and how long had you from from the time that you saw that primary care doc to when you founded the company, how long was that

Jonathan Hunt-Glassman 2:56
was about five years, that kind of I was making this progress in my personal life that I was super happy with. But also now and then thinking and even having conversations with individuals in my life who also had the goal of drinking less or quitting. And I could kind of see often kind of the look on their face when I mentioned what was working for me. And you know, typically, they were really surprised that there was a medication that could be helpful to them. Because there’s a low harness of this option. The biggest problem is that less than 10% of people with alcohol use disorder get any sort of treatment. But even among those who get treatment, a minority are prescribed one of the three FDA approved medications. And so the more of those conversations that I had, the more I came to feel a there are a lot of people that could benefit from at least awareness of this option. And be there might be an opportunity to build a business around closing that gap.

george grombacher 4:05
For sure. So I’ll be 45 here in a couple of weeks. And you and I probably walk pretty similar paths of like recognizing just pretty much everything you described high school college drinking too much and I have been able to be like one of those people who dialed it down. But I could have easily seen myself going the opposite direction and know plenty of people who have gone the opposite direction. And I’m sitting here completely unaware that there are medically described or or FDA prescribed medications. So awareness is obviously at least from me, from my perspective, a huge issue.

Jonathan Hunt-Glassman 4:46
It is and appreciate your your sharing the echoes of my story. I think, you know, one of the things that jumps out at me about what what you describe George is that there’s no one In version of recovery, sometimes that’s what’s represented to us in the stories we see in the media. But there are a lot of folks like you who are able, as they get a little older, grow up, maybe make some other changes in their life are able to dial it down and move away from patterns of alcohol misuse that were causing problems in their in their lives. And then there’s a big group of us that need a little bit of help. And that can be in the form of prescription medication, it can be in the form of mutual peer support. So a would fall into that category. But there are other options within that category to things like smart recovery, things like moderation management, it can be working with an individual coach, counselor, or therapist. And so you know, one of the biggest kind of probably, things that I wish more people kind of had an awareness of earlier is that there are multiple pathways to recovery, some self entirely self guided others with the help of someone. And even within that help of someone bucket, there are numerous evidence based options, some of which are going to be better and worse fits for any individual.

george grombacher 6:22
I appreciate that. It strikes me is, I don’t know if I’ve become more thoughtful if I was always thoughtful, but I’ve been doing more thinking. And I think since I had kids, which has now been, I have a seven year old and a four year old, and, and a baby, essentially. And that changed my perception and just just just my, my perspective on the world. But I recognize that there are things that I struggle with, and I’m afraid of doing. And I’m ashamed of having done and things I’m ashamed of doing. And it does mean no good to just be ashamed of them, because I keep doing it. And maybe sometimes I even do them more, because I am ashamed. It’s like the death spiral kind of a thing. And I’m sure that that’s very, very, very common. And so I think it’s So absolutely, I think that will probably resonate, that you’re making this available to people in a way that is accessible. I don’t know if that’s the right term.

Jonathan Hunt-Glassman 7:26
Yeah, access to safe, effective options is one of the things we think about and try to provide the most. So the word is right on. And, you know, I think sometimes what we’ve seen in the more than 25,000 people that we’ve we’ve served at or health is that sometimes just taking one simple, effective step forward, can be the beginning of breaking out of that cycle of shame and repetitive compulsive or addictive behavior that you described. And that will sound familiar to almost everybody who has a pattern of alcohol misuse. You know, sometimes we have this mental image that things just keep getting worse, worse, worse, worse, worse, worse, worse, then you hit this point called rock bottom, and then things get better, better better. That’s not really what I’ve seen, in my experience, I think most of us who struggle with behaviors we’d like to change, who are more familiar with a cycle of regret, trying to commit to change, struggling to achieve that change, feeling of regret, again, and I think one of the things that folks find helpful about any sort of intervention, whether it’s going to a meeting, meeting with a counselor, or starting with safe effective medication from the comfort of their own home, is it can be kind of something that breaks that that cycle.

george grombacher 8:59
Yeah, just moving more towards the solution. Instead of just trying to white knuckle it on on on your own, because I’ll just use me again, as an example. I am fully capable. Jonathan have white knuckling through things and running through walls. In fact, that’s probably something I’m very proud of. But that which serves that which feeds me destroys me kind of a thing because it also directly feeds into and I’m sure that the term addiction is is maybe a third rail term, which is why it’s not necessarily but certainly misuse.

Jonathan Hunt-Glassman 9:40
Yeah, I don’t have any any problem with the with the term. You know, I think my my view is, everyone needs to find kind of the right words that makes sense to them in terms of describing the either With the problem they’re trying to address or the change they’re trying to create in their life, it is true as if you old, if you talk to professionals, we’ve moved away from the term alcoholic, for example, and towards a term like alcohol use disorder, which is the current diagnostic terminology, and I think is helpful in that it’s defined as a spectrum disorder with mild, moderate and severe subtypes. And I think that helps to get to certainly what my experience has been. And I think your story, you know, supports it in some ways, which is, it’s not really right to look at the world as there are two groups of people, alcoholics, who can never have another sip of alcohol again, and must remain abstinent, and then people who have no problem with alcohol whatsoever, there are clearly a lot of us that fall somewhere between those two poles. And one of the things we try to encourage people to think about is that it’s it’s never too early to start making a change, you don’t have to wait for that rock bottom point. Some of our members describe it as I’m seeing yellow flags in my life. Maybe they’re not red flags yet, but I’ve noticed them, and I want to change that. And that’s great. You know, think of any other chronic condition with the potential to get worse and worse. Do you want to wait until someone has a heart attack before you start lowering their blood pressure and cholesterol? No, of course not. You want to try to intervene as soon as possible?

george grombacher 11:38
That makes a lot of sense. And it’s so so human of us to just want to go a or be black or white? I don’t have time for nuance, Jonathan? Totally. There’s so much space. All right. So you mentioned your interaction with a primary care physician who made you aware of these different interventions. How many primary care Doc’s out there are are aware is that is it an actual field or

Jonathan Hunt-Glassman 12:13
you’re hitting on one of the main reasons that these medications are so under prescribed and under utilized. And that’s not just my opinion, that’s what the National Institute on Alcohol Abuse and Alcoholism would tell you. Awareness, training and comfort with these safe effective medications among physicians is not as high as it should be. I’ve spoken to physicians our age, who said that when they were in medical school, looking back, they can’t believe how little time was spent on issues of addiction, given how frequently it presents in their day to day work. Historically, that physician training has kind of shunted off issues of addiction and said, Oh, you need to go to specialty treatment, you need to go to rehab, you need to go to AAA, those are all options on the menu. But it’s also true that any licensed prescriber in the United States can get someone started on on these medications and primary care, emergency room. These are all great settings to get started. And so we have a lot of work to do to train and increase the awareness among physicians, the trend is in the right direction. But still still a long way to go. That’s one of the reasons we created our health is we wanted to create an option for people who need help right now and can’t wait for two more generations of physicians to catch up with the evidence on this.

george grombacher 13:49
Yeah. All right. So you have gone and sought out a network of for lack of a better term of Doc’s that are well trained and do understand.

Jonathan Hunt-Glassman 14:03
Yeah, that’s right. So we’ve worked with our chief clinical advisor is one of the key is one of the X is an expert in this field. He’s actually done significant amounts of research on the use of these medications in primary care and other community settings, as well as practicing in a clinic across the river in in in Manhattan, where these medications are prescribed every day. And then, just as you said had built up a network across 41 states of doctors and nurse practitioners who have been trained in the appropriate use of this medication and are ready via telemedicine to help patients for whom they’re a good fit. Get started with the

george grombacher 14:50
What’s with the nine other states?

Jonathan Hunt-Glassman 14:54
Good question. The regulations of telemedicine are complex. and evolving, and we take them very seriously. So we have gone state by state to those 41. When our model our the way we provide services, where we have clinicians licensed can accommodate. So we’ll get there. We want to do it the right way. Yeah.

george grombacher 15:21
All right. So walk me through the walk me through the experience, I go to the site, just kind of take me through how it works, please,

Jonathan Hunt-Glassman 15:29
we try to make it as easy as possible to get started, folks come to us at Oral Health, OA, our health.com. And there they can learn about alcohol use disorder, medication assisted treatment, the specific medications that are available. If that seems like something they’re they’re interested in, they click on one of the big get started buttons, and then are guided through a series of questions about their patterns of alcohol use their general medical history and the medications that they’re on. And then they do need to verify their identity by uploading a copy of their driver’s license back to those telemedicine regulations. All of that gets bundled up and shared with a clinician who’s licensed in their state, that clinician may have follow up questions, all with the goal of putting together an individualized treatment plan that will often include non medication resources, so forms of support that they may be able to access online or in their community. And then when medically appropriate a prescription most commonly for a medication called naltrexone, which is kind of the recommended frontline medication for this condition. And then at the patient’s choice, they can either get that prescription sent to their local pharmacy, or what a lot of folks do is get it delivered from directly from our mail order pharmacy partner so that it comes in discreet packaging right to their front door, then they can always come back to or health and get back in touch with that prescribing clinician if they have any questions, side effects dosing results, I’m seeing typical or atypical, what might we need to layer on to the medication, things, things like that. But that initial get started process is usually concluded within 24 hours.

george grombacher 17:21
Nice. I love it. Jonathan, thank you so much for coming on and sharing your story and starting to bring awareness to these different solutions that are out there. And the reality that not everything needs to be binary and black and white. And there’s a potential that you can change your relationship with alcohol and if you are seeing those yellow flags, or those red flags or any color flags at all, go to or health.com o ar health.com and get well thanks again.

Jonathan Hunt-Glassman 17:58
Thank you, George. Thank you, George for using your platform to help spread the word about this option,

george grombacher 18:04
for sure. And until next time, remember, do your part by doing your best