My main problem with alcohol was that I drank too much.
An after-work cocktail could spiral into a binge. Weddings and ski trips were danger zones. Social anxiety or a need for social connection could be a reason to order another drink. And then two or three felt so good that I wanted nine or ten.
Binges, blackouts, and bad decisions started to accumulate. My health, energy, creativity and important relationships suffered. I experienced withdrawal symptoms after multiday binges and ended up in the emergency room after a scary fall and again because of a panic attack.
I knew that I had a drinking problem. I felt regret and shame and vowed to drink less or quit.
I tried AA and psychotherapy, and each was helpful in its own way. But neither had much of an impact on how much I was drinking.
The turning point
After fifteen years of inconsistent progress, a turning point came when I saw a primary care doctor who suggested a new option.
I was not interested in giving up drinking entirely. I just wanted to cut back. He accepted my goal of moderation rather than lifelong sobriety and suggested prescription medication as a tool that might help achieve it.
He prescribed naltrexone. He encouraged me to take it daily, make a concerted effort to drink less, and follow up with him in a few months.
I filled my naltrexone prescription that day. Then let it sit on my bathroom shelf for a month.
My ambivalence was twofold. I worried that naltrexone wouldn’t work. And I worried that it would work: how would my social life change if alcohol was no longer at the center of it?
Eventually, I took the leap. I told myself, “Let’s consider this an experiment. I’ll take one tablet, have one drink, and see how it goes. If it doesn’t work at all, I’ll be no worse off.”
I was lucky to experience an immediate response. Alcohol felt less exciting and rewarding. I could be satisfied with one drink. If I poured a second, I might not finish it. I was finally back in control of alcohol rather than feeling like it controlled me.
When I told my friends that I was trying to drink less, they were supportive. Many thought the change was overdue.
I still remember the first time I left a bar with two-thirds of my beer sitting on a table unfinished. In the past, I would have been more likely to finish someone else’s drink than to surrender my own. Something profound had changed in my relationship with alcohol.
The decision to build something
About a year after starting on naltrexone, I found myself on a work trip to New Orleans. It is a city I love, but also one where I had historically abused alcohol.
This evening was different. I found myself winding down at 9 pm, and it struck me: I would be well-rested and ready for an early meeting the next morning.
A year earlier, that would have been unthinkable in that city.
That quiet moment planted the first seed of an idea: more people needed access to the medication that had changed my relationship with alcohol.
I had spent fifteen years searching before anyone mentioned medication as an option. And I worked in healthcare. I considered myself a well-connected, well-informed healthcare consumer. If it took me that long to find naltrexone, I suspected the problem was structural, not personal.
It didn’t take much research to confirm I was far from alone. Thirty million Americans meet the diagnostic criteria for alcohol use disorder. Fewer than 3% are ever prescribed any medication to help them drink less or quit.
I saw ads for erectile dysfunction pills and hair loss medication prescribed via telehealth and delivered nationwide, but not for the safe, effective medication that had helped me take back control over alcohol.
That felt wrong. And fixable.
Founding Oar Health
At the time, I was working at a large health insurance and services company, doing work I loved. I was not the kind of person looking for a reason to quit my job. The idea of starting a company was something I weighed carefully.
I took a deliberate path. I spent close to two years from idea to first customer. I partnered with a business incubator that contributed resources and technical expertise I didn’t have — financing, software engineering, and product design. Together, we built the first version of what would become Oar Health.
There was also a practical reality: you cannot simply start shipping pharmaceuticals from your apartment. Building a healthcare company responsibly required money, compliance infrastructure, and clinical relationships from the beginning. The incubator path made that possible without requiring me to abandon a career I valued before I knew whether the idea would work.
What finally pushed me to take the leap was not the market data, though the statistics were clear. It was the response from the first few people who found Oar and used it. Their stories echoed mine in some ways and diverged in others, but what they had in common was relief. Early results. A sense that something had shifted. That was enough.
So, I went all in on Oar Health — a telehealth platform that provides private, convenient, judgment-free access to naltrexone plus expert, empathetic support as members use the medication to work toward their sobriety or moderation goals.
Since launch, we’ve helped more than 75,000 people start naltrexone treatment through Oar. We now enroll over 3,000 new members each month. According to their feedback, about two-thirds are meeting their goal of drinking less or quitting.
Why naltrexone remains so underused
The question I hear most often is some version of: if this works, why haven’t I heard of it? After five years building Oar and fifteen years before that trying to find help, I think the answer comes down to three things.
First, naltrexone has been available as a generic for decades, predating the era of direct-to-consumer pharmaceutical advertising. There is no drug company with a financial incentive to make it a household name, like Viagra or Prozac.
Nobody — except Oar Health — is spending money to make naltrexone famous.
Second, most physicians still receive insufficient training in addiction medicine relative to how often substance misuse shows up among their patients. Medical school curricula tend to go organ by organ, and addiction doesn’t fit neatly into that structure. Too many patients are still being handed a pamphlet for AA when a prescription might serve them far better.
Third, stigma persists. The phrase “don’t replace one drug with another” still gets said, even about a medication that is neither addictive nor subject to abuse. The shame people feel around their drinking makes it hard to ask for help. Even clinicians can be reluctant to raise the subject for fear of alienating their patients. The result is a medication that works, sitting unused on the shelf while millions of people who could benefit never learn its name.
Learning from our members
I’ve learned from our more than 75,000 members that my experience represents only one data point in a rich array of recovery stories.
Some members pursue goals of moderation, like me. Others commit to sobriety. Some take naltrexone daily, as I did. Others find more success with targeted use, such as The Sinclair Method.
Some respond quickly. Others find it takes weeks or months to see meaningful progress. And some find that naltrexone is not the right tool for them. We encourage those members to keep exploring other medications and other forms of support.
Each person differs in the recovery toolkit they assemble. Many use the coaching and tracking tools we offer at Oar or attend the weekly SMART Recovery meetings we host. Others combine medication with AA, Moderation Management, individual therapy, or group therapy. Yet others find what they need through exercise, online community, or support from friends and family. What they each have in common is a desire to build a life where alcohol takes up less space.
What I know now
What I know from my own story and from our members is this: recovery is possible, options are more numerous than most people realize, and it is never too early or too late to start assembling the toolkit that fits you.
Medication is one of the most important tools to consider putting in that toolkit. For too long, it has been the last thing people learn about, when it should be among the first. I spent fifteen years finding that out for myself.
Oar exists so that more people can find out sooner.
If you are struggling with alcohol yourself or are concerned about a loved one, feel free to reach out via Oar’s website: https://www.oarhealth.com/our-story
Disclosure: Joe Volpicelli, series editor, serves as Senior Adviser at Oar Health. Jonathan Hunt-Glassman is the founder and CEO of Oar Health.
Editor’s Note (JRV)
In start-up businesses, people often begin with an MVP, which stands for minimum viable product. An MVP is a lot like a scientist testing a theory. Before investing too much in a product, one builds the smallest possible version to test it, then uses the results to learn what actually works. Based on the result, one refines the model for the next version.
I first met Jonathan Hunt-Glassman at a naltrexone symposium in 2024. What stood out to me was the way he thought about the problem. He spoke about establishing Oar Health the way a careful researcher speaks about a clinical trial: form a hypothesis, test it empirically, analyze the results, and revise accordingly. No hype. No grandiosity. Just a disciplined attempt to solve a problem he knew personally and understood professionally.
His approach matched my own beliefs. Theories are only our best approximations of the truth, and progress comes from continually testing and refining them.
That conversation is why I later agreed to join Oar Health’s advisory board, a role I want to be transparent about here. Science alone is never enough: proven treatments only matter if people can get them. In Jonathan, I found someone applying the same empirical discipline to the problem of access that my colleagues and I used to study naltrexone’s safety and efficacy.
Rather than treating access as a marketing problem, he approached it as an implementation problem. Oar was deliberately designed around the barriers that had kept naltrexone out of reach for so many people: limited physician training in addiction medicine, the stigma of asking for help, and the near invisibility of a generic medication with no advertising budget behind it.
In 2024, approximately 700,000 Americans with a diagnosis of alcohol use disorder were taking an FDA-approved medication to treat it. Naltrexone accounts for the large majority of those prescriptions. Oar Health has now helped more than 75,000 people begin treatment with naltrexone and enrolls over 3,000 new members each month. That is a remarkable share of everyone currently using medication to cut back or quit their drinking, for a company that did not exist five years ago.
Jonathan’s essay belongs in this series because the grassroots movement around naltrexone did not emerge only from research labs and advocacy groups. It also emerged from people who looked at a thirty-year-old medication that almost nobody was prescribing and decided that it was a problem worth solving.
