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

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.

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

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

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

This is entirely anecdotal, but I know six people who've quit either heroin or prescription/illicit oxycodone usage via Kratom.

The only real problem to Kratom is that there is no standardization to potency or means of labeling.

The percentage content of the active alkaloids in Kratom (Mitragynine and 7-Hydroxy-Mitragynine) can vary widely, with the stuff sold in gas stations and smoke shops being particularly low-potency or volatile.

The worst that will happen in the event of a Kratom overdose though, is horrendous nausea and vomiting that will make you wretch at the sight of the stuff for a good while.

Another personal anecdote, I have been a daily user for several years and had periods of weeks/months without use due to inconvenient life circumstances (traveling, too busy to buy more, etc) and never felt any ill effects from sudden cessation. Some people online report the opposite, though I suspect this might be largely psychological.

I don't know if you guys are aware of it, but two other overlooked medications for opiate withdrawal/recovery are Baclofen and Loperamide (yes, Immodium, the drugstore constipation medicine).

Immodium is active at the mu-opiod receptor but does not cross the blood-brain barrier, and so is not psychoactive. This can help to ease some of the withdrawals without risk of relapse.

Baclofen is mildly psychoactive but helps with opiate and benzodiazepine or other GABA-ergic drug withdrawals, with much less of the risk factors associated with traditional medications like methadone or buprenorphine.

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.

>> 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.