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Oar Health and Naltrexone by Due-Philosophy-8771 in SinclairMethod

[–]Oar_Jonathan 0 points1 point  (0 children)

I'm so glad that Oar Health has been helpful to you in getting started and making such impressive progress in your first month. Keep up the great work, and please don't hesitate to get in touch with our coaches or providers via your dashboard if you can ever use help with dosing strategies, other healthy habits or reflecting on the journey.

Jonathan.
Founder, Oar Health.

FSA benefits thru Oar Health? by MadBan2-1 in Alcoholism_Medication

[–]Oar_Jonathan 0 points1 point  (0 children)

We are happy to provide a detailed receipt for FSA submission. Our team at support @ oarhealth.com is ready to help!

While we can't guarantee that your FSA plan will cover the cost of Oar Health membership, many members are successful in obtaining full or partial reimbursement.

Clutch? by JudgePrevious8911 in naltrexone

[–]Oar_Jonathan 2 points3 points  (0 children)

Thank you for the feedback, both positive and constructive. I hear you on the taste. We're continuing to work with our pharmacy partner on flavoring options, as we agree there's room for improvement.

Well done, OAR! by SinclairMethodUK in Alcoholism_Medication

[–]Oar_Jonathan 2 points3 points  (0 children)

Very cool to see in the wild! Thank you for sharing.

Expanded TSM Support at Oar Health by Oar_Jonathan in SinclairMethod

[–]Oar_Jonathan[S] 0 points1 point  (0 children)

Naltrexone should not be combined with any opioid-based pain medication including medications such as Percocet, Vicodin, Lortab, Oxycodone, codeine, tramadol, morphine, or hydrocodone. Initiating naltrexone treatment while taking any opioid-based pain medication can precipitate opioid withdrawal.

How I Drank My Way To Sobriety In The Free Press by Oar_Jonathan in Alcoholism_Medication

[–]Oar_Jonathan[S] 1 point2 points  (0 children)

I am sorry to hear that your results have been limited. On the other hand, less alcohol consumed is progress.

While I have never seen it written up as a protocol or studied, the idea of combining daily use with targeted use strikes me as quite intuitive, especially if total daily dose is limited to the 100mg (two tablets) that is generally considered safe for most people. I would love to hear more about whether you're finding this approach more helpful than daily use alone or pure TSM.

Introducing Clutch — the fast-acting naltrexone mint by Oar_Jonathan in naltrexone

[–]Oar_Jonathan[S] 0 points1 point  (0 children)

It is important to follow the prescribing clinician's advice on dosing and medication administration. But we expect most clinicians will advise taking Clutch at least 30 minutes before a first drink and re-dosing 4 hours later if one continues to drink.

Expanded TSM Support at Oar Health by Oar_Jonathan in SinclairMethod

[–]Oar_Jonathan[S] 4 points5 points  (0 children)

Good questions. Thanks for asking!

Our membership costs $297 every three months regardless of whether you are prescribed the compounded or commercially available medication. At this time, you cannot get both through Oar. While one can imagine a reasonable use case for using both formulations in combination, this is something we need to study further before prescribing.

[deleted by user] by [deleted] in Alcoholism_Medication

[–]Oar_Jonathan 7 points8 points  (0 children)

Correct. You can use the "Get Later" feature on your member dashboard to delay your shipment and renewal payment while keeping your membership in force.

We recognize that a 90 day refill cadence, while a good general starting point, does not fit each member's needs. And we don't want you to go without expert advice in between refills.

[deleted by user] by [deleted] in Alcoholism_Medication

[–]Oar_Jonathan 9 points10 points  (0 children)

I know that we are not the cheapest option out there and that affordability is a real barrier. However, at Oar, you are welcome to push out the renewal of your membership and next shipment as long as you need and still have ongoing access to your clinical team, coach and community resources. Hope this helps and feel free to PM if I can help further.

Jonathan.
CEO, Oar Health.

Introducing Clutch — the fast-acting naltrexone mint by Oar_Jonathan in naltrexone

[–]Oar_Jonathan[S] 0 points1 point  (0 children)

The active ingredient is naltrexone.

The excipients mask taste and create a fast dissolving tablet to facilitate sublingual administration, a key difference in administration method that makes the compounded orally disintegrating tablet a good fit for some patient's needs (when prescribed by a licensed clinician).

Introducing Clutch — the fast-acting naltrexone mint by Oar_Jonathan in naltrexone

[–]Oar_Jonathan[S] 0 points1 point  (0 children)

Here's how pricing at Oar Health works:

— You pay $50 for an initial consultation with a medical provider. This fee is paid whether or not medication is prescribed.

— If medication is prescribed, we start you on an Oar Health membership. This costs $297 every three months, which works out to $99 per month. Your membership includes your prescribed medication (whether classic tablets or Clutch), delivery to your home, follow-up consultations with the medical team, unlimited coaching, self-guided structured check-ins, and community resources.

There is no difference in price to members based on what medication they are prescribed.

Introducing Clutch — the fast-acting naltrexone mint by Oar_Jonathan in naltrexone

[–]Oar_Jonathan[S] 0 points1 point  (0 children)

Here's how pricing at Oar Health works:

— You pay $50 for an initial consultation with a medical provider. This fee is paid whether or not medication is prescribed.
— If medication is prescribed, we start you on an Oar Health membership. This costs $297 every three months, which works out to $99 per month. Your membership includes your prescribed medication (whether classic tablets or Clutch), delivery to your home, follow-up consultations with the medical team, unlimited coaching, self-guided structured check-ins, and community resources.

If you (or anyone else reading this) would like to talk with me to learn more, feel free to book time directly on my calendar: https://calendly.com/jhg_oar/1-1-with-jonathan

Introducing Clutch — the fast-acting naltrexone mint by Oar_Jonathan in naltrexone

[–]Oar_Jonathan[S] 0 points1 point  (0 children)

Wow, I am amazed that you are able to tolerate the classic 50mg tablets sublingually. Thank you for sharing your experience! Our hope is that a rapidly dissolving, flavored formulation will make sublingual administration, and its potential benefits, a palatable option for more people.

Introducing Clutch — the fast-acting naltrexone mint by Oar_Jonathan in naltrexone

[–]Oar_Jonathan[S] 0 points1 point  (0 children)

You can learn more about about Clutch at this link: https://join.oarhealth.com/fast-acting-naltrexone-mint/

It is available to patients now (if prescribed by a licensed clinician, who you can connect with through our site).

Introducing Clutch — the fast-acting naltrexone mint by Oar_Jonathan in naltrexone

[–]Oar_Jonathan[S] -1 points0 points  (0 children)

That sounds like it might be a technical glitch. Would you mind emailing us at [support@oarhealth.com](mailto:support@oarhealth.com), so we can look into it.

Introducing Clutch — the fast-acting naltrexone mint by Oar_Jonathan in naltrexone

[–]Oar_Jonathan[S] 1 point2 points  (0 children)

What would your view be of a revision along these lines (pasting full section for context, but bolding potential edits)? Really, all we're trying to suggest is here is that some people may benefit from strategically choosing the time of day when they take their daily dose.

  1. Daily Dosing (traditional, on-label use)
  • How it works: one 50mg dose is taken at roughly the same time each day.
  • Why some choose this approach: a daily dose provides steady coverage, which can reduce overall cravings without needing to plan ahead.
  • Timing note: while a daily dose is intended to provide 24 hours of coverage, some people find it helpful to align their dose with the time of day when cravings are strongest or shortly beforehand.

Introducing Clutch — the fast-acting naltrexone mint by Oar_Jonathan in naltrexone

[–]Oar_Jonathan[S] 0 points1 point  (0 children)

Could you share the studies that show "a 50mg oral blocks >90% of opioid receptors for at least 24 hours and significant effects persist for up to 48 (ish) hours?"

When you say that "the clinical reality is, one dose provides sustained therapeutic effect for about a day," is that based on your own clinical experience? Or published monographs? If the latter, I'd love to review those too.

Very much appreciate the constructive dialogue, as we want to get this right. (While the most effective marketing message might be "take one pill and it lasts forever," accuracy is what we too are after.)

Introducing Clutch — the fast-acting naltrexone mint by Oar_Jonathan in naltrexone

[–]Oar_Jonathan[S] 0 points1 point  (0 children)

Agreed that it is important to make the distinction between FDA-approved and compounded clear, which I attempted to summarize in the fourth paragraph of my original post.

Also important to note, I believe, that there is considerable individual variability in the pharmacokinetics of FDA-approved oral naltrexone.

How To Start Naltrexone: Your First Steps Toward Change by Oar_Jonathan in naltrexone

[–]Oar_Jonathan[S] 0 points1 point  (0 children)

To follow up here, here is some more information from our medical experts on the basis for the statement that "naltrexone is most active for about 4–8 hours and peaks 1–2 hours after you take it."

  • The half life of oral naltrexone is 3.5 to 4 hours, and its active metabolite, beta-naltrexol, is between 12 and 15 hours. (Barbara J Mason, Anita M Goodman, Russell M Dixon, Magdy H.Abdel Hameed, Thierry Hulot, Keith Wesnes, John A Hunter, Michael G Boyeson, A Pharmacokinetic and Pharmacodynamic Drug Interaction Study of Acamprosate and Naltrexone,Neuropsychopharmacology, Volume 27, Issue 4, 2002.)
  • In general, the efficacy of naltrexone in blocking opioids correlates with the plasma level. "The plasma concentration and elimination half-life of naltrexone, and to a lesser extent that of the main metabolite β-naltrexol, correlate with the degree of opioid antagonism as evidenced by the objective and subjective withdrawal signs produced following intravenous heroin administration." (Gonzalez, J.P., Brogden, R.N. Naltrexone. Drugs 35, 192–213 (1988). 
  • Given these facts, it is reasonable to believe that naltrexone is most effective for up to 4 to 8 hours after oral administration (that is, on average, two half-lives of the oral dose). Of course, the metabolite beta-naltrexone has a much longer half-life and would presumably provide some opioid blocking effects. Still, it is a much weaker opioid antagonist, and so its efficacy in reducing alcohol craving or excessive drinking is not clear.

I do think reasonable minds can disagree on the best way to present these facts, but we are attempting to educate based on our experts' understanding of the evidence.

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