The 3% Problem: Why Almost Nobody With Alcohol Use Disorder Gets the Medication That Could Change Their Life

"Recovery is possible. Treatment options are likely more diverse than you may be aware of."– Jonathan GlassmanIn this week's episode of Compound Wisdom, host Steve Sood sits down with Jonathan Glassman — CEO of Oar Health — to dig into one of the most personal and purpose-driven startup stories in modern telehealth: how a healthcare strategy consultant turned his own decade-long struggle with alcohol use disorder into a platform that has now helped over 75,000 people drink less or quit entirely.Jonathan shares how he went from binge drinking to blackout to finding naltrexone through a single empathetic primary care physician — and how that turning point became the seed for Oar Health. He explains why only 3% of people with alcohol use disorder ever get prescribed medication, how telehealth is uniquely positioned to close that gap, and why privacy isn't just a feature for their members — it's often the deciding factor in whether someone seeks help at all.They also get into the harder side of building in healthcare — what happened when naltrexone went into national shortage during one of Oar's fastest growth periods, how the team made painful decisions to protect existing members even at the cost of new growth, and why Jonathan sees AI as a tool for empowering patients rather than replacing providers. The episode closes with Jonathan's direct message to anyone struggling with their drinking: you don't have to wait for rock bottom, and it is never too late to start.TakeawaysNaltrexone works by blocking the reward and pleasure signals that make alcohol feel good — it doesn't require sobriety as a goal.Only 3% of people with alcohol use disorder are ever prescribed medication — telehealth exists to close that gap.Privacy is often the deciding factor — no waiting rooms, no pharmacy lines, and discreet delivery changes who seeks help.Recovery looks different for everyone — Oar Health doesn't prescribe a single program; they build around the individual.When a crisis hits, set one clear, non-negotiable principle and fold every operation around it.A drug shortage can be a crash course — Ōr came out of their naltrexone shortage with deeper pharma supply chain relationships than they ever expected to need.AI belongs in operations, not in direct patient care — at least until patients say otherwise.The best use of AI in healthcare may be helping patients walk into appointments better prepared, not replacing the appointment.Cutting back on drinking is rarely just about drinking — it tends to become a catalyst for broader life change.You don't have to wait for rock bottom. Recovery is possible, and it's never too late to begin.Chapters00:01 — Intro: How a healthcare insider's personal struggle became a 75,000-member platform01:27 — What Oar Health does and why it exists02:22 — From binge drinking to blackout — Jonathan's personal story05:20 — Finding the right physician: empathy, moderation, and naltrexone07:50 — How naltrexone actually works in the brain10:31 — Spotting the market gap: telehealth for ED and hair loss, but not for AUD?13:02 — Why only 3% of people with alcohol use disorder ever get prescribed medication15:06 — What telehealth has gotten right — and where it still falls short17:40 — The fragmented healthcare system problem and where Oar fits in18:12 — Privacy as a product feature: why it matters more in stigmatized conditions19:21 — What Oar is building next: coaching, peer support, and smoother care transitions22:08 — Beyond sobriety: the liver, brain, and gut supplement Oar is launching24:52 — GLP-1s, peptides, and what the evidence says about addiction28:46 — The naltrexone shortage: two years of crisis management and what it cost32:35 — The bright line rule that saved existing members — and froze new growth35:10 — Compounded naltrexone and the Sinclair Method community38:22 — Daily vs. targeted use: how flexible is the medication really?41:05 — AI at Oar: where they lean in and where they draw the line44:49 — The future of AI in healthcare: better prep, more empathy, not less47:01 — Advice for anyone struggling: recovery is possible, and options are wider than you think