Oar Health Online Therapy Review

In 2019, a reported 14.1 million Americans were diagnosed with Alcohol Use Disorder (AUD), a mental health condition that causes a person to drink compulsively despite adverse consequences in their daily life and takes a toll on their overall physical health. 

The good news is, AUD can be treated. With the help of rehab, individual therapy, group therapy, support groups, and medication, people can recover from AUD—and stay in remission. In fact, naltrexone (one of three drugs that reduce the desire for alcohol) was approved by the Federal Drug Administration in 1994 because of how effectively it helps people curb their drinking by shutting down the release of dopamine (a pleasure hormone) when they drink. 

Unfortunately, many doctors and treatment programs are still focused on abstinence, which means that many people with AUD don’t seek help. They’re simply unsure that they’ll be able to give up alcohol completely—which is how Suzanne Del Rossi, an Oar Health patient we interviewed, was feeling too. 

“I had been aware that I liked my wine for a while,” she says, “[and] I wasn’t liking the way I was feeling almost every day waking up.”  Her primary care doctor had also been pushing her to get treatment for her drinking—but he was advocating for her to go to Alcoholics Anonymous (AA), which pushes total abstinence. 

She didn’t think AA was the right choice for her at that time because she wasn’t ready to stop drinking completely. And while she’d heard about naltrexone as a medication that could help her curb her drinking, both times she tried to get a prescription, she was told either to abstain from drinking for a month (which, she said, was “not going to happen”) or had been quoted a cost she couldn’t afford. 

That is, until she found Oar Health, a company that takes a harm reduction approach rather than abstinence by offering affordable prescriptions for naltrexone to people who want to cut back on their drinking.

To evaluate how well Oar Health helps people with AUD, we surveyed 105 users, interviewed Suzanne, spoke with the company's founder, and sent the company a questionnaire. We then compared our findings to 54 other therapy companies. Here’s how it fared in our research.

What Is Oar Health?

Formerly known as OarRx, Oar Health is a medication management company for people with AUD. It was launched in January 2021 by Jonathan Hunt-Glassman, a former healthcare executive who was inspired by his own struggles with Alcohol Use Disorder. 

“I sought treatment in a lot of places—primary care offices, individual psychotherapy sessions, the emergency room—and I pretty much always heard the same thing [every time]: You need to stop cold turkey and start going to [AA] meetings,” he tells Verywell Mind. “And I gave that a shot, many times, but was never successful.” 

Finally, though, Hunt-Glassman found a primary care physician willing to help him work towards moderation, rather than abstinence, and he prescribed him 50 milligrams of naltrexone every morning. And it worked: The medication curbed his overwhelming urges to drink, allowing him to be able to drink one beer without spiraling into a binge or blacking out. This then inspired him to help others get the same kind of help by founding Oar Health in partnership with the prescription drug company Health Warehouse.

“No two people's experiences of Alcohol Use Disorder are the same,” he says, “and it is our job—and those of us who think of ourselves in the helping business—to provide as many safe, evidence-based options as possible.” 

“Of the 14 million people who meet the diagnostic criteria for Alcohol Use Disorder, a single digit percentage of them are prescribed one of the three FDA-approved medications to treat that condition,” he continues, even though, this medication is “safe, effective, and FDA-approved. And in cases like mine, [it] can be transformational—even life-saving.”

Oar Health Services

As noted above, Oar Health is essentially a medication management company for people over 18 who live with AUD, or who have tried to quit drinking alcohol and haven’t been able to. The company will assess you to determine if you’re eligible to take this medication, prescribe it if you are, and put you in touch with a team of doctors and nurse practitioners through its patient portal. 

You also receive access to a private Facebook community with around 200 other Oar Health patients. This group serves as a safe place where clients can talk about their sobriety or moderation journey with others with AUD. 

How Much Does Oar Health Cost?

Oar Health costs $35 for your initial treatment plan, which involves you taking an assessment to see if you’re a good candidate for the drug. The plan might also recommend therapy or self-help group support to you—but you’ll have to sign up for those elsewhere as the company doesn’t provide these services directly (unlike some of its competitor companies we reviewed, like Monument).

Then, if you’re approved for a prescription, you will pay for the cost of your prescription up front and are charged as often as every three months, depending on what plan you choose. These plans include:

• The three month plan, which costs $79 a month
• The six month plan, which costs $59 a month
• The 12 month plan, which costs $39 a month.

Insurance

Oar Health doesn’t take insurance, which is disappointing since many of its competitors—including Monument—do.  

That said, you can pay for Oar Health with most Health Savings Accounts (HSAs) and Flexible Savings Accounts. 

Still, this means that Oar Health may not be the most cost-effective for everyone. In fact, of the users we surveyed, only 43% felt Oar Health was affordable. If insurance coverage is important to you, you might be able to pay less if you’re able to find a doctor who will prescribe the medication since most primary care physicians do accept health insurance. 

Oar Health Discounts

Oar Health regularly offers discounts. For example, Verywell Mind readers can get 20% off their initial provider consult fee with the discount code SAVE20NOW.

Navigating the Oar Health Website 

I found the Oar Health website easy to navigate, and 64% of the surveyed users also said it was easy or very easy to navigate. 

The first thing you see when you visit the site is a video featuring a montage of people playing with kids, smiling, petting a cat, eating out with friends, and cruising on a boat—the kinds of typical imagery you’d see in most drug commercials. Layered on top of the montage are the words “Less is more…” with the end of the sentence flipping to “…confidence,” “…chances to connect,” “…happy mornings,” “…time together,” “…freedom,” and more. The message of the video is clear that this is a program where you can learn moderation as a way of decreasing the side effects of drinking. 

Directly under the video is a photo of a bottle of naltrexone and a section explaining that the medication is FDA-approved and meant to help you drink less or quit alcohol. It also tells you that the pills start at $39 per month but conveniently neglects to mention this is the price only if you’re willing to sign up for a whole year of prescriptions. 

If you continue scrolling down the page, you’ll find details about the service, including a spot to connect with a licensed provider or find referrals for individual counseling, group therapy, or support groups. 

I found it odd that, when talking about seeing a provider, it uses the language “visit virtually,” without specifying what the means. At other companies we reviewed, "virtually" means through live video sessions—but Oar Health doesn’t offer live sessions. Instead, you just fill out a questionnaire and/or send messages to your doctor in order to qualify and get your prescription. As such, the language used on the site felt a bit misleading; however, when I spoke to Hunt-Glassman, he did tell me the company is working on being able to offer live telehealth visits soon. 

Towards the bottom of the page, you’ll find illustrations showing the steps involved in signing up for Oar Health: Take the assessment, get your prescription, and message your doctor or other patients online. You’ll also find a “What to expect” section, which goes over what naltrexone does without going into detail about the side effects. 

You’ll also find patient testimonials, the patient’s first name, and a photo of an actor (to keep the patient’s identity private). To be honest, choosing to include any photo at all feels a bit unnecessary—especially since they are not real patients. 

Then, at the very bottom of the page, you’ll find the words “You don’t have to hit rock bottom to start making changes,” followed by a “Start Today” button which takes you to the clinical review.

The website’s navigation at the top of the page will also lead you to pages about naltrexone, an FAQ, a resource blog (that began in July 2022 and hasn’t been updated since November 2022), and an About Us page which recounts the founder’s personal story and lists five employees. 

I was pleased to see that both the naltrexone and FAQ pages are informative and honest about the drug and the services provided. The information on the naltrexone page is based on well-cited sources, including SAMHSA and the CDC, though I did feel like there wasn’t enough emphasis on the drug’s side effects, which can cause nausea in 10% of patients and headaches in 7%. Meanwhile, the FAQs page is honest about how the services do not include any video or phone contact with clinicians. It is worth noting, though, that you can schedule a video chat with the founder on the site—which I did for this story and I was offered a call the following work day.

Does Oar Health Have an App?

While there are references to an app on the website and in promotional emails, when I asked for access to the app, Hunt-Glassman told me that they had closed their beta test for the app and were not giving users access until version 2.0 was ready. 

I found this disappointing—and kind of misleading. The app that isn't available right now is repeatedly mentioned in the company’s promotional emails as being part of the company’s services.  

Signing Up for Therapy at Oar Health

To sign up for the program, click the Start Assessment button at the top of the site. 

The assessment then includes 12 questions about your alcohol use over the previous year, such as “In the past year, have you had times when you ended up drinking more or longer than you intended?” and “In the past year, have you found that drinking—or being sick from drinking—often interfered with taking care of your home or family? Or caused job troubles? Or school problems?” 

It also asks whether you aim to quit or cut back your alcohol use.  

The doctor- or nurse practitioner-created assessment determines if you qualify to receive naltrexone, and you then pay the one-time fee of $35 for the “message-based consult." After that, you decide what plan you want to pay for, for which you are finally given the prices. If you are approved for the prescription, you’ll be given a chance to select your chosen plan (i.e. how often you want to receive your medications), and then pay. 

When we interviewed Suzanne, she said she was comfortable with this prescription process. She found it straightforward and transparent, but the lack of a doctor visit did raise some concerns for us because you don’t actually have a telehealth appointment to determine if you’re a good candidate for the medication.

“Because everyone is different, even if a written assessment is thorough, it might not provide all the information necessary to determine if someone is a good candidate for medication,” explains Hannah Owens, LMSW and subject matter expert. “This is what an intake process is for—to learn as much about the patient as possible and evaluate their options. Only providing an online assessment can easily miss important details specific to the individual patient.”

How Oar Health Works

The whole process—from getting approved for the prescription to paying and getting the medication delivered to your home—is “very timely,” Suzanne told us.

Prescription Shipment

Your prescription comes in three, six, or 12-month supplies, depending on what plan you signed up for, and they’re shipped in discreet bubble mailers. The medication itself comes in an Oar-labeled bottle and is accompanied by a pamphlet with tips and tricks for success.

You’ll also get some information about the side effects, but Suzanne said she wasn’t totally prepared for the adjustment period after taking it. 

When you first go on the medication, you only use a half dose of 25 milligrams before ramping up to 50 milligrams after a week.

“You definitely need to get used to it,” she says. “It took a couple of weeks, and I had a number of side effects.”

Commons side effects include:

• Nausea
• Sleepiness
• Headache
• Dizziness
• Vomiting
• Decreased appetite
• Painful joints
• Muscle cramps
• Cold symptoms
• Trouble sleeping
• Toothaches

More serious reactions are rarer but can include liver damage, pneumonia, dizziness, and depressed mood. 

The medication is not addictive, though, and doesn’t cause withdrawal symptoms if you stop taking it. It also takes effect pretty quickly. “I was surprised by how effective the medication is for me,” Suzanne says. “I still have my wine and my martinis but I’m much more aware of ‘do I really want that?’”

As noted above, you do not get a telehealth appointment or therapy sessions when you sign up for treatment with Oar Health but you are connected with a doctor or nurse practitioner after you are approved for the prescription (usually within 24 hours), and from there, you can do message-based consultations. This clinician is matched with you based on where you live—but you are not guaranteed to always be able to speak with them. 

Sometimes, you may receive messages from one of the other clinicians on the treatment team, though, because if your main provider isn’t available, the portal re-routes your message.

“This team approach can be greatly beneficial for someone who needs to contact a doctor right away, as it guarantees that at least someone is reachable in an emergency or urgent situation,” says Owens. “However, even if information about you and your health is accessible to any clinician at the company, it’s always better to be able to speak to the doctor you’ve been working with most closely, as they will have a more detailed understanding of your history.”

In addition, while you’re receiving your medication from Oar Health, someone from the company will reach out to you periodically to see how you are doing, but you are not obligated to respond.

If you don’t reply, your prescription will be filled for one year. After a year, you need to have a message-based assessment to see if you still qualify for the prescription. Seventy-six percent of users said the prescriber got back to them regarding refills in a timely manner, while 78% said the prescriber was always available when needed.

Facebook Group

In addition to access to the messaging platform, you’ll also receive an email after signup linking you to the Oar Facebook group—which seems to be a perk of the platform for users, including Suzanne. 

She told us that she found a lot of support in the group, as well as tips for ways to minimize side effects. For example, someone told her what time of the day they took the medication to mitigate side effects—and she found this helpful.

She also felt strongly that being a part of the group helped her feel less stigmatized for her addiction and less ashamed that she was taking naltrexone.

Canceling Treatment at Oar Health

You can cancel your Oar prescription at any time by emailing support@oar.com. Oar does not normally refund payments retroactively, but if you have a specific issue, such as side effects, that make the drug unworkable, they are sometimes willing to provide a refund.

You can also opt to stop after one year when your prescription runs out—the medication does not cause withdrawal symptoms if you abruptly stop taking it.

Quality of Care and User Satisfaction

Oar Health has “been a blessing and not quite a miracle,” Suzanne says. “It's been very effective. I never wanted to abstain. I always wanted to moderate. And I am.” 

She especially spoke highly of the private Facebook group, which helped her feel part of a community of others who supported each other and didn’t judge. “[Oar Health] is really so much more than a medication [prescription] company; it really is a whole wellness program,” she says. “They seem to have a plan to normalize [alcohol use and naltrexone], not to make you ashamed or embarrassed.” 

This, she says, is why she would recommend Oar Health “absolutely, without hesitation.”

Sixty-nine percent of the users we surveyed agreed with her, stating they were likely or very likely to recommend it to a friend, and 91% said it was better, much better, or a little better than services they used in the past. In addition, 90% rated their experience with Oar Heath as good, very good, or excellent overall. 

While many users like the discreteness of Oar Health, it is worth noting that this approach also allows Oar Health patients to work around their primary care physician—they do not have to tell their other doctors about their naltrexone usage.

“I went on this without my primary care’s knowledge,” Suzanne says, “and when I did tell him, he was not impressed.” 

“Taking medication without informing your primary care physician or any other doctors on your treatment team is at best misguided and at worst dangerous,” explains Owens. “If your doctor does not know you are on a certain medication, they cannot, for example, factor in possible drug interactions you might experience if you need a prescription for a different medication for another health issue. Your entire care team needs to be aware of every medication you are on in order to provide safe and effective service.”

SAMHSA reports that practitioners should be aware of many things before prescribing naltrexone, including if the patient has liver problems, is pregnant, or takes other medications. These are elements a primary care physician may be more aware of than Oar Health when prescribing you the medication after only reviewing an intake form.

Hunt-Glassman told me, “We certainly encourage folks to share that they're on the medication with their primary care provider or other professional medical professionals they're interacting with.” “But,” he continues, “there are instances in which people are not comfortable seeking care in their community.” 

It’s also worth noting that once Oar Health provides access to naltrexone, you do not actually need to have any additional interactions with any experts at Oar Health for up to a year. 

Owens says that this practice is potentially harmful. “When starting a new medication, especially a psychotropic medication, it is important to be closely supervised by your provider to effectively manage any side effects or otherwise adverse effects of the medication,” she explains. “Leaving the patient to their own devices when continuing a new medication can prevent the patient from reporting reactions that might be medically relevant.”

Another weakness, as we noted, is that Oar Health’s main focus is on providing medication—it does not provide therapy or support groups like some of its competitors do. 

“Our view is that everyone who's looking to change their relationship with alcohol is going to benefit from a different mix of modalities, both medication and psychosocial support,” Hunt-Glassman says. “But, as a small company, we cannot directly provide every form of psychosocial support that might be beneficial.” 

So, if you are interested in therapy, an Oar Health doctor or nurse practitioner can only give you a referral through your message portal. But it will be up to you to follow up on that and seek additional support. 

The team approach for the user portal may also be both a benefit and a weakness of the company. It does make sure you can communicate with clinicians in a timely fashion, which is important if patients are having side effects or need support. However, this doesn’t allow you to create a connection with any one clinician—which might lead to feelings of isolation. “Not establishing a therapeutic rapport with your clinician might prevent you from sharing intimate or potentially embarrassing details that you might otherwise feel comfortable sharing with your regular clinician,” Owens notes, “including details that might be medically important, such as information about side effects.”

Forty-eight percent of those surveyed said their prescriber was responsive to questions and medication needs, and only 14% said they felt the prescriber did not consider their opinions about their medication.

Oar Health clinicians are found through a partnered company that matches digital health companies with doctors and nurse practitioners. We do like, however, that all clinicians are licensed, disciplinary issues are reviewed, and clinicians undergo regular training on the best approaches to treating AUD.

Privacy Policies at Oar Health

We ultimately have a few concerns about Oar’s privacy policies. Hunt-Glassman told us, “Oar is not a covered entity under HIPAA, but we take extensive measures to protect the privacy and confidentiality of our members' sensitive health information.” This is not an issue to be taken lightly, though, according to Owens. “HIPAA is the federal law protecting personal health information." Although the company might undertake security measures, the patient needs to be hyper vigilant of what information is provided and how it is used and stored.

That said, Health Warehouse, which ships the medication, is HIPAA-compliant. 

Upon further review of Oar’s privacy policy, it fully details what information is collected, stored, and shared with its partners, affiliates, and services used to provide your medication. And these practices are in line with many other telehealth companies.

Oar Health vs. Competitors

Of the 55 online therapy companies we reviewed, Oar Health has two main competitors that specialize in addiction support: Monument and Mindful Care.

Founded just a few years before Oar Health in 2019, Monument is also focused primarily on treating alcohol use; but unlike Oar Health, it does so through a combination of therapy, group support, and medication management. It also offers two drugs, not just one: naltrexone and disulfiram (more commonly known as Antabuse).

One main difference between the two drugs is that naltrexone can be used for moderation, while disulfiram is only used to quit completely. Instead of curbing cravings, Disulfiram causes a severe allergic reaction if you drink alcohol. “For those who want to practice abstinence, having access to both medications is useful,” says Owens, “and if you try one medication and do not like it, you have other options. But some people might need the severe shock of a serious adverse effect in order to change their behaviors around alcohol consumption.” Ultimately, Owens says, “when it comes to psychiatric medication, having options is always preferable.” 

Both sites are well laid out, though on Monument, it is a bit easier to find the pricing for its treatments, which are generally more affordable and varied. For $10 a month, you get an introductory physician appointment and intake, medication management, messaging with a physician, and access to support groups and an anonymous community forum. You can fill your prescription at your pharmacy or online.

Monument also accepts health insurance, which gives it an edge over Oar, and it has therapy plans that cost up to $249, offering 45-minute therapy appointments and unlimited physician appointments. There is also a free plan that offers therapist-moderated support groups and an anonymous 24/7 community forum. It is also HIPAA-compliant. “Having all of these options,” explains Owens, “can only mean more ways to support yourself through treatment and more ways to improve your relationship with alcohol.”

However, even though Monument offered more services, it ranked lower with the users we surveyed, with only 78% saying it was good, very good, or excellent, compared to Oar Health's score of 90%. This is probably because most Oar Health users understand exactly what they are getting and are happy with it. Similarly, only 24% of Monument users said they were very likely or likely (38%) to recommend; 37% of Oar Health users said they were very likely or likely (31%) to recommend.

Compared to the other two companies, Mindful Care is a little more established. It was founded in 2018 and it offers a variety of therapy options, including individual therapy, group therapy, psychiatry, and addiction support. Mindful Care also offers a similar addiction support program to Oar Health. For $49 a month, you get medication-assisted treatment, one-on-one and group therapy, and care navigation; Mindful Care also offers video communication and is HIPAA compliant. 

Mindful Care’s “Mindful Recovery” program uses a harm reduction approach, which strives to help those suffering from alcohol use disorder live their best lives possible, whether they are cutting down, quitting, or continuing to use. It aims to lower the physical and social harms associated with alcohol, making sure clients as safe themselves and around others.

The program doesn’t preach abstinence, instead allowing clients to set their own goals, and treats them without judgment for their decisions. “Harm reduction, as opposed to abstinence, aims to take the shame and failure out of substance use treatment,” explains Owens. “While abstinence is a black-and-white issue—wherein if you abstain, you succeed, and if you don’t, you fail—a harm reduction approach understands that there are many ways to relate to substance use and many ways to treat it.” 

Mindful Care also offers a vast number of other services clients can tap into, including individual and group therapy focused on many of the issues people with AUD also face, such as anxiety, depression, and trauma. It also has specialized LGBTQ support groups and offers psychiatry, urgent care, and same-day 20-minute "MicroTherapy" sessions. 

Ninety-two percent of Mindful Care users surveyed said it was good, very good, or excellent. Forty-three percent of Mindful Care users said they were very likely or likely (40%) to recommend the company to people like them.

Final Verdict

For many suffering from alcohol use disorder, it can feel like there is only one option for treatment: abstinence and 12-step groups. But the reality is that many are not ready for that and are seeking alternative ways to treat their AUD—and Oar Health provides them with that alternative. Oar Health’s program is focused on doing one thing: prescribing and shipping naltrexone to your home if you’re a good candidate for the medication. And if this is all you want as you work to cut back or stop drinking, this may work for you. The service is relatively affordable despite not accepting health insurance; it advocates for a harm reduction approach to substance use; and it will connect you with other people who understand what you’re going through.

However, because Oar Health doesn’t offer therapy resources or support groups besides a Facebook group, many people may find that the care they receive here is not sufficient to treat their AUD diagnosis. It will also not work if you experience serious side effects from the medication or if you’re simply not a good candidate for the drug because of a preexisting condition.

Methodology

To fairly and accurately review the best online therapy programs, we sent questionnaires to 55 companies and surveyed 105 current users of each. This allowed us to directly compare services offered by gathering qualitative and quantitative data about each company and its users’ experiences.

Specifically, we evaluated each company on the following factors: website usability, the sign-up and therapist matching processes, therapist qualifications, types of therapy offered, the service's quality of care, client-therapist communication options, session length, subscription offerings, client privacy protections, average cost and value for money, whether it accepts insurance, how easy it is to change therapists, overall user satisfaction, and the likelihood that clients would recommend them. We interviewed the founder and CEO of each company about how they support users along with therapists within each company. Lastly, we engaged three subject matter experts to get their analysis on the suitability of each company for providing quality care to therapy seekers.