Introducing Halcyon Health
The first time I stepped foot in a 12-step meeting in Orange County, CA I heard someone say something that stopped me cold in my tracks. It was something to the effect of “throughout my life I’ve always felt like everybody else had gotten the manual to life and I must’ve been absent from school that day.” This was a decade ago when my life looked quite a bit different than it does today.
It’s not a stretch of the imagination to say that in the years preceding this moment, I had become a self-destructive, self-hating person with a life that somewhere along the way spiraled out of control.
While externally I was a “normal” kid growing up in the suburbs of New York, I never quite felt that way inside. I suffered from social anxiety and episodes of depression. I spent much of the time feeling inadequate, fearing rejection and failure.
It wasn’t however until I graduated from high school and went away to college in Boston, forcing me to leave the little bubble I’d grown up in, that these feelings of inadequacy would result in a perfect storm causing a chain reaction that sent my life into a downward spiral.
Dormitory life was new to me and I was wholly unprepared to live on my own. Fear of rejection continued to be the force that informed so much of my outlook and response to life. I had a hard time making friends, still shackled by the juvenile need to fit in (rather than simply focusing on my studies and allowing the world to fit in around me). I got very sick with mononucleosis during the first semester of my freshman year, perhaps my body’s way of giving me a convenient escape from my fears. I missed several weeks of classes, which further hindered my acclimation to college life. Not surprisingly, I fell behind in my schoolwork and my grades plummeted. Even when I recovered physically, I didn’t feel good enough about myself to socialize. Unlike in the years prior, I had no one I could turn and cling to for safety.
Instead, I found a way to numb these feelings using alcohol and a variety of substances. In the beginning, it was mostly recreational in nature but it worked so well that it became a habit that would increase in frequency and severity over a two year period. By my sophomore year, I rarely showed up for classes. I rarely left my apartment other than to go out drinking, to buy more drugs, or if I absolutely had to take an exam. When I found out that the professor of a class I had enrolled in took regular attendance, I would drop the class immediately, frequently accumulating withdrawals on my transcript. I became a shell of my former self. I had no self-respect, no real friends, and nothing to live for. Life seemed hopeless and I thought a lot about suicide.
After my sophomore year, with my family’s urging and strong recommendation from the university, I decided to take a leave of absence from school. I went to an outpatient treatment program for young adults with co-occurring mental health issues and substance use disorder. It only took about four months for the program to kick me out and suggest a higher level of care, in an environment away from home. I couldn’t pass a drug test and to be honest, I never actually tried to either. I was in denial, believing my issues to be solely related to my depression while using substances to self-medicate. As far as I was concerned, I had no reason to stop as long as it continued to make those feelings go away.
I had run out of options though and faced with the choice of finding a new place to live or picking one of the pamphlets they handed me, I decided I’d do the latter. It had been the hardest decision I’d ever made. I was terrified of leaving home and going so far away. I was terrified of what I would encounter there, what they would think of me, what they would diagnose me as. It might sound peculiar to hear that I was afraid of rejection in a treatment facility, but that was a gripping fear that would not subside.
So I packed my things and a week or two later flew out to Orange County, to an inpatient rehab center that was very much rooted in the Minnesota Model around 12 step groups and big book study. I spent four months there in the program and then another four months in a sober living facility owned by the same individuals while working at a convenience store nearby.
After those 8 months, I moved back to New York, enrolled in courses at CUNY Baruch, raised my grades and later transferred to NYU. NYU was where I really came into myself. I learned about technology and software which later led to my path into VC where I’ve worked for the past 7+ years.
And most importantly, I’ve been sober ever since. This isn’t something I often talk about in a professional context and in fact it was only a few years ago that I spoke about it with a small number of people for the first time. When I do however, people often congratulate or commend me. I’ve never been comfortable with this because I don’t feel like I did anything at all.
I certainly didn’t do anything differently than friends in the treatment program did during our stay — many of which are no longer with us. We were told if we just “put in the work” and “worked the program” we would achieve “a life beyond our wildest dreams” yet they did the work and seemed to be on the same track I was.
To be completely honest, I don’t know why the program worked for me when it so rarely works for others. My best guess though is that in many ways I was just a little bit luckier. Certain things fell into place and when they didn’t, I narrowly avoided catastrophe with a lucky break or fortuitous timing. Looking back, those first few years in sobriety were much like a game of Jenga — every time it all came close to crashing down, the one block that would’ve collapsed the tower was never quite the one that the world pulled out on me.
All of this to say that this past October when Compound announced that I would be transitioning away from my day-to-day responsibilities as a GP, it wasn’t some spur of the moment decision but something that was over a decade in the making.
Drug overdose is the leading cause of death in America for people under the age of 50. I don’t know exactly when it happened but eventually I just became fed up. Fed up with logging onto Facebook and seeing memorials for people I knew (or in some cases lived with) years prior, tired of reading op-eds by grieving parents and siblings wondering why their loved ones didn’t receive high-quality care despite emptying their savings for treatment they were told was the gold standard, and tired of hearing people talk about addiction; rehab; and addiction-related incarceration as if these are reserved for some kind of self-absorbed, delinquent and not for people suffering from a chronic disease.
As I got to thinking about some possible avenues in the sector, I reached out to Andrew, a friend I had met years earlier at NYU who had spent the previous three years in the mental health space at Quartet Health. Serendipitously, it was at this time that Andrew had just begun working on his MPH at John Hopkins where he was focusing his research on the on mental health and substance use policy,. Together we spent countless hours at a whiteboard, exchanging ideas, zeroing in on the overarching problems and navigating the idea maze through a combination of our collective experiences and conversations with experts on public health, policy, emergency medicine, addiction medicine and health insurance.
There were three overarching themes that became apparent which can be attributed to a combination of path dependence, regulations with unexpected consequences, and an emerging understanding of addiction as a chronic but treatable medical condition. These are:
- A complete lack of standardization in addiction treatment
- A fragmented provider landscape and
- A focus on “episodes of care” counter to the principles of chronic disease management.
This is best be summed up by a quote from addiction policy and research expert, William L. White who wrote:
“People seeking help for the resolution of alcohol and other drug (AOD) problems in the United States encounter not comprehensive systems of care but silos of care based on single pathway models of addiction with narrow menus of derived services, each highly critical of competing silos… Future advancements in addiction recovery are more likely to come from personally and culturally potent and carefully sequenced service combinations delivered across the life cycle in expansive environmental venues than from any new single element added to existing addiction treatment or recovery support services.”
Eventually we came to see that there was one extremely large opportunity that stood out to us like a sore thumb. It wouldn’t be easy but it’s the only path forward we saw that could ensure that those suffering the most wouldn’t need to sit idly by and hope that the cards they’re dealt are stacked in their favor. Instead we could rig the deck, making certain that they receive personalized, evidence-based treatment throughout the continuum of care.
We developed what we call “The Halcyon Program”, a comprehensive, evidence-based treatment program that begins in environments where the highest acuity patients are often found — guiding people suffering from SUD through the full continuum of care leveraging fully integrated care teams empowered by technology.
Halcyon aims to address the “whole person”, addressing all of the roadblocks to long-term recovery from substance use disorder while providing personalized care to empower each person to overcome this insidious disease. I’m excited to share more specifics on this in the coming months.
We’re just getting started and we have a lot of work ahead of us but we’re determined to bring cost-effective care of the highest quality to millions of people suffering from substance use disorder.
I know firsthand what it’s like to suffer alone in darkness, the feelings of desperation and hopelessness consuming every second of every day. We’re committed to doing everything in our power to help those suffering to overcome it.
We can’t do this alone so if this journey is something that resonates with you please do drop me a line at josh [at] halcyonhealth.co.
