Substance abuse, whether it be of alcohol or other drugs, is becoming increasingly prevalent in the U.S. According to the National Survey on Drug Use and Health, 19.7 million Americans fought substance use disorders in 2017.
Through the use of an online, mobile platform, Boston-based DynamiCare Health aims to help those struggling with addiction. The 2019 50 on Fire winner is partnered with Brightview, the largest addiction treatment system in the state, and is live at six other treatment systems across the country.
Signing up for the platform is simple. At registration, each user is matched with a personal recovery coach who will work with them for the duration of the program. Shortly after, each user receives a breathalyzer or saliva-testing equipment in the mail. Users are required to self-test throughout their treatment.
At the outset, DynamiCare's platform sets up random tests throughout the week to ensure users are complying with the treatment plan. Users can personalize the window of the random schedule according to their workday and social life, and when the alert goes off, they are required to take a video of themselves administering the test. For the Bluetooth-connected breathalyzer, users get their results immediately, and for the saliva testing, which uses a color-changing cup, the video is reviewed by DynamiCare’s staff and approved.
Rewards are monetary and provided via a smart debit card. This card blocks access to bars, liquor stores, and cash withdrawals, discouraging users from using the card for purchasing substances. These financial incentives usually amount to around $100 a month and can be provided by insurance companies, employers, family members, or the users themselves.
“By using a saliva test rather than a urine test, we aim to give the member more autonomy and dignity by giving them control of their own testing,” said Eric Gastfriend, DynamiCare’s CEO and co-founder.
Users are also rewarded for other in-app activities, like completing surveys and cognitive behavioral therapy modules, as well as for attending appointments. Attendance is verified through GPS tracking.
“There’s so much scientific literature on contingency management, this method of using positive reinforcement to help people stay sober,” said Gastfriend.
The company provides its services to individual clients as well as treatment facilities, health plans and businesses. DynamiCare Health also partners with a number of universities in academic research studies, where the startup’s platform is used to conduct research on contingency management.
"DynamiCare is about rewarding people for doing the right thing instead of punishing them for doing the wrong thing."
At the heart of the company’s model is its coaching system: DynamiCare matches each user to a coach, who they communicate with over the phone or over video on a weekly basis. Clients can also text coaches during business hours. This coach’s role is something between a therapist and an AA sponsor, helping users set personal goals and mend relationships with family members.
For founder Gastfriend, the startup's mission is personal. The Harvard Business School graduate founded DynamiCare Health in 2016 when both a friend and a relative were struggling with opioid addiction. Gastfriend turned to his father, David Gastfriend, an expert on addiction psychiatry. The two became interested in the idea of contingency management and the use of positive reinforcement in treatment, something that had been proven to be effective in numerous studies, but that seemed to be seldom used in rehab centers.
The two pitched the idea to combine positive reinforcement with technology to some of David's Gastfriend's colleagues, who, instantly excited about the idea, became the father-son duo's early collaborators. Now the company is going strong, with David Gastfriend working alongside his son as DynamiCare's chief medical officer and co-founder.
DynamiCare is currently its seed stage of funding, with $4 million raised thus far. The company has won an additional $1.3 million in prizes and another nearly $400,000 in grants. In August, the startup took home a $1 million grand prize at the Ohio Opioid Technology Challenge. Gastfriend plans to begin raising a Series A round next year.
In the future, DynamiCare Health aims to continue to partner with health insurance plans in order to help reduce addiction treatment costs. Above all though, the company wants to continue to emphasize its focus on positive reinforcement.
“DynamiCare is about rewarding people for doing the right thing instead of punishing them for doing the wrong thing. Because I think a lot of the time in the field of addiction, people are used to getting punished for doing the wrong thing,” said Gastfriend. “When we flip that on its head and use positive reinforcement, it makes a big difference. It has an impact."
