Boulder Care: Helping Save Lives by Increasing Access to Substance Use Disorder Care
The numbers are overwhelming, the headlines heartbreaking. In 2020, 40 million people in the U.S. suffered from a substance use disorder (SUD), including 2.7 million - a full 1% of the U.S. adult population - afflicted with an opioid use disorder (OUD)(1). A person suffering from OUD has a 20 times greater risk of early death due to overdose, trauma, infectious disease, and suicide, than someone who does not(2). For the 12-month period ending November 2021, 76,975 individuals in the U.S. died from an opioid overdose, up from nearly 33,500 overdose deaths in 2016(3). In addition to the individual impact, OUD presents a significant burden on the healthcare system and first responders. In 2016, over 100,000 EMS calls were dispatched to treat opioid overdoses with 15% of those cases presenting signs of opioid-associated out-of-hospital cardiac arrest, representing almost 9% of all EMS-treated cardiac arrests(4). Each death from OUD represents a sister, a brother, a daughter, a son, a mother, a father, a friend, a colleague. A life cut short.
There is hope – evidenced-based therapies exist to assist individuals suffering from this affliction. These life-saving medications – buprenorphine and methadone, otherwise known as medication-assisted therapy (MAT) - help individuals suffering from OUD by curbing withdrawal symptoms, putting patients on the road to recovery. And MAT really works - people with OUD are 50% less likely to die when they engage in long-term treatment with buprenorphine or methadone(5). However, only 19% of adults with OUD receive medication treatment, and among those who do, 6-month retention rates hover around 40%(6).
Systemic and social barriers preclude individuals from receiving this life-saving medication-assisted therapy. Prior to the Covid pandemic, the Ryan Haight Act required clinicians to see patients in-person before prescribing medication. While well-meaning, Ryan Haight had unintended consequences that prevented many of those suffering from OUD from receiving care, especially people living in the 56% of rural US counties that lack a buprenorphine provider(7). Even in communities with a provider, the vast majority - 87% - lack a sufficient number of treatment programs to meet the needs of their patient populations(8). And finally, even if a person has access to treatment, barriers persist. The cost of inpatient and outpatient programs, the logistics required to receive in-person care, and the social stigma of visiting an outpatient rehabilitation facility are major deterrents.
The need for a better solution that addresses all of the aforementioned barriers is clear, and that is why the Laerdal Million Lives Fund is excited to announce our investment in Boulder Care (“Boulder”). Based in Portland, Oregon, Boulder is an all-digital treatment program for opioid and alcohol use disorder that treats patients through MAT and virtual therapy. The company’s dedicated care team, including prescribing clinicians, care advocates, and peer recovery specialists, delivers customized, evidenced-based, whole-person care. By providing 24/7 support through its all-digital platform, Boulder is able to democratize treatment by delivering care whenever and wherever an individual needs it - breaking down many of the barriers that have limited patient access historically. Approximately 25% of Boulder’s patients are located in rural counties and communities. Patient access is a critical focus for Boulder, but so too is affordability - with nearly 80% of patients covered by Medicaid and Medicare, these patients pay nothing out-of-pocket. Thus far, the results are incredibly promising across Boulder’s patient population. 93% of Boulder’s patients are meeting their goals of reducing unwanted opioid use. 12-month retention is near 70%, twice the industry average. And with a Net Promoter Score of 90, over two times the industry average, Boulder is delivering quality care to those that need it most.
As our name implies, the Laerdal Million Lives Fund has a goal to help save one million lives annually by 2030. We are excited to partner with Boulder Care on this life-saving journey to help those suffering from substance use disorder receive the personalized, evidence-based, accessible, and destigmatizing care they have long deserved.
Citations:
(2). https://www.ncbi.nlm.nih.gov/books/NBK541390/
(3). https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm
(4) https://www.ahajournals.org/doi/10.1161/CIR.0000000000000958
(5). https://www.ncbi.nlm.nih.gov/books/NBK541390/
(6). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7666540/
(7). https://onlinelibrary.wiley.com/doi/10.1111/jrh.12307
(8). https://www.healthaffairs.org/doi/10.1377/hlthaff.2014.1205
