An Interview with John Mendelson of DxRx

“Rehab on Your Phone”

Photo: John Mendelson (center) and the DxRx team.

Not everyone who occasionally overdrinks is seen as an alcoholic in need of help. DxRx is a service for people who want to manage their alcohol consumption using an app, a breathalyzer, and medication if needed. DxRx wants to break the stigma of alcoholism and make treatment obtainable for people who can’t deal with traditional rehab or Alcoholics Anonymous, in terms of financial and social cost. We asked one of the company’s founders, John Mendelson, a few questions:

Tell me about your background, how did you become interested in public health?

My father was one of the first scientists to study alcoholism. His enthusiasm led to my interest in alcohol, opiate, and stimulant addiction, which blossomed into a career in clinical research for addiction treatments. Besides conducting research, I also treat patients. I have been in practice for 30 years and have had the extraordinarily good fortune to watch addictive diseases go from untreatable severe diseases often ending in death to manageable problems.

What problem are you working to solve with DxRx?

If you ask the average American to list the most deadly diseases, alcoholism doesn’t make the cut. Yet alcoholism is a devastating disease that destroys lives and kills more people then diabetes. Despite the toll of alcoholism, most people have no idea what makes a person an alcoholic, how to identify early problem drinking, or treat the disease. Part of the problem is that alcoholism is often viewed through binary lens – you are either a flawed person or the inevitable victim of a purely biological disease. In fact, like most important problems in life, voluntary choices combined with biologic vulnerabilities lead to the eventual disease state. Both my approach and DxRx’s philosophy is to provide tools to enable better choices of when and how much to drink, while also addressing underlying biological motivators of behavior.

If you could only pick one thing to validate your reason for forming a startup, what would it be? In other words, what would be the single biggest indicator to you that you are doing the right thing?

Of all the progress we have made over the past four months at IndieBio, there is one thing that convinces me we are on the right path. Our customers use a breathalyzer every day to measure their blood alcohol content so they can track their progress. When we average the results from the first dozen patients, the results are astonishing. The average patient at DxRxMedical is able to cut their drinking in half in a month.

How do you think success can change your industry?

At present there is no cure for alcohol addiction so treatment needs to be one day at a time. Our light, daily, empowering touches support patients for the long haul. 34 million Americans are estimated to have Alcohol Use Disorder yet only 2.5 million get treatment and only when the disease has done much of its destruction. The costs are enormous with an estimated $16 billion being spent to treating this small proportion of people in need. Success means 34 million people with AUD can get help and prevent hitting rock bottom.

How is your team uniquely able to tackle this? What’s the expertise?

Our team is successful, experienced and creative. I am a practicing physician and NIH-funded researcher with 30 years of experience treating patients and developing treatments for addiction. David Deacon, our CEO, has launched four companies of his own and helped found 20 others. Bob Nix, our CEO, has been a software architect at Athena Health for the last nine years and has been VP of engineering for nine start-ups.

Our Scientific Advisors are all leaders in addiction science. Chuck O’Brien developed naltrexone for addiction and is the leading academic physician in addiction. Ivan Diamond founded the UCSF Gallo Center, edits Alcohol Clinical and Experimental Research and is the leading academic expert in the biology of alcoholism. Warren Bickel is a Psychologist whose works pairs psychological interventions with technology. 

Any big lessons learned transitioning to startup entrepreneurship?

To be concise! I try!

What’s the biggest challenge you’ve encountered so far?

There is a lot of stigma associated with addiction, which fuels denial, and deconstructing this stigma and empowering our patients to take charge has been a big challenge we are quickly learning to overcome. 

What are the big goals and milestones you’re looking to hit in the short term? Long term?

Over the last month we have enrolled our first group of patients and have launched demonstration projects with key stakeholders in medicine including a Yale-associated hospital, researchers at the NIAAA, and the largest hospital chain in California – Dignity Health. The team at DxRxMedical is now rolling out our solution to everyone in California, starting with employees at a few key companies, and hospitals that need a solution for their patients. If we are successful in California, we will scale up by hiring physicians across the country to deliver addiction treatment in every state. 

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