- 22-year-old Shrenik Jain dropped out of a triple major at Johns Hopkins to create Marigold Health, a startup that offers a new kind of addiction treatment.
- Jain's startup recently got backing from Silicon Valley health venture fund Rock Health, along with Rough Draft Ventures powered by General Catalyst, a VC that's funded successful startups like Jet.
- Other notable backers include the National Institutes of Health, the US government's chief medical research agency.
- Marigold offers patients access to text-based peer support groups that are monitored by a social worker and informed by advanced data analytics software.
After working as a Baltimore EMT for two years and regularly reviving people who'd overdosed on opioids, Shrenik Jain decided there had to be a better way to help people with addiction.
So a few years ago, he dropped out of Johns Hopkins and went to work on a startup designed to help prevent people from overdosing in the first place.
Today, that startup is called Marigold Health, and it recently received an undisclosed amount of funding from influential Silicon Valley health venture fund Rock Health. Other backers include Rough Draft Ventures of General Catalyst, the Cambridge-based VC that's funded successful startups like Jet, Snap Inc., and Kayak, as well as Johns Hopkins' tech venture arm. The National Institutes of Health also offered Marigold a grant to validate the platform.
Marigold provides people with access to group therapy — somewhat similar to what people with addiction may engage in face-to-face in the rooms of 12-step programs like Alcoholics Anonymous or Narcotics Anonymous. But unlike those resources, Marigold's group texts can be paid for by insurers. And thanks to a finely-tuned set of data analytics tools, Marigold also keeps track of patients in the system to ensure they're progressing; if they're headed in the other direction, someone from Marigold reaches out to help.
No other system for helping patients with addiction in this way currently exists. For patients with depression or anxiety, a handful of tools let individuals text a therapist (or an AI-powered chatbot) for support between in-person sessions; some of those tools allow people to keep track of their symptoms, but many do not. But when it comes to drug addiction, which can coincide with depression but is a separate clinical issue, those kinds of tools are scant.
"There's nothing else like this today," Jain told Business Insider.
To be clear, neither Jain nor his cofounder Ravi Shah aim for Marigold to replace any current addiction treatment method. Instead, Marigold is intended to complement a patient's existing treatments, which could include attending NA meetings, taking medications like naltrexone or buprenorphine, or having regular sessions with a therapist in person.
"We're not saying that peers are going to replace clinicians," Jain said. "We're saying that peers can do something valuable and distinct from clinicians in the care continuum. And they can do so cost-effectively."
Peer groups: an imperfect lifeline for patients with addiction
In 2016 alone, 62,000 Americans died from a drug overdose, and recent data suggest that our current treatments for addiction are barely making a dent in the problem.
Part of the problem is that addiction is a chronic condition that can last anywhere from several years to a lifetime, but most current healthcare models treat it as a short-term illness. Health insurance coverage for in-patient treatment can be limited; during this time, patients are advised to detox and attend 12-step meetings. If and when patients relapse, there's little recourse for help. Patients frequently end up back in the hospital, where they can rack up large medical bills.
Peer groups can help. The authors of a 2016 study published in the journal Substance Abuse and Rehabilitation, for example, found higher rates of abstinence, more satisfaction with treatment, and significant reductions in relapse rates among people who participated in peer groups for substance abuse compared with people who did not.
But peer groups aren't perfect — many lack the necessary structure to keep discussions on track and the oversight needed to ensure patient safety and security. Jain has some first-hand experience with this, having worked at a nonprofit called Thread where he served an advisory role with a group of underserved Baltimore high schoolers who'd experienced trauma and anxiety.
"When you put patients in peer groups they engage really well, but the problem is it's really hard to have oversight," Jain said.
On Reddit, for example, people will invade peer groups created for individuals with depression who are being monitored on suicide watch. At 12-step programs, drug dealers show up to take advantage of vulnerable attendees, and sexual harassment is widespread (there's even a name for it: "13th stepping"). Plus, there's little that peers can do when one of their members suddenly goes missing.
"It's not like high blood pressure or any other kind of disease where you can look at labs," Jain said. "There's no way to passively track a patient in the community short of tracking them down."
What Marigold offers that other text-based interventions don't
Marigold offers a potential solution.
Its algorithm, which Shah designed, uses artificial intelligence and natural language processing to monitor group chats; a certified social worker regularly scans the group and looks at the data that the algorithm provides. All of this happens under the oversight of Geetha Jayaram, an associate professor of psychiatry at Johns Hopkins. The Marigold platform is HIPAA-compliant, so patient privacy is secured.
"Coming from an engineering perspective, we were like, let's use natural language processing — not to build a bot — but to actually look at the sentiment in the messages and make it so a health care provider doesn't have to read every single message manually," Jain said.
Jain claims this will allow providers to see anywhere from seven to 10 times as many patients as they would without the tool. That's all thanks to Satya Bommaraju, Marigold's chief data scientist and a fellow former Johns Hopkins student who put his plans for a PhD on hold to work at the startup.
Jain and Shah plan to sell Marigold directly to health care providers and health plans. He says they'll be incentivized to cover the treatment because it will save them in the long-term on hospital readmissions, ER visits, and other medical bills that crop up when patients with addiction relapse.
Bill Evans, the CEO and managing director of Rock Health, one of Marigold's backers, agreed.
"For providers right now there's an opportunity to get reimbursement for something they want to provide but they don't have the tool," Evans told Business Insider.
Marigold could be one of those tools, he said.