Digital health unicorn Cerebral has quietly begun winding down its medication-assisted treatment (MAT) program for opioid use disorder (OUD), marking a significant shift in the company’s virtual behavioral health offerings. This Cerebral OUD program closure comes as the telehealth industry faces evolving federal regulations and heightened scrutiny around controlled substance prescribing.
The closure coincides with a recent proposal from the Drug Enforcement Administration (DEA). Under the proposal, providers could prescribe buprenorphine for treating OUD for up to 30 days, but would then be required to conduct an in-person evaluation. This regulatory shift could have wide-reaching implications for virtual health providers that operate primarily online without physical clinic locations.
Transitioning Patients to Alternative Care
Cerebral has been gradually offloading its OUD patients to other providers over the past several months. A company representative told Behavioral Health Business, “Cerebral stopped accepting new patients for OUD treatment in December 2022. There are currently less than 20 clients under care for OUD, all of which will be safely transitioned to alternative care by mid-March 2023.”
The telehealth provider launched its MAT program in April 2022 with the goal of expanding access to OUD treatment for patients who struggled to find X-waiver-licensed clinics. To facilitate this, Cerebral offered incentives to clinicians to complete the required X-waiver training, enabling them to prescribe buprenorphine. Since then, however, the federal government has eliminated the X-waiver requirement. This makes the Cerebral OUD program closure especially notable in the context of regulatory evolution.
A Competitive Virtual MAT Landscape
Cerebral was not alone in entering the virtual MAT space. Other companies, including Boulder Health, Bicycle Health, and Ophelia Health, have established themselves as major providers of telehealth-based opioid treatment.
Cerebral initially positioned itself as a holistic behavioral health provider, offering care for conditions including depression, anxiety, ADHD, and serious mental illnesses. Its strategy focused on integrating virtual care with accessible behavioral health interventions, leveraging technology to reach patients who might not otherwise receive care.
Founded in 2019, Cerebral has raised approximately $462 million in funding, with a Series C round valuing the company at $4.8 billion. Despite substantial funding and rapid growth, the Cerebral OUD program closure signals a refocusing of the company’s business model away from controlled substances and MAT programs.
Challenges and Regulatory Scrutiny
The closure of the OUD program occurs amid a turbulent period for Cerebral. The company has faced public scrutiny and a Department of Justice investigation regarding its prescribing practices for ADHD medication, specifically Adderall. Following these concerns, Cerebral made the decision to discontinue prescribing all controlled substances, including ADHD medications and MAT treatments.
Leadership changes have also shaped the company’s path. In 2022, founder Kyle Robertson stepped down as CEO, and Chief Medical Officer David Mou assumed the role of company leader. These changes, coupled with regulatory pressures, influenced the strategic decision leading to the Cerebral OUD program closure.
Workforce Reductions and Service Cutbacks
In addition to changing its clinical offerings, Cerebral has undertaken substantial workforce reductions. Most recently, the company announced layoffs of more than 250 employees, representing approximately 15% of its workforce. A spokesperson said, “Over the past year, we have taken steps to refocus on the most important service offerings for our patients. Today’s announcement is the culmination of that reorganization, which regrettably means reducing the size of our workforce… Affected employees will be fully supported with extended severance pay and benefits, as well as outplacement services.”
This latest round of layoffs follows previous reductions, including a 20% workforce cut in October and earlier layoffs in July. Alongside staffing changes, Cerebral has also discontinued services such as coaching and care counseling, further underscoring the Cerebral OUD program closure as part of a broader company-wide strategic shift.
Implications for Telehealth and MAT
Cerebral’s exit from the OUD MAT space highlights broader challenges facing telehealth providers that deliver virtual substance use disorder care. Regulatory changes, such as the DEA’s proposed requirement for in-person exams after 30 days of buprenorphine prescriptions, may further complicate the operational models of fully remote providers.
The company’s transition may also have ripple effects for patients who have relied on virtual care for OUD. While Cerebral has committed to safely transitioning its remaining patients, the reduction of virtual MAT providers could exacerbate access issues, particularly in areas with limited in-person clinic availability.
Looking Ahead
The Cerebral OUD program closure is a cautionary tale about the challenges of scaling virtual behavioral health services amid changing regulations, public scrutiny, and the operational demands of treating controlled substance disorders. For patients, providers, and investors alike, it represents a pivotal moment in the evolution of telehealth as a platform for mental health and substance use care.
As Cerebral continues to evolve, the company appears focused on consolidating its core behavioral health offerings while stepping back from more complex, high-risk services like MAT. Other virtual providers such as Boulder Health, Bicycle Health, and Ophelia Health may absorb some of the demand, but regulatory changes could continue to shape which services can be effectively delivered online.
Overall, the Cerebral OUD program closure reflects both the opportunities and challenges of telehealth in providing critical care to patients with opioid use disorder, highlighting the delicate balance between access, compliance, and sustainable operations.
