Digital behavioral health company Cerebral is continuing to expand its digital opioid use disorder treatment program, now adding Colorado and Washington state to its service areas. The program, which launched on a limited basis in Florida earlier this year, combines medication-assisted treatment (MAT) with behavioral therapy — a comprehensive approach that addresses both the physical and psychological aspects of opioid dependence. Cerebral’s CEO, Dr. David Mou, has expressed the company’s intention to gradually expand the program across the United States to meet the urgent and growing need for effective OUD care.
However, Cerebral’s expansion coincides with significant obstacles stemming from the decisions by major pharmacy chains CVS Health and Walmart to stop filling controlled substance prescriptions for Cerebral patients. This includes Suboxone, a widely used medication crucial for opioid dependence treatment. CVS and Walmart hold a massive share of the U.S. prescription market — CVS being the largest by total prescription revenue and Walmart ranking fifth — so their refusal to fill Cerebral prescriptions could create real barriers for patients relying on the company for treatment continuity.
Pharmacy Giants’ Refusal to Fill Controlled Substances Poses Challenges
The news that CVS and Walmart would no longer fill Cerebral’s controlled substance prescriptions has sent ripples through the telehealth and behavioral health communities. Access to medications like Suboxone is essential for many patients’ recovery journeys. Disruptions in medication access risk not only compromising treatment outcomes but also increasing the possibility of relapse or other negative health effects.
Dr. Mou acknowledged the challenge in a LinkedIn post, stating, “We will work with patients to help them find other nearby pharmacies that can meet their needs when our licensed providers conclude the drug would be safe and effective.” This proactive stance shows Cerebral’s dedication to maintaining patient care despite significant logistical hurdles.
This development also reflects broader tensions in the healthcare and pharmaceutical industries around telehealth providers and controlled substances. Pharmacy chains have heightened scrutiny on prescribing practices, especially amid concerns about potential overprescribing of stimulants and narcotics through digital platforms.
Cerebral’s History and Recent Controversies
Founded in 2019 and headquartered in San Francisco, Cerebral has positioned itself as a major player in the digital behavioral health space. The company has raised approximately $462 million in venture funding to date, including a $300 million Series C round that valued Cerebral at $4.8 billion.
Initially focusing on providing telehealth services for mental health conditions such as anxiety, depression, and ADHD, Cerebral quickly attracted millions of users seeking convenient access to therapy and medication management.
However, the company has faced criticism and legal challenges regarding its prescribing practices, especially related to ADHD medications. A Bloomberg report highlighted concerns that Cerebral’s emphasis on medication management sometimes pushed clinicians toward prescribing stimulants like Adderall more aggressively than warranted. This led to a former employee filing a lawsuit alleging retaliation after raising ethical concerns about these practices.
Moreover, digital pharmacy Truepill announced it would stop filling Cerebral’s Adderall prescriptions, and CVS Health previously blocked some Cerebral prescribers from issuing these prescriptions. In light of this scrutiny, Cerebral announced plans to halt all new Adderall prescriptions and phase out existing ones by the fall, signaling a strategic pivot.
Adding to the shakeup, Cerebral’s board recently replaced founder and former CEO Kyle Roberston with Dr. David Mou, the company’s former chief medical officer. This leadership change appears to align with a renewed focus on substance use disorder programs and possibly a more cautious approach to controlled medication prescribing.
Addressing a National Opioid Crisis Through Innovation
The opioid epidemic remains a pressing public health crisis in the United States. According to the Department of Health and Human Services, about 10.1 million people misused opioids in 2019 alone. Opioid use disorder contributes to tens of thousands of overdose deaths annually, making access to effective treatment a national priority.
Medication-assisted treatment, which combines medications like buprenorphine (Suboxone) with counseling and behavioral therapies, is widely regarded as the gold standard for OUD care. However, access to these treatments is often limited by geographic, financial, and logistical barriers.
Digital health companies like Cerebral offer an innovative approach by leveraging telehealth technology to deliver integrated OUD care directly to patients in their homes. This model can help overcome traditional barriers such as transportation, stigma, and provider shortages. Cerebral’s digital opioid use disorder treatment program exemplifies how technology can bridge gaps in care.
Cerebral’s plan to expand its digital opioid use disorder treatment program beyond Florida to new states reflects a growing recognition of the need for scalable, accessible care options for people with opioid dependence. Dr. Mou emphasized the program’s gradual rollout, aiming to meet urgent treatment needs across the country while ensuring safety and quality.
The Road Ahead: Opportunities and Challenges
While Cerebral’s expansion into Colorado and Washington is a positive step for increasing access to digital opioid use disorder treatment, the pharmacy challenges illustrate the complexities digital health providers face in integrating with existing healthcare infrastructure. Pharmacy partnerships are vital for prescription fulfillment, and losing major partners can threaten patient adherence and outcomes.
Cerebral’s ongoing efforts to secure alternative pharmacy arrangements will be critical in navigating this landscape. At the same time, the company’s pivot away from ADHD medication prescribing and leadership changes signal an evolving strategy that prioritizes responsible care delivery and regulatory compliance.
For patients battling opioid use disorder, access to comprehensive and continuous treatment can be lifesaving. Digital opioid use disorder treatment programs, which combine medication-assisted treatment with behavioral therapy, have the potential to transform care delivery. Cerebral’s story highlights both the promise and the challenges inherent in scaling these new models within a complex and sometimes resistant healthcare system.
