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AA Challenger Offers New Path for Treating Alcohol Dependence

Tempest sees opportunities to serve 50m+ Americans

12 Minute Read

There are more than 50m problem drinkers in this country—people who binge drink or regularly harm themselves or others by overindulging. Yet only 1m of those people seek treatment for alcohol dependence.

Holly Whitaker is on a crusade to close that gap, providing inspiration to thousands of families struggling with one of America’s most misunderstood diseases.

Four years ago, Whitaker, a former health-care executive who struggled with alcohol and drugs, started Hip Sobriety, an eight-week positive psychology and community-building program designed to help people overcome unhealthy relationships with alcohol.

The first sketch of the Hip Sobriety website, which Whitaker penned in June 2013.

In treating her own addiction problems, Whitaker learned that traditional rehabilitation programs are not set up to help the many people who don’t consider themselves alcoholics, but who put themselves and others at risk because of their use of the drug.

By integrating technology and social media to make treatment accessible and affordable, her program has the potential to serve a much broader population of drinkers than Alcoholics Anonymous––the 12-step Christian-based cessation program that has some 2m members worldwide.

A brewing storm

Hip Sobriety—refashioned last year as Tempest, or “violent storm,” as in “we turn and face our storm,” Whitaker says—serves up daily doses of self-help content and creates small groups where people can open up about their problems.

Tempest recently launched its 15th “sobriety school”––an eight-week, $647 program that has served nearly 4k people––allowing problem drinkers to create a different path to self-care than AA and other rehab programs offer.

The company also offers a $197 annual membership. About half of its sobriety school participants convert into annual members, who receive monthly content, access to online communities, and the opportunity to attend Tempest events. 

Whitaker has big ambitions to change the way Americans think about alcohol and the harmful effect it can have.

“When we think about alcohol, we think that we are supposed to drink it. I wanted to change that. When we think about addiction, we think that there are only a certain small number of people that will become addicts. I wanted to change that. And when we think about recovery, we think it’s like managing a chronic condition. I wanted to change that, too,” she says.

Tempest founder Holly Whitaker (photo via Kathy DeNinno Photography)

Tempest has received $4.3m in seed funding, allowing Whitaker to expand her company from 2 to about 30 employees. She is in the process of securing another funding round to expand her business, which has grown mostly through SEO, word of mouth, and the company’s daily emails.

Whitaker is hopeful that, as more people understand the risks they’re taking with alcohol, they will be more willing to confront their demons.

“Alcohol is a really strong motivator to do something because it doesn’t feel good and the consequences are high,” she says. “If you don’t fix this, it gets worse. You can lose your family, your job, your reputation, and your life.”

Market opportunities

Whitaker has discovered a vast, underserved market of problem drinkers. But that’s not what motivated her to create Tempest.

“When I was looking at the market, it was far more about trying to figure out what makes people well,” she said. “What was able to take me from being a very sick person who was going to be a liability and an expensive patient—with multiple addictions and a history of not sticking with things—into somebody who was so quickly transformed and empowered?”

Her approach involved creating options for more people on the spectrum of problem drinking than other programs were treating, removing the qualifier many people ask before seeking treatment: Am I an alcoholic or not?

Her program encourages people to ask a different question with a more understandable answer: Is alcohol getting in the way of my life?

Part of the Tempest “manifesto.”

Tempest’s approach does share some things in common with AA. Its students benefit from sharing what are often deeply personal stories with otherwise perfect strangers experiencing similar problems. In addition to meet-ups, Tempest’s groups also get together on video calls and in private Facebook groups.

Whitaker has been surprised at people’s openness. “Executives and care providers have come into Facebook and written about their divorces, about their drinking, about drinking with their kids in the car—just putting so much on the line,” she says.

But much of Tempest’s approach is very different from that of Alcoholics Anonymous, a nonprofit treatment program that was started in 1935. 

Whitaker says that AA and other traditional recovery programs are primarily centered on fixing problems that men have mostly experienced.

“Typical recovery kind of breaks down male privilege, and we created something that didn’t assume people had male privilege,” she says. “We wanted to establish an alternative modality that was not created with the image of a man.”

Interestingly, when assessing the market, Whitaker did not see Alcoholics Anonymous as a competitor—or her main competition, at least.

“I really did truly look at people not doing anything as the problem,” she said. “That’s the main competition, is that people are not actually able to…advocate for themselves and manage their own health.”

Below are outtakes from my conversation with Whitaker, who shares insights on how she’s grown her business, how she assesses the market, and what opportunities she sees for addiction services, including anything from screen addiction to pot.

How did you come up with the idea for your business?

I went to work at a healthcare startup in 2009, and I was incredibly bought in on what we were doing to increase access to healthcare. And it’s important to state that I’d had an eating disorder since I was in my teens that I had never effectively or even really tried to treat, and I never had a specifically healthy relationship with alcohol. But I would also say I never really had an addiction to alcohol.

But I started to work a ridiculous amount of hours, and my drinking went off the rails. I was probably drinking anywhere from one to two bottles of wine a night and more. And I hit a point where it was not working and I needed help. And I made an appointment with one of our physicians that was a friend of mine and I went in and I sat down and had this like, first honest conversation about my bulimia and also about my drinking. And my provider had to Google how to help me. And I would later discover our healthcare providers in America aren’t trained in addiction medicine––that they go to 12-step meetings as part of the residency, but it was just this moment of being told I could go to AA, and I did not identify as an alcoholic. And that’s extremely important to understand what we do now.

And the other piece was, I was given an option of going to an inpatient or intensive outpatient treatment program, and these were cost-prohibitive. I couldn’t afford them, insurance didn’t cover a substantial portion of it––and I couldn’t afford to miss work anyway.

What does it cost to do one of those programs?

Foundations Recovery was one of them. And I think it was up to like $15k/month for IOP. And then going away for a month is anywhere from like $25k to $40k––and some places are even more than that. So a lot.

I know someone who literally broke the family by doing one of these programs where he went away for a month––and it didn’t even work.

The rehab industry is just atrocious. And you’re right, it doesn’t work. I mean, there’s no real good long-term care solution. It’s acute, and people like mortgage their homes to try to get well. 

And these were not options I wanted. I didn’t want to be one of those people. I don’t want to be an alcoholic. I just didn’t see myself in the picture painted for me and the solution felt very extreme and also totally inaccessible.

And so for me it started me on a path to research this. I threw myself into hacking together what was a recovery that fit me, that felt good, and that was incredibly effective…I stopped drinking in October 2012, then I got over my eating disorder. December 2013 was last time I purged, and then I stopped smoking cigarettes. I was also a daily pot smoker, and I stopped smoking pot and using all recreational drugs in early 2014. And also I got certified as a yoga instructor and my life changed dramatically… In terms of money invested, it was a few thousand dollars versus hundreds of thousands of dollars.

One part of what I researched and figured out was that we were sold a message that we’re supposed to make alcohol work. One of the biggest flips for me was understanding that alcohol was something that we’re not supposed to be consuming, that our bodies aren’t designed to break it down. And that we’ve been duped essentially into an alcohol culture. I realized that I didn’t have to do it anymore.

How did you assess the market? What opportunities did you see?

It was never like, “Wow, this is a great business.” What I saw was the chance to change the way we think about alcohol, the way we think about addiction, the way we think about recovery…I’d say the first part of this was really trying to stop looking at this and splitting people into addicts and non-addicts, and really be able to look at the actual substance and the culture around the substance and what’s actually systemically happening to drive people to drink the way that they do, and then leave them without options, or at least provide them options only when they’re dying.

So, when you thought about the market, Alcoholics Anonymous had been around forever––who were the competitors in this space?

The competitor is somebody not doing something. You give me too much credit for thinking in terms of market. I wasn’t. I was thinking far more in terms of 16 systemic issues that prevented people from reassessing their relationship with alcohol. And also, from seeing very clearly, I had codified what makes people well, there’s a general framework that comes with it. It’s essentially like looking at social determinants. And then also expanding health care. Iora Health is a great model for this…

It’s important to understand that when we try to break down what’s wrong with healthcare in the United States, we’re looking at things like obesity or diabetes or heart conditions and partially not looking at depression and anxiety and addiction…There are these things that make people sick and unable to engage and care for themselves…

I went to something called Health 2.0 back in 2014. It’s a Silicon Valley health-tech startup—like almost a glam show. It’s just like all these startups coming in with all of their inventions and ideas…And addiction wasn’t mentioned once. I’m not kidding. And I was trying to tell them, they needed to talk about this.

How big is the rehabilitation industry?

It’s a $35B industry. And when we look at how we define alcohol use disorder on the spectrum of what is in spectrum for treatment, it’s about 5m people. And of those 5m people, about 1m people will access treatment.

And then when you actually look at what problematic drinking looks like, across the drinking population in the United States, it’s 51m Americans that are on the spectrum of problematic drinking. So that’s 30% of drinkers who are either problematic drinkers or binge drinkers.

So how did your business come about?

I designed what was then called Hip Sobriety around essentially these three things: One, alcohol is going to have a reversal and it was going to follow the trajectory of the cigarette industry. Two, a larger population needed to be served. And three, we needed to create something that people would want more than their addiction––an aspirational model.

And then four, that it needed to be accessible. And so I codified what had worked for me and pieced together something that could be repurposed for anybody that wasn’t just specific to my circumstance and privilege. And then essentially put it into an 8-week program and started testing it out in 2015.

How did people respond to it?

A number of them stopped drinking and they also loved it and wanted more of it. I ran the school again in 2016, around 100 individuals participated, and that went well. Then in May 2016, I ran it for the third time with about 170 individuals. And so it pretty quickly achieved product-market fit.

What did your product look like at first, and how has it changed?

We started by sending emails every day, giving little bits of what we call mantras. So it could be anything from, “How do I want people to remember me in this interaction?” to “I’m allowed to be angry” or “I can do hard things, too.” Just a piece of information someone can use in their real life to start changing the way they think. So it’s cognitive behavioral therapy and positive psychology. We sent those out with essays I wrote every night.

Then, weekly, I delivered live lectures. I would read a bunch of books, and I would tell people things they needed to know. We would start with, say, talking about how to piece together a recovery map. How to build a toolbox. How to understand what happens to the brain in addiction. How to start making new habits or change habits. How to work with willpower. And then it would go into like, how to use yoga and nutrition, how to work with trauma, how to find a therapist, how to find meaning and purpose. And so it’s leading individuals over an 8-week period through a curriculum that allows them to start creating their own map. We’re teachers—we’re not care providers. I was teaching individuals, “Hey, here’s how you empower yourself with this knowledge. And then here’s some homework exercises. So try this this week.”

And then we were getting together on a call once a week—there were 13 people in our group. About eight of us would end up on a live call and we would sit there and we just say, “Hey, what’s going on?” We were having these really personal conversations, and we were also using Facebook groups. And people had a lot to lose, executives and care providers were coming into Facebook and writing about their divorce, about their drinking, about drinking with their kids in the cars… just putting so much on the line.

We typically attract perfectionists, and we were breaking that need to do something perfect in order to do it at all. And really my focus was to keep people coming back and also have people break up with the idea of what it means to struggle with alcohol––how shameful that is. So that was the original product. And I was working, I don’t even know how many hours a day on it, and they all had my cell phone number. And it was totally not sustainable. I went to Italy for three months afterwards because it was just so exhausting. But it proved that it worked.

When you size up the market now, where are the under-served areas?

When we look at what the total market is in terms of alcohol alone, we are looking at close to 51m people in the United States. But that ignores the fact that there’s cross-addiction. There are subsets that are completely under-served and where there’s no competition whatsoever. 

Like what?

A good example is alcohol use disorder and cigarette cessation. And there’s other ones that are incredibly specific to it, like eating disorders along with alcohol use disorder. There are almost no solutions at certain intersections of our populations. And when you’re talking about historically under-served populations––like women, people of color, queer people––there are a number of intersections of identity of addiction of co-morbid conditions that aren’t addressed entirely.

So there are some populations that are just not being served?

Yeah, typically. It’s not because there’s not enough of a population, it’s because they’re women. Or again, like, I mean, for the most part, healthcare has been built around white men. And you know that because of drug trials they run on, like PTSD. When we think of PTSD, we think of trauma left from war. And you just need to look up the hashtag #metoo to realize how much unprocessed trauma related to sexual assault and abuse there is.

But then when you expand this out, you start opening it up to multiple addictions, you got—I mean, God bless the company that figures pot out, right? … I have a number of friends who are venture capitalists, and the number of CBD and pot companies that are coming onto the market––and there is no pot recovery center. And it’s a nut to crack, right?

This is how I look at it. There’s an incredible book called “The Globalization of Addiction,” and it ties in the expansion of a free market society with the increasing rate of addiction. And when we talk about addiction, we’re talking about Internet addiction, work addiction, gambling, behavioral stuff, and chemical substances.

I have a book coming out at the end of this year [“Quit Like a Woman: The Radical Choice to Not Drink in a Culture Obsessed With Alcohol“], and one of the things I talk about is that there’s not a mutant addicts gene flooding the gene pool…What’s wrong is we have a society that essentially causes extreme dislocation, and dislocation from each other, from real life, from community, from belonging. And what you end up with is that people are commodified, and their priorities are messed up.

With an increasing free market, you’re just going to get more addiction. And so that’s the market cap––everyone. And for us, we’re specific to alcohol, like we’re starting with this one thing where we think there’s absolutely really no good form of existing care. We’re starting with a market that’s totally under-served. We’re starting with a product––and not just a product, but a proprietary way of how we talk to people, and also how we help people.

So what’s your longer range goal? Do you see scaling out into some of these other forms of addiction you talked about––whether it’s other drugs or behavioral issues?

Yeah, absolutely. I think it’s like figuring out like, how do you build off of what we currently have within our population and eventually expand it. One is expanding it across the spectrum of severity, and also of engagement. It takes a long time for somebody to get treatment––for them to come to terms with getting treatment––and so it’s expanding across levels of severity and then also expanding across like different archetypes, populations, different payment channels, and then obviously different addictions. We have a very specific roadmap but there is a sea of possibilities.