Cerebral, a telehealth startup that specializes in prescribing medications like Adderall, Ritalin and Xanax over the internet and relies on social media advertising to reach customers, has come under fire for writing a huge number of prescriptions. But Instagram continues to accept the company’s advertising dollars, even as Cerebral has drawn investigations from the Justice Department and the Drug Enforcement Administration. 

A former executive is suing the company, which is worth an estimated $4 billion, on grounds that he was fired for raising concerns internally about Cerebral’s controversial business model — specifically, its habit of seemingly overprescribing stimulants as a ploy to retain customers. The DOJ has reportedly subpoenaed the company for records as part of an investigation into potential violations of the Controlled Substances Act and, per Insider, the DEA has interviewed former Cerebral employees for its own investigation.

Media Matters found that Cerebral spent more than $5 million dollars advertising on Instagram since the beginning of the year. According to Pathmatics, a company that tracks digital marketing data, those ads have earned more than 630 million impressions during the same time period. (The company continues to advertise on TikTok as well.)

And though the company has reportedly paused prescribing controlled substances like Adderall and Ritalin, it’s still running ads on Instagram for ADHD diagnoses and other services.

Companies like Cerebral are able to legally prescribe potentially addictive medications online because of the coronavirus pandemic. As hospitals and other medical facilities became overwhelmed with COVID-19 patients and millions of Americans began seeing their doctors online, federal authorities relaxed rules that had prohibited controlled substances from being prescribed via telehealth appointments. This resulted in an explosion of telehealth clinics that advertise their services online.

In response to this changing online health care landscape, Instagram's parent company Meta (formerly known as Facebook), updated its advertising policies for prescription drugs last fall. These updates require telehealth providers to undergo a third-party certification process and implement age and location restrictions on telehealth customers. 

After receiving increased public scrutiny around their targeted advertising, Meta announced in January that it planned to remove the option to target advertisements based on what could be considered “sensitive” information,” including “health causes.”

Cerebral isn’t the only company taking advantage of the new telehealth landscape and relaxed federal guidelines around prescribing controlled substances. A startup called Done, for instance, bills itself as a telehealth clinic that treats ADHD. According to Pathmatics, Done has spent more than $800,000 on Instagram ads since the beginning of the year — some of which seemingly violate Meta’s policy against listing prices in ads promoting prescription drugs.

Both Cerebral and Done have been accused of overprescribing stimulants — in fact, some major pharmacies no longer fulfill prescriptions written by the companies’ clinicians.

Telehealth companies have focused their social media advertising on other treatments as well. Hims & Hers Health, Inc. uses Meta’s platforms to advertise easier and cheaper access to medication for everything from anxiety to erectile dysfunction, with “no office visits or pharmacy trips required.”

Nue Life Health has also published ads through Meta promoting its at-home ketamine treatments for depression.

Telehealth services have proven useful — especially during the pandemic, when many could not see a doctor in person. But when companies prioritize their bottom line to overprescribe medications and utilize targeted advertising with Meta — a company which has also been shown to put its own profits before its users’ safety — it's clear that patient care is no longer the main focus.

Despite Meta’s claims that it has strengthened its advertising policies around prescription medications, the company pockets millions as it enables predatory companies like Cerebral to use its marketing tools to peddle potentially dangerous drugs directly to consumers.