Adam’s Journal
GLP-1 drugs like Ozempic, Wegovy and Mounjaro have transformed the field of weight loss. Now I’ve started hearing and reading stories of how the drugs can also curb addiction to alcohol and drugs. Are these just anecdotes, or is there more to it?
Dr. Scofield Prescribes
Ozempic and its chemical cousins work by mimicking a chemical receptor for a compound known as glucagon-like peptide-1 (GLP-1). These drugs, known as GLP-1 agonists, have been approved to treat obesity and diabetes, and they’ve yielded dramatic results. In clinical trials, participants dropped an average of 5-15% of their weight, and the medications also have proven effective in reducing blood sugar levels.
As more people have taken these drugs for longer periods of time, researchers have begun studying other effects of the drugs. Over time, they’ve noted a growing list of potential benefits: reduced risk for cardiovascular events like heart attack, stroke and heart failure; slowing the decline of kidney function in people with kidney diseases; lowering blood pressure; and a drop in the levels of inflammation and levels of lipids in the blood.
To this list, scientists have also added another potential boon: the ability to tame desires for things other than food.
GLP-1 agonists make people feel full by delaying the movement of food through the stomach. But they also target the brain’s reward pathway, regulating the release of dopamine, a neurotransmitter tied to motivation and pleasure.
Because GLP-1 agonists seem to reduce patients’ desire for food, it isn’t surprising that they might also shrink or even extinguish other cravings – alcohol, drugs and even behaviors like sex, shopping and gambling.
Research in this area is still in its infancy, with clinical trials just getting started. However, pre-clinical evidence suggests that GLP-1 agonists could cut alcohol and substance abuse. Recent observational studies also lend support to this idea.
In research published in the journal Nature, scientists looked at nearly 2 million people in the U.S. Department of Veterans Affairs database. They found that compared to those receiving standard care, people taking GLP-1 agonists had a reduced risk of substance use disorders, including alcohol, marijuana, stimulants and opioids.
In Sweden, researchers followed more than 200,000 individuals with alcohol use disorder. Over an eight-year period, people taking GLP-1 agonists had a markedly lower rate of alcohol-related hospitalizations than those not using the medications.
These are observational studies, so they examine correlation rather than causation. Still, early clinical studies have shown similarly promising results.
In one small study of people with opioid use disorder, a GLP-1 agonist reduced their cravings for opioids by 40%. In another, people with alcohol use or opioid disorder who took GLP-1 agonists had substantially lower rates of opioid overdose and alcohol intoxication than those who didn’t.
A growing number of clinical trials are underway to test GLP-1 agonists as therapies for alcohol and substance use disorders. If the trials bear out the early results we’re seeing, these drugs could be game changers for the treatment of addiction.
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Dr. Hal Scofield is a physician-scientist at the Oklahoma Medical Research Foundation, and he also serves as Associate Chief of Staff for Research at the Oklahoma City VA Medical Center. Adam Cohen is OMRF’s senior vice president and general counsel. Send your health questions to contact@omrf.org.
