Could Ozempic be the Cure for Addiction?
Glucagon-like peptide 1, or GLP-1 medications sold under the brand names Ozempic and Wegovy have been approved since 2005 to treat type 2 diabetes. They have gained public notoriety for the until recently, off-label (approved by the FDA in 2023) treatment for obesity with some patients losing up to 15% of their total body weight.
Additionally, these medications are found to lower cholesterol, reduce inflammation, and even reduce or reverse heart disease. Many of these observations are anecdotal, but still, results like these warrant further study for their potential to better the health of millions of people worldwide.
These medications are so successful at inducing weight loss because they help to increase satiety and reduce a patient’s desire for food, making it much easier for overweight and obese people to stick to their weight loss program.
Researchers, doctors, and patients are beginning to see new potential for this reduction in desire — addiction treatment. Let’s take a deeper look into how GLP-1 medications work and the potential for their use as an effective addiction treatment.
How GLP-1 medications work
GLP-1 medications like tirzepatide or semaglutide (used interchangeably in this article) are an analog of a hormone that your intestinal cells produce after eating a meal. The hormone interacts with your pancreas, increasing insulin production which lowers your blood sugar, as well as slowing the stomach emptying.
The effect is that patients feel fuller faster and stay satiated longer, effectively working as an appetite suppressant. Anecdotally, we find that many patients report that they simply don’t desire food as much, which points to a secondary mechanism at play.
What we are learning is that this secondary mechanism of desire may not only apply to weight loss. Many other structures in the brain produce GLP-1 or have receptors for the hormone. The way the drugs interact with these areas of the brain indicate that they can have an affect on other pathways of human desire, including addiction.
How does this apply to addiction?
The structures in our brain that create or receive GLP-1 hormones control how we perceive desire. In other words, the reward pathways that motivate us to seek pleasurable activities like eating rich food, scrolling our social media feeds, or even hanging out with our friends are controlled by these pathways.
Addiction works by hijacking these neural pathways by using substances like drugs or alcohol to stimulate high levels of happiness-causing hormones such as dopamine. It is in this way that people become addicted to things like alcohol, drugs, sex, gambling, or even food.
Researchers believe that GLP-1 medications may also be interacting with these reward centers in our brain, and evidence is beginning to show that patients are reporting less of a desire to drink and smoke in addition to reducing the desire for food.
Some patients are even reporting that they have ceased self-soothing activities like nail biting or shopping. Let’s take a look at some of the research so far.
Current research is promising but inconclusive
Semaglutide’s interaction with addiction and desire remains mostly anecdotal, with clinical trials still quite new, but what we are seeing is promising.
There are currently nine phase 2 clinical trials either in progress or being planned. These trials aim to test whether semaglutide can conclusively help patients to quit everything from cigarettes and alcohol to opioids and cocaine.
Studies on rodents and primates have supported this idea and researchers have observed the medications curb subjects’ desire for alcohol, fentanyl, nicotine, and heroin.
Researcher Anders Fink-Jensen of the University of Copenhagen showed that the medications reduced the instance of drinking in a notorious group of Caribbean Island primates who are so inclined to imbibe that they frequently steal alcohol from tourists.
The research in human patients is just beginning. One study, led by Luba Yammine from the University of Texas Health Science Center in 2021, found that almost half of patients who both wore nicotine patches and received weekly doses of semaglutide stopped smoking compared to only 27% of patients who tried to quit with patches alone.
The future of addiction research
There are other, less successful trials that tend to use older GLP-1 analogs, spurring a need for new trials using newer and much more effective forms of the medications which may have greater affect on addiction.
One concern that researchers share is that this quelling of desire may trickle into a patient’s ability to find joy or pleasure in everyday life. The fear is that this could create unwanted side effects like depression, lethargy, or even relapse.
Whatever the case, new research will help to better understand the impacts that these medications can have on those suffering from addiction and hopefully provide new and more effective pathways for addiction treatment.
Until then, these medications are not recommended for addiction treatment and other better-studied treatment options are preferred.
Other barriers to use for GLP-1 medications is the price. Since these medications are being prescribed for off-label treatment, they can cost as much as $12,000 per year, not accessible to most working people.
Insurance likely won’t cover these alternative applications of GLP-1’s until the medications gain FDA approval for addiction treatment which would require conclusive data from phase 3 trials. Until then, cost remains a significant barrier to the application of these medications for their off-label use, no matter how promising they may be.
Conclusion
The research is still new and inconclusive, but it’s beginning to look like these medications could be applied to many problems outside of diabetes and weight loss treatment.
Addiction treatment is a notoriously understudied topic because of the false perception that addiction should not be treated as a disease or that the potential for relapse negates the need for better treatment options.
Supporting new research will only help to legitimize this area of study and create better treatment for addiction which has one of the highest fatality rates of any disease and is worthy of serious study.
If you are in need of assistance or support regarding substance use, please contact your medical provider and ask for help.
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