Guest Contributor – Jeffrey L. Reynolds, Ph.D
The ubiquitous earworm commercial on television promises that Ozempic – along with diet and exercise – can lower blood sugar in adults with type 2 diabetes and help you lose weight, but can the blockbuster drug – and others in its class – also treat addiction?
An increasing number of studies suggest that could be the case.
More than 15 million Americans are taking once weekly injections of Ozempic and Wegovy (Semaglutide), Mounjaro and Zepbound (Tirzepatide), Trulicity (Dulaglutide) and a few lesser-knowns. They are all GLP-1 (Glucagon-Like Peptide-1) receptor agonists and help people lose weight by curbing their appetites and cravings.
GLP-1s work in slightly different ways, but in general they slow digestion, leaving patients feeling fuller for longer, and improve insulin sensitivity, which helps regulate blood sugar fluctuations that can trigger the urge to eat and drink. These medications also target areas in the brain’s hypothalamus that regulate hunger signals, and they influence dopamine reward pathways, potentially reducing the pleasurable aspects of eating that drive cravings.
Beyond Weight Loss: A Surprising Ripple Effect
With all that going on, it’s not surprising that patients are shedding pounds and report being satisfied with smaller meal portions, have fewer urges to snack and have lost their hankering for high-calorie foods like cupcakes, cheeseburgers and pizza. Many also say they are less interested in booze, weed, cigarettes and even opioids.
Their anecdotal experiences are in line with a growing body of published studies, including one from 2023 that found that people using GLP-1s hoping to eat less also drank less alcohol. National Institute on Drug Abuse (NIDA) Director Dr. Nora Volkow was a researcher in a study last year suggesting GLP‑1 agonists may prevent relapse among those with alcohol use disorder (AUD) and she co-authored another study that found that GLP-1s may reduce the incidence and relapse of cannabis use disorder (CUD).
A Loyola University study published last October that found that people with alcohol use disorder (AUD) who also had a prescription for Ozempic or similar medications had a 50% lower rate of binging on alcohol, compared to people who were not on the medications. And people with opioid use disorder who were taking the medications had a whopping 40% lower rate of opioid overdose.
Another paper published in February found that people on low-dose GLP-1s not only had fewer heavy drinking days, but also reduced their cigarette use.
GLP-1 users have also said that as they lost their weight, they also gave up or cut back on other addictive behaviors like compulsive shopping, problem gambling, and even nail-biting.
The Catch: Side Effects, Stigma, and Unknowns
Like every other drug, GLP-1s have some known side effects, including headaches, nausea, vomiting, diarrhea, and constipation. The long-term side effects of prolonged use remain unknown. But curbing America’s historically unsatiable appetite for not only food, but booze, opioids and other drugs – maybe even gambling, shopping and hoarding – could save countless lives and dramatically change longevity in our nation.
Despite a recent decline in fatalities, 87,000 Americans die annually from drug overdoses or poisonings – mostly due to fentanyl. More than twice as many – 178,000 people – die from excessive drinking each year. Cigarette use has dropped, but vaping is up and with cannabis legal in most states, more folks will use weed, some recreationally, but some problematically.
The mortality and morbidity associated with drugs and alcohol are preventable, and we urgently need more tools to save lives. Pharmaceutical companies may have accidentally invented a whole new class of blockbuster anti-addiction drugs, but the federal Food and Drug Administration (FDA) hasn’t approved them for that.
That’s ok; don’t we already have FDA-approved medications like methadone, buprenorphine, and naltrexone to treat substance use disorders (SUD)?
Indeed, we do, but only about 1 in 5 of adults with an opioid use disorder receive medication assisted treatment (MAT), despite it being the gold standard in addiction medicine.
That’s partly due to stigma, partly due to cost and partly due to inaccessibility. And stigma (there’s that word again) is probably part of the reason why GLP-1 drug manufacturers aren’t rushing to formally test these drugs in people with addiction, lest they harm the brand.
The Bigger Picture
It’s too early to know whether using GLP-1s to treat addiction comes with additional side effects and since current research suggests that many people regain weight after stopping GLP-1 medications, the same may go for alcohol and drug use.
Some have also questioned whether a pre-filled pen that allows consumers to easily cut calories could heighten body shame and lead to eating disorders. One psychiatrist – interviewed by Piers Morgan went so far as to say, “These drugs are rocket fuel for people with eating disorders.”
Another doctor and eating disorder specialist – Elizabeth Wassenaar – puts it this way on a treatment center website:
“I worry that GLP-1s could have a similar impact on the eating disorder community as opioids did on people in chronic pain,” she cautions. “We may not know the true harm for many years, and by then, countless people will have suffered from preventable mental illness. The only way to stop this from happening is to understand the dangers now and educate people early and often about the realities of GLP-1s.”
That’s sobering.
These drugs are in their infancy and assuming the federal government continues to fund biomedical research (an open question these days), there will be additional clinical trials to better pinpoint the benefits, limitations and risk profiles of GLP-1s.
We just might find – as we have so many times before – that while “wonder drugs” can address the biology of disease and give us an on-ramp to address the psychological, spiritual and social aspects of what ails us, there are no miracle cures.
The real magic comes from doing the work.
As one of Long Island’s largest and oldest health and human service organizations, Family & Children’s Association goes above and beyond to care for the region’s most vulnerable, serving over 35,000 individuals annually and helping them prepare for the future. Amid rising costs and increased demand for mental health and support services, FCA’s work is more crucial than ever. The organization provides services for clients aged 2 to 102, including comprehensive addiction prevention, treatment, and recovery programs, along with wraparound services.
Since joining FCA, as President and CEO, Dr. Jeffrey L. Reynolds has secured over $18 million in new funding and launched several innovative services, including three THRIVE Recovery Centers and a Certified Recovery Peer Advocate program. He also helped secure funding from SAMHSA to establish a new Certified Community Behavioral Health Clinic in Nassau, integrating mental health and substance use disorder treatment.
An influential thought leader, Jeff has earned seats at significant tables, contributing to discussions on gaming, cannabis/opioid use, human trafficking, mental health, and more.
He has authored more than 250 news and op-ed articles that have appeared in a wide variety of publications and is consistently used as an expert source by local and national radio, television, online and print outlets.
Dr. Reynolds holds a Bachelor’s degree in psychology from Dowling College (1988), a Masters in Public Administration (MPA) with a specialization in health administration from Long Island University (1997) and a doctorate from Stony Brook University’s School of Social Welfare (2007).
With a dedicated team of over 360 staff members, 200 volunteers, and over 40 programs, Jeff ensures FCA remains at the forefront, making Long Island a better place. As a lifelong Long Islander and two-time cancer survivor, he brings his drive, passion, and unwavering commitment to everything he does.
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