People taking the trendy drug Ozempic for weight loss say they’ve also stopped drinking, smoking, shopping and even nail biting. Semaglutide, the main ingredient in Ozempic and Wegovy, was marketed as an injectable type 2 diabetes treatment before people zeroed in on its weight loss properties. As the drug skyrocketed into popularity, people began noticing that it not only suppresses the appetite, but also reduced a whole range of addictive and compulsive behaviors.
According to The Atlantic, addiction scientists have been testing drugs similar to semaglutide to curb the use of alcohol, cocaine, nicotine and opioids in laboratory animals and the results have been promising. While most treatments are specific to the addiction, Christian Hendershot, a clinical psychologist at the University of North Carolina at Chapel Hill School of Medicine, says that semaglutide and its chemical relatives seems to work on a wide range of addictive behaviors.
Hendershot is now running clinical trials to see if semaglutide can help people quit smoking and drinking alcohol. Scientists believe that the drug works because it prompts the pancreas to release insulin by mimicking a hormone called GLP-1, or glucagon-like peptide 1. They believe that drugs like semaglutide may act not only on the pancreas, but also in areas of the brain where they bind to receptors on neurons to suppress urges for not only food, but other things as well.
Specifically, GLP-1 analogs affect the dopamine, feel-good pathways in the brain which are the reward circuitry. Food and sex, for example, trigger a dopamine hit in the brain which makes us want to repeat the cause of the response. People with addiction have fewer dopamine receptors in the brain so it takes more of a trigger to achieve a pleasure response.
According to Insider, Dr. Paul Kolodzik, a metabolic specialist in Ohio who is also board certified in addiction medicine, says that semaglutide “could be the next big thing in addiction management, certainly related to alcohol.” Kolodzik said that some of his weight-loss patients say they no longer experience alcohol cravings while on the drug. A similar phenomenon was observed in rat studies, too.
While human trials and research on the benefit of semaglutide on addiction are still scarce, experts also warn that it may work in some people and not others. The long-term impact of semaglutide is a mystery as well, says The Atlantic. We do know that in diabetes and obesity, semaglutide is a life-long medication. When it is stopped, the effects stop too.
“The weight comes back; the suppression of appetite goes away,” says Dr. Janice Jin Hwang, chief of the Division of Endocrinology and Metabolism at UNC-Chapel Hill. Since semaglutide is a relatively new drug, approved for diabetes since 2017, the long-term risks and benefits will not be known for decades.
However, Kolodzik says he has the evidence he needs to feel comfortable prescribing semaglutide to some patients in his addiction-medicine practice. One woman, who was originally drinking 45 alcoholic drinks weekly, cut her consumption in half by taking naltrexone on the days she drank. When Kolodzik introduced semaglutide, he said her weekly drinks plunged to three to five. She reported that alcohol used to be the focus of her day, but after taking semaglutide she became disinterested.
Kolodzik added that patients taking the injectable drug for weight loss need to follow a diet and exercise plan for the most benefits. Alcohol patients should take the drug as part of a comprehensive treatment plan that could also include therapy, but he sees no problem in prescribing the drug off-label since the risks of alcohol abuse outweigh the potential risks of semaglutide.
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