A kitchen table in Riga is seen with an Ozempic (semaglutide), injection pen on the 6th of August 2023.
Jaap Arriens | Nurphoto | Getty Images
Heather Le Biller shed 9 pounds within the first week of taking
Novo Nordisk‘s blockbuster diabetes drug Ozempic – and then even more as she continued treatment. Le Biller, who is a French flight attendant, noticed that her appetite decreased while she was taking the weekly injection. Her desire for wine also decreased, which she described as “almost customary” to drink with every meal in France. Le Biller said to CNBC that “when I was on Ozempic it made me want this less and less.” “I was able to have a few sips of wine, and be satisfied. I could then move on.” It helped me to not drink multiple glasses of wine at night. Le Biller is among several patients who took diabetes and weight loss drugs and also noticed an effect on their cravings for alcohol, nicotine, opioids or even some compulsive behaviors, such as online shopping and gambling.
Those drugs – including Ozempic and its weight loss counterpart from Novo Nordisk, Wegovy – are called GLP-1 agonists, which mimic a hormone produced in the gut to suppress a person’s appetite. These anecdotal accounts add to the growing list that GLP-1s may have benefits beyond just shedding pounds. The primary reason for the popularity of these drugs in the U.S. is dramatic weight loss, even though they cost up to $1,000 per month and many health insurance companies no longer cover them. “We are prescribing these medications and seeing this as a secondary advantage in patients.” One of my patients said that they are not shopping online as much, which has helped their wallet,” Dr. Angela Fitch said, an obesity medicine doctor and president of the Obesity Medicine Association. This group is the largest association of physicians, nurse practitioner and other health care providers who are dedicated to treating obesity.
A client drinks a glass wine at the It’s Italian Cucina Restaurant on April 5, 2023 in Austin. According to a new analysis of over 40 years’ worth of research, moderate drinking is not beneficial for your health. Getty Images
This striking effect of GLP-1s isn’t a new idea. Multiple studies have shown that certain GLP-1s reduce alcohol consumption in monkeys and rodents.
More studies, especially on humans, are needed to confirm that these drugs have this effect. Novo Nordisk told CNBC in a statement that they aren’t pursuing this research
.
“Pharma has this general lack of interest in investing in the addiction field,” due to a perfect storm of factors, including the high stigma around addiction disorders among doctors, physicians and even patients.
Novo Nordisk told CNBC in a statement that they aren’t pursuing that research
.
“Pharma has this general lack of interest in investing in the addiction field” due to a perfect storm of factors, including the high stigma around addiction disorders among doctors, physicians and even patients, according to Dr. Lorenzo Leggio, clinical director of the National Institute on Drug Abuse, or NIDA.
Leggio and other scientists are working to fill the gap – and have already made strides toward confirming the potential of GLP-1s as addiction treatments.
What do we know so far?Scientists have published nearly a dozen studies showing how GLP-1s stop binge drinking in rats and mice, reduce their desire for alcohol, prevent relapse in addicted animals and decrease alcohol consumption overall. In earlier studies, older and less potent GLP-1s like exenatide – a diabetes drug sold under the name Byetta or Bydureon – were examined. According to Elisabet Jirlhag, pharmacologist and pharmacologist at the University of Gothenburg in Sweden, recent studies have shown that semaglutide (the generic name for Ozempic or Wegovy) and dulaglutide (
Eli Lililly
) reduced alcohol consumption by 60-80%. She said that studies have shown that rats who stop taking the drug dulaglutide (also known as Trulicity), which is approved to treat diabetes, take weeks before they begin drinking again. Reuters
Other studies on animals have also found that GLP-1 drugs reduce the consumption of nicotine, cocaine, heroin and amphetamines. Semaglutide has been studied on animals, but there are six clinical trials underway to see if it can change people’s smoking and drinking habits. Leggio, from NIDA, says that the GLP-1s are responsible for this anti-addiction action because they also affect the brain and not just the gut. Leggio, CNBC’s senior analyst, said that the mechanism in the brain which regulates overeating also plays a role in addictive behavior. There is a distinct overlap. It’s therefore possible that these medications could help those with addictions by acting on this specific mechanism. “
GLP-1s decrease the amount dopamine released by the brain after people engage in behaviors such as drinking, smoking, or eating sweet desserts. This is according to Dr. Steven Batash who offers nonsurgical weight-loss procedures in Queens. Batash explained that dopamine, a neurotransmitter, “reinforces” the pleasure of these activities. GLP-1s remove the pleasure from these activities, and they eliminate motivation.
What needs more research?
Still, NIDA’s Leggio advises against using GLP-1s off-label to reduce addictive behaviors, “simply because there’s not enough evidence in humans that they work.” “The animal studies are promising, and what people report is very, extremely important. But as a scientist I will tell you that this is not enough,” Leggio told CNBC. Leggio says scientists should conduct more double-blind randomized placebo-controlled human studies – where neither participants nor researchers know whether they are receiving a drug or a placebo. These studies are the “gold standard” to prove whether or not a treatment has a positive effect. “We know that, in fact, these medications, and any drug, do not work for everyone,” he added. Digitalvision Researchers wrote that the reason could be because “leaner” patients treated with exenatide had a greater decrease in blood glucose, which may have been associated with an increased desire for alcohol. It’s not clear how long GLP-1s can have an anti-addiction impact. Patients have a common complaint about weight loss. People who lose weight while taking Ozempic and Wegovy usually gain it all back – or more – within a couple of years. Leggio stated that it is possible for some patients to relapse into heavy drinking after stopping the medication. He said that addiction is a chronic illness and some patients may need to be treated constantly. Leggio, however, said that there is “nothing inherently wrong” if a patient seeks GLP-1s for diabetes, obesity or addiction disorders. “If you’re interested in seeing if Ozempic can help you control your sugar levels and also reduce your alcohol consumption, then that is wonderful. Leggio stated that it was possible to kill two birds with one rock. If you only want to use the drug because you smoke or drink, you should wait until more research is done. Scientists and health experts are hopeful that new treatments for alcoholism, smoking, and other addictive behaviors will be available in the future. It may take several years. “It’s possible that in three, four, or five years, we may say that GLP-1-agonists are great for treating mild diabetes and weight loss. We might also say they are fantastic for curbing addictive behavior,” Batash said to CNBC. The uptake of addiction medications is low. As of 2019, approximately 14 million American adults suffered from alcohol use disorder, a condition associated with excessive drinking. Only 1.6% of Americans used one of the FDA-approved medications to treat the disorder.