Could Ozempic Be Used to Curb Addiction? Why Researchers Are Looking at This Future Option

Recent studies have unveiled a potentially groundbreaking connection between anti-obesity drugs and their ability to mitigate alcohol cravings, particularly in individuals dealing with both obesity and alcohol use disorder (AUD). This emerging research is beginning to shed light on a promising avenue for the treatment of AUD, offering hope for a population that has limited therapeutic options.

The focal point of this research lies in the observation that anti-obesity drugs, including Ozempic, may exert a notable influence on alcohol cravings, thereby diminishing the risk of relapse for those grappling with AUD. This effect arises from a reduced sense of reward associated with alcohol consumption, effectively making relapses less probable.

These early findings represent a pivotal juncture in addiction medicine and offer a glimpse into the potential synergy between obesity treatment and the management of AUD. Ozempic and Wegovy, both of which are part of a class of drugs known as glucagon-like peptide-1 receptor agonists (GLP-1s), have emerged as key players in this research. Originally developed for the management of type 2 diabetes, they have garnered approval for obesity treatment, and now their potential utility in addressing AUD is under scrutiny.

The significance of this research becomes even more apparent when considering the scale of the AUD problem in the United States. With nearly 30 million individuals aged 12 and above grappling with AUD, and an alarming annual death toll of 140,000 attributed to AUD-related causes, it is evident that new treatment options are urgently needed. Currently, only four medications are approved by the Food and Drug Administration (FDA) for AUD treatment, underscoring the scarcity of therapeutic choices available to patients.

The gravity of the situation is well expressed by Elisabet Jerlhag Holm, PhD, a professor of pharmacology at the University of Gothenburg in Sweden, renowned for her research on the Gut-Brain Axis and Addictive Disorders. She emphasizes the pressing need for more medications to combat AUD, given its prevalence. Among the three FDA-approved medications for AUD—Disulfiram, Naltrexone, and Acamprosate—there remains a gap in terms of efficacy and suitability for all patients, emphasizing the necessity for a broader array of treatment options.

GLP-1 drugs like Ozempic and Wegovy function by mimicking a hormone that induces a sensation of fullness, consequently reducing food intake and facilitating weight loss. They also help in stabilizing insulin and blood sugar levels, which is pertinent in both diabetes and obesity management. However, it is crucial to acknowledge that these medications are not a panacea. Their effectiveness can vary among individuals, and AUD, as with any other medical condition, is not a one-size-fits-all problem.

Lorenzo Leggio, MD, PhD, a physician-scientist at the National Institute on Alcohol Abuse and Alcoholism (NIAAA) and the National Institute on Drug Abuse (NIDA), has been at the forefront of the National Institutes of Health’s (NIH) research on GLP-1s and their potential role in reducing alcohol consumption. He underscores the fact that while the existing AUD medications are valuable, they are underutilized and do not yield favorable results for everyone. This discrepancy reinforces the demand for a more diverse arsenal of treatment options to cater to the individualized needs of patients.

The central question revolves around how GLP-1 drugs influence alcohol use disorder at a neurobiological level. In an insightful rat study published in The Lancet, Holm and her research team made a significant discovery. They found that a semaglutide drug, a member of the GLP-1 class, interacts with the nucleus accumbens, a critical area in the brain associated with reward. In humans, this region releases dopamine in response to alcohol consumption, contributing to the pleasurable sensation derived from drinking.

The study’s findings indicated that by acting upon the nucleus accumbens, semaglutide reduces both alcohol intake and the likelihood of relapse drinking, a phenomenon where individuals return to substance use after a period of abstinence. The reduction in the reward sensation linked to alcohol appears to be the key factor in preventing relapse drinking, which is pivotal for achieving sustained success in AUD treatment.

However, it is essential to tread cautiously when extrapolating findings from animal studies to human applications, as the complexities of human neurobiology often differ from those of rodents. Nonetheless, these initial insights serve as a foundational step in comprehending how GLP-1 drugs may function in humans, particularly in the context of AUD.

While the rat study was illuminating, human-focused research is vital to determine the real-world applicability of GLP-1 drugs for AUD. A randomized, double-blinded, placebo-controlled clinical trial published in 2022 involving 127 human participants with AUD offered valuable insights. Over a span of 26 weeks, participants were administered 2 mg of exenatide, a GLP-1 medication used for type 2 diabetes but not approved for weight loss, or a placebo. Both groups also received cognitive-behavioral therapy as part of the treatment.

The results indicated that only overweight individuals with AUD experienced a reduction in alcohol intake following exenatide treatment. This observation hints at the possibility of different neurobiological mechanisms underlying AUD in overweight individuals compared to those with a regular weight. However, further research is needed to substantiate these findings and determine the specific patient population that might benefit most from GLP-1 drugs in AUD treatment.

The implications of this research extend beyond the laboratory and into clinical practice. If subsequent studies confirm the safety and efficacy of GLP-1 drugs for AUD, it could represent a significant advancement in the field of addiction medicine. However, it is essential to approach these findings with caution, as they mark the initial steps in a broader exploration of treatment possibilities.

One aspect that future research will need to address is a direct comparison between weight loss drugs like Ozempic and established AUD medications. To determine the true potential of GLP-1 drugs in AUD treatment, head-to-head trials with existing therapies are warranted. Such trials will provide critical insights into which patient populations might benefit most from these medications.

Elisabet Jerlhag Holm underscores the promise of these findings, emphasizing that the preclinical models used in the research show a high level of validity, suggesting that what is observed in rodents may indeed have relevance in humans. This early evidence that GLP-1 drugs could be effective in individuals dealing with both AUD and obesity is a significant breakthrough.

Lorenzo Leggio echoes the importance of these findings in early science, recognizing that while the initial trial revealed promising results, further research will be required. Future investigations will need to delve into the use of semaglutides and GLP-1 drugs specifically in individuals confronting both AUD and obesity. Additionally, researchers will need to confirm that the weight loss achieved through these drugs primarily involves fat loss rather than unhealthy muscle loss.

In conclusion, the intersection of obesity treatment and AUD management presents a compelling avenue of research with the potential to revolutionize addiction medicine. Early studies hint at the promise of GLP-1 drugs like Ozempic and Wegovy in mitigating alcohol cravings and preventing relapse drinking in individuals with both obesity and AUD. However, cautious optimism is essential, as more extensive clinical trials are needed to validate these findings and determine the precise patient populations that could benefit most from these medications. Regardless, this research offers a ray of hope for individuals struggling with AUD, emphasizing the ongoing need for innovative and effective treatment options in the battle against addiction.