Will Ozempic be the Next Addiction-Fighting Drug?

November 6th, 2023

By P. Casey Arrillaga, LCSW, LCDC

Ozempic
has been all over the news as the latest hot medication for weight loss. Treatment
centers usually ignore these sorts of drugs unless they show addictive
potential (Ozempic doesn’t so far). Nonetheless, at Windmill, we are always on
the lookout for over-the-horizon treatment possibilities, the things that may
be coming in the next few years. This brought Ozempic to our attention, because
along with its more popular uses for diabetes and weight loss, it turns out
that it may give people an edge when they are trying to get sober. This post
will look at what we know so far about this possibility and what to make of
this information.

What
We Know So Far

Ozempic
(generic name semaglutide) is in a class of medications called “GLP-1” that was
developed to manage Type 2 diabetes. It works by lowering blood sugar in
response to eating, which is extremely helpful, but not the sort of thing that
usually makes headlines. It only started bursting into the public consciousness
in the past year or so because of a completely different and unexpected
side-effect. Users of the medication started reporting weight loss, but not
because of nausea or anything else unpleasant. Instead, they said they just
weren’t as hungry. Amphetamine-type weight loss drugs can depress a person’s
appetite, but they can be very addictive and have serious health consequences (anyone
remember Fen-Phen?). Instead, Ozempic users reported that they simply felt
satisfied on much less food without feeling “amped up,” jittery, or having the
heart palpitations associated with amphetamine use.

Essentially,
GLP-1 medications create a feeling of feeling satisfied. They mimic a chemical
released in the small intestine that tells us we’ve eaten enough, and also helps
regulate blood sugar levels. This highlights why Ozempic and other GLP-1
medications help with diabetes and weight loss. What brought all this to the
attention of researchers and others who are fighting addiction is that patients
taking Ozempic reported another unexpected side effect: they found they had
reduced cravings to use alcohol or other mood-altering substances.

This
seems to be because Ozempic and other GLP-1 medications target the mesolimbic
pathway, our brain’s reward circuitry that is central to all known addictions.
This pathway is what everyone who is addicted tries to activate, whether they
abuse drugs, sex, gambling, food, or shopping to do it. Thus, anything that
reduces that mesolimbic pathway’s response, and more importantly reduces the
feeling that it needs to be activated, is a potentially powerful ally in the
battle against addiction.

This
had led to a wave of explorational research. What has been found so far is that
GLP-1 medications reduce alcohol and other drug use in rats and non-human
primates. Early evidence suggests that these medications even have the
potential to help with cocaine cravings and use. This is particularly exciting
given that medications such as naltrexone have been shown to help reduce
cravings for alcohol and opiates, but no effective drug has been found to help
reduce cravings for cocaine and other stimulants.

Is
Ozempic the Answer to Addiction?

While
many medications and treatments have been touted as “the cure to addiction,” all
have fallen far short of this promise. This is likely because there is a lot
more to addiction than reducing cravings. Addiction is a complex brain disease
that is exacerbated by unresolved trauma, subtle environmental cues, and low
self-image among other factors. This is probably why so many previous “miracle
drugs” have helped but have not solved the addiction. In fact, a common problem
is that people often stop taking anti-craving medications when they are clearly
helping, and sometimes they can’t give a logical reason why.

The
most likely explanation is that there are deeper issues that need to be sufficiently
resolved before a person is ready to stop relying on the addictive behavior.
This is why treatment at Windmill centers on much more then medication
management. We do genetic testing to find the right medications, but we spend
much more time on finding the right therapy and recovery tools for each client.
That way, they are able to make headway on the underlying issues that would
otherwise undermine any medication or recovery effort, no matter how well
intentioned.

It’s
also vital to keep in mind that all the findings on Ozempic and addiction are
preliminary and mostly speculative. It will likely take years to have solid
research to say one way or the other whether this and other GLP-1 medications
are effective enough to justify using on people with addiction.

The
Bottom Line

Ozempic
and other GLP-1 medications offer the promise of a potential new tool in the
fight against addiction. They may reduce cravings and thus help people through
a difficult time that might have led to relapse. Nonetheless, even if they do
all that early results suggest, a full treatment and recovery program is still
necessary.

About The Author

P. Casey Arrillaga is the Team Leader for Education at
Windmill Wellness Ranch, and he is the author of books including “Realistic
Hope: The Family Survival Guide for Facing Alcoholism and Other Addictions”.
His book