Weight loss drugs like Ozempic can also curb drug and alcohol addiction

These drugs, called glucagon-like peptide-1 receptor agonists (GLP-1RA), could represent a promising new direction in the treatment of alcohol and other substance dependence disorders.

“Early animal and human research suggests that these treatments can help reduce alcohol and other substance use,” said study leader Lorenzo Leggio, MD, Ph.D., of the National Institute on Drug Abuse (NIDA) and the National Institute on Alcohol Abuse and Alcoholism (NIAAA), both part of the National Institutes of Health (NIH) in Bethesda. Md. “Some small clinical trials have also shown encouraging results.”

Current treatment options are limited

Addictive addiction disorders are identified through four key patterns: physical dependence, risky behavior, social difficulties, and loss of control.

The widespread damage caused by these disorders extends far beyond individual health, affecting families, communities and societies around the world. In particular, alcohol is considered the most harmful drug in general, contributing not only to health problems, but also to traffic accidents and violent incidents, according to the researchers.

Even with the scale of the problem, fewer than one in four people received treatment for an alcohol or other substance use disorder in 2023.

The authors point to numerous barriers, including stigma and limited resources for patients and providers. “Current treatments for [alcohol and other substance use disorders] they do not meet public health needs,” the study states.

GLP-1 drugs and their potential role in addiction

GLP-1 drugs have recently gained notoriety for their success in reducing appetite and promoting weight loss.

In addition to their effects on digestion, GLP-1 molecules play an important role in the brain. Activation of GLP-1 receptors in the central nervous system helps regulate hunger signals, prompting people to eat when they are hungry and stop when they are satisfied.

The study highlights that some forms of obesity share biological and neurological traits with addiction, although this idea is still debated.

“Pathways involved in addiction also contribute to pathological overeating and obesity,” the study says.

Recognizing this overlap, scientists began investigating GLP-1 drugs as a possible treatment for addictive disorders. Early animal and human studies suggest that these drugs may affect the brain circuits that drive addictive behavior, potentially reducing drug craving and use, and may also affect other existing health problems.

Evidence from early research

Studies examining the effects of GLP-1 on addictive disorders include:

• Alcohol use disorder (AUD): A randomized controlled trial with exenatide, the first GLP-1 receptor agonist approved for diabetes, showed no significant effect on alcohol consumption, although a secondary analysis indicated reduced alcohol intake in a subgroup of people with AUD and comorbid obesity. A more recent randomized controlled trial showed that low-dose semaglutide — a newer GLP-1 receptor agonist approved for both diabetes and obesity — reduced laboratory self-administration of alcohol, as well as drinking per drinking day and craving, in individuals with AUD.
• Opioid use disorder: In rodent models, several GLP-1 receptor agonists have been shown to reduce self-administration of heroin, fentanyl, and oxycodone. Studies have also found that these drugs reduce drug-seeking relapse, a rodent model of drug addiction relapse.
• Tobacco use disorder: Preclinical data show that GLP-1 receptor agonists reduce nicotine self-administration, reinstatement of nicotine seeking, and other nicotine-related outcomes in rodents. Initial clinical trials suggest the potential of these drugs to reduce the number of cigarettes smoked per day and prevent the weight gain that often follows smoking cessation.

The way forward

Leggio and his colleagues stress that more research is needed to confirm how effectively GLP-1 drugs treat addiction and to understand the underlying biological mechanisms.

Despite the unanswered questions, researchers remain optimistic.

“This research is very important because alcohol and drug addiction are major causes of disease and death, but there are still only a few effective treatment options,” Leggio said. “Finding new and better treatments is critical to helping people live healthier lives.”

Other research Authors are citizens M. Srinivasan from the University of Galway in Galway, Ireland; Mehdi Farokhnia Of nida and niaa; Lisa A. Farnelli herself; and Anna Ferrule from the University of Milan and istuto di ricovero e curation a caratere science (irccs) multimedia in Milan, Italy.

The research reported in this article was supported in part by NIDA and NIAAA. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.