Semaglutide (marketed as Ozempic, Wegovy and Rybelsus) was initially developed for the treatment of diabetes. It works by stimulating insulin production to keep blood sugar levels under control.
This sort of drug is increasingly prescribed for weight reduction, though it was initially approved for a different purpose. Recently, there was growing interest in one other possible application: addiction treatment.
Anecdotal reports from patients taking semaglutide for weight reduction suggest that it reduces appetite and food cravings, but surprisingly, it may additionally reduce the will to drink alcohol, smoke cigarettes, or take other drugs.
But does the scientific evidence support this?
Animal studies show positive results
Semaglutide acts on glucagon-like peptide-1 receptors and is often called a “GLP-1 agonist”.
Animal studies in rodents and monkeys have yielded overwhelmingly positive results. Research suggests that GLP-1 agonists may reduce drug use and drug satisfaction, including alcohol, nicotine, cocaine and opioids.
Our team reviewed the evidence and located that over 30 different preclinical studies have been conducted. Most show positive leads to reducing drug and alcohol consumption or cravings. More than half of those studies focus specifically on alcohol use.
However, translating research findings from animal models to people living with addiction is difficult. While these results are promising, it remains to be too early to tell whether it should be secure and effective in people affected by alcohol use disorder, nicotine addiction, or other drug addiction.
What about human studies?
Results from human studies are mixed.
Just one large, randomized, controlled trial conducted to this point regarding alcohol. In a study of 127 people, there was no difference between exenatide (a GLP-1 agonist) and placebo (a dummy treatment) in reducing alcohol consumption or heavy drinking over 26 weeks.
In fact, all study participants reduced their drinking, each those taking energetic medications and people receiving placebo.
However, the authors conducted further analyzes to examine changes in drinking depending on body weight. They found that for individuals who had each alcohol use problems and obesity, alcohol consumption was reduced.
For individuals who began at a normal weight (BMI lower than 30), despite initially reducing their alcohol intake, they saw a sharp increase in heavy drinking after 4 weeks of treatment, with an overall increase within the variety of days of heavy drinking compared to those that took medication. placebo.
There were no differences between groups on other measures of alcohol consumption, corresponding to craving.
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In one other 12 weeks testresearchers found that dulaglutide, a GLP-1 agonist, didn’t help reduce smoking.
However, people receiving dulaglutide, a GLP-1 agonist they drank 29% less alcohol than those on placebo. More than 90% of individuals on this study were also obese.
Smaller studies have evaluated GLP-1 agonists short-term cocaine AND opioidswith mixed results.
Many other clinical trials are currently underway for GLP-1 agonists and alcohol-related and other addiction disorders.
We are awaiting results from larger studies, however it is difficult to interpret the conflicting results. These differences in response to treatment could also be due to individual differences that influence addiction, including physical and mental health problems.
Larger studies in broader human populations will tell us more about whether GLP-1 agonists will work in addiction, and in that case, in whom.
How might these drugs work for addiction?
The exact mode of motion of GLP-1 agonists just isn’t yet well understood, but as well as to reducing intake (food or medication), they may additionally reduce appetite.
Animal studies have shown that GLP-1 agonists reduce appetite cocaine AND opioids.
This may involve a key region of the brain’s reward system, the ventral striatum, with experimenters showing that once they directly administer GLP-1 agonists to this region, rats show reduced “hunger” oxycodone Or cocainepossibly by limiting drug-induced dopamine release.
Using human brain imaging, experimenters can induce cravings by showing images (signals) related to alcohol. Exenatide, a GLP-1 agonist decreased brain activity in response to an alcohol cue. The researchers observed reduced brain activity within the ventral striatum and septal areas of the brain, which connect to emotion-regulating areas corresponding to the amygdala.
In human studies, it’s unclear whether GLP-1 agonists act directly to reduce cravings for alcohol or other drugs. This must be directly assessed in future studies, taking into consideration any limitations of use.
Are these medications secure for addiction treatment?
Overall, GLP-1 agonists have been shown to be relatively secure in healthy adults and in individuals with diabetes or obesity. However, negative effects include nausea, digestive problems, and headaches.
And while some people don’t mind shedding weight as a side effect, others don’t. For example, if someone is already underweight, this medicine is probably not right for them.
Additionally, little or no research has been conducted on people affected by addictive disorders. However, some negative effects could also be more of a problem for addicts. Recent research shows, for instance, that: rare risk of pancreatitis related to GLP-1 agonists, and folks with alcohol use problems are already at greater risk of developing this disorder.
Other pharmacological treatments at the moment are available
While recent research on GLP-1 agonists for addiction treatment is an exciting development, far more research needs to be done to understand the risks and advantages of using these GLP-1 agonists for people living with addiction.
In the meantime, the variety of effective addiction treatments available remains to be too few. Just about 3% Australians addicted to alcohol, for instance, are prescribed such drugs naltrexone, acamprosate Or disulfiram. We need to make sure that current treatments can be found and that healthcare professionals understand how to prescribe them.
Continuous innovation in addiction treatment can be crucial. Our team is researching other personalized and effective treatments for alcohol addiction, while others are researching treatments for nicotine addiction and other drug addictions.
