Alcohol, Nicotine and More – Can Drugs Like Ozempic Stop Cravings for Bad Habits?

Michael McCluskey, 61, was known as a heavy drinker after getting out of the Navy. He drank an average of four to five drinks per dayht. Even drinking up to 10 drinks was “a no-no”Common occurrence,” he says.

but all that chanfour years ago, when He started taking Ozempic for weight loss. Weighing in at 110 pounds, McCluskey lost his appetite for alcohol — quickly and rapidly.Ply. Nowadays, he drinks twice a year – when he hosts sci-fi conventions.

“It’s just like a switch flipped in my brain,” the Dartmouth, N.S., man said. “No desire. That’s just it.”

His story is not unique. Previous patient data studies have shown a similar association between glucagon-like peptide-1 receptor agonist drugs (GLP-1 RAs) such as Ozempic. and lack of appetite for more than just food. GLP-1 RA has becomeN is associated with those who want less and consume all kinds of evils, no matter what Liquor, nicotine, cannabis Or narcotics, a study Viewing social media posts suggesting people reduce their habits On habits like caffeine use and Even compulsive shopping.

Scientists do not have a clear explanation for why drugs like Ozempic reduce cravings for bad habits, including addiction. But they have some ideas they’re testing — some here in Canada, where any progress would help significantly as the country faces a growing opioid crisis.

emerging research

There have not been many randomized clinical trials on whether GLP-1 reduces RA addictive behavior—which are considered the gold standard for evaluating medical claims.

there are only beesTwo such trials are studying their effect on alcohol addiction, none Two for opioid addiction and one for nicotine addiction, according to recent reviews Published in the Journal of the Endocrine Society.

Christian HendershowTee, California-based Canadian researcher, co-auThored one of them randomized controlled trialRecently published in JAMA PsychiatrYes, given the alcohol consumption.

In the study, they divided 48 people who drank heavily into two groups. received one a weekly shot Drugs such as Ozempic and Vegovy used the active ingredient semaglutide, while others were given a placebo. Then, they tracked how much alcohol both groups consumed at home and in a laboratory setting.

“The semaglutide group consumed significantly less alcohol,” said Hendershott, who previously held the Canada Research Chair in Alcohol Use Disorders, and is now a professor at the University of Southern California.

Hendershott says this finding is particularly surprising because The subjects were notTrying to reduce drinking.

“The next step is to conduct clinical trials that can establish that these drugs are safe and effective in clinical populations,” he said.

Still, Hendershott is urging caution until larger, long-term studies are conducted.

a blunt dopamine rush

Some scientists are studying the brain’s reward system to try Understand the mechanisms that may explain why medications like Ozempic may reduce cravings or desire.

An important part of that system is dopamine, a neurotransmitter that is released when you do something pleasurable, like eating a piece of cake or getting a satisfying workout. thAt the time of release essentially telling you, “This feels great!”

It also encourages you to do it again, giving you motivation to repeat the action. And while the dopamine rush you get after exercise may not be the same as the one you get after eating Chocolate has some similarities to reward circuitry, says Dr. Rodrigo Mansour, a psychiatrist and researcher at Toronto Western Hospital.

“Of course, there are meaningful differences in how (different rewards) are regulated. But they share those underlying neural circuits,” Mansour said.

Drugs like Ozempic can affect those neural circuits, he said.

Researchers like Mansour say that GLP-1 RA blunts the reward mechanism, the dopamine rush that comes with reward. This can change the way people feel desire, happiness, and motivation.

Mansoor has just completed a phase 2 randomized clinical trial I see how GLP-1 affects motivation in 72 people with RA depression. He’s trying to find out how hard patients taking the drug are willing to work for the cash rewards, by measuring how much energy they burn while performing cognitive tests. he is mineThe energy expended is measured with a metabolic cart, which the body analyzes as it takes in oxygen and releases carbon dioxide.

The brain is the most metabolically demanding organn throughout the body, which means it consumes about 25 percent of the body’s energy. That’s why Mansour thinks his study can measure people’s motivation, and whether GLP-1s change it.

that’s stewTest the medications to see how they affect depression patients who already suffer from low energy and motivation. But he also wants to know how GLP-1 causes RA Affect motivation and pleasure, which they hope may be helpful for people with mood disorders – and which could have further implications in treating other diseases such as addiction.

“We need to better understand what causes these problems with motivation in people with depression, and we need better treatments for it.”

Chances of Addiction Treatment

Addiction researchers in Canada also say they are excited by the potential of GLP-1 RA in their practicesnow. Substance abuse is a growing and complex problem across the country: About 15 percent People surveyed by Statistics Canada had a moderate to high risk of alcohol use disorder in 2023; For cannabis, it was 13 percent. Since 2016, there are approximately 54,000 Opioid overdose deaths.

For that reason, researchers say they are hungry for more evidence.

Working hypothesis – that GLP-1 may reduce RA dopamine spikes Follows the consumption of an addictive drug – exciting, as it deals with the “vulnerable”“Neural currency accounts for all addictive behaviors,” says James MacKillop, chair of the Peter Boris Center for Addiction Research at McMaster University.

“The existing medications we have are generally medication-specific: opioid medications for opioid-use disorder, nicotine medications for tobacco-use disorder.”

GLP-1RA, in contrast, appears to target a central pathway common to all psychoactive drugs, he says. But MacKillop cautions that we are still in the early days of the research.

‘Hype is outweighing evidence’

If GLP-1 RAs are effective in treating addiction, researchers must also find out who they are effective for — and that’s not yet clear, says Dr. Sanjeev Sockalingam, chief medical officer of the Center for Addiction and Mental Health (CAMH) in Toronto.

He says the center has proposed several trials on GLP-1 RA to treat nicotine and alcohol use.

even if rejectingFor people who are struggling with their mental health, the side effects the drugs can have are also important – and Sockalingam says that although there is some preliminary evidence that shows there are no significant side effects on mental health, he would like to see long-term studies.

“We just need to make sure there is no unintended fraudSokkalingam, who is cautiously optimistic, says About the potential of drugs in treating addiction.

MacKillop agrees – he believes GLP-1 RAs are game-changers in many ways, but there are very few “free lunches” when it comes to drugs. soI am on their behalf Effects such as nausea, vomiting and constipation are already known.

“Almost all medications have some drawbacks and it takes some time to become aware of exactly what they are,” he said. He is afraid that enthusiasm may not be visiblet complete rereality

“In many ways these drugs are still unproven,” he said. “Hype is outweighing the evidence.”

thThe truth, he says, is that a drug alone cannot cure addiction. Creating a healthy lifestyle where people can find joyHe says things like exercise, hobbies and friends are keys to addiction treatment.

And, they worry, if GLP-1 RA is an anti-desire drug, they may decrease.People’s motivation to maintain those aspects of their lives.

“They may be anti-pleasure or anti-desire drugs. And that’s not necessarily a good thing in terms of promoting healthy recovery.”