How Ozempic, GLP-1 Weight Loss Drugs Affect the Brain to Curb Substance Misuse

• A new study shows a 50% lower risk of alcohol intoxication among people with alcohol use disorder who take GLP-1 drugs prescribed for weight loss and diabetes.
• The findings also show that people with opioid use disorder taking GLP-1 drugs like Ozempic had a 40% lower chance of an opioid overdose.
• The study authors explained the medications interact with a part of the brain that can help suppress appetite, which may also help curb addictive behaviors.
• Experts say the study results are promising, but more research is needed.

GLP-1 drugs prescribed for obesity and diabetes such as Ozempic and Mounjaro could help treat alcohol and drug use disorders, according to a new study.

The research, published in the journal Addiction, reports that people with substance abuse issues who take weight loss drugs with the active ingredients semaglutide and trizepatide had significantly lower rates of opioid overdoses and alcohol intoxication.

The reductions were seen only in more extreme instances involving opioid and alcohol misuse. While the results are nonetheless promising, further studies are needed to determine whether GLP-1 drugs can curb the desire for pain medications and alcohol.

“These medications are promising new pharmacological treatments for addictions, including (but not limited to) alcohol use disorder and opioid use disorder,” said Lorenzo Leggio, MD, a clinical researcher at the National Institute on Alcohol Abuse and Alcoholism (NIAAA) and the National Institute on Drug Abuse (NIDA). Leggio wasn’t involved in the study.

“That said, an important word of caution is the fact that we need double-blind placebo-controlled randomized trials to further test whether these medications work for patients with substance use disorders,” Leggio told Healthline.

Effects of weight loss drugs on substance use disorders

For their study, the researchers looked at 1.3 million health records compiled by Oracle’s Real-World Data system. The medical data for these cases was gathered between January 2014 and August 2022.

The researchers studied more than 500,000 people with a history of opioid use disorder. Of them, about 8,100 had a prescription for a GLP-1 drug, such as Ozempic, Mounjaro, and Wegovy.

The study authors report that people with opioid use disorder who take a GLP-1 drug had a 40% lower rate of opioid overdose compared to those who did not have a prescription.

The researchers also examined more than 800,000 people with a history of alcohol use disorder. Of them, about 5,600 had a prescription for a GLP-1 medication.

The study authors stated that people with alcohol use disorder who take a weight-loss drug had a 50% lower rate of alcohol intoxication when compared with those with didn’t have a prescription.

The researchers noted that this is the first large-scale study with humans on the potential use of weight loss drugs to reduce addiction risks.

“This study suggests that patients with heroin or alcohol addiction who are prescribed Ozempic (typically for diabetes or obesity) are less likely to be hospitalized for heroin overdose or alcohol intoxication, respectively,” Matt Field, a professor of psychology at the University of Sheffield in the United Kingdom, told Healthline. Field wasn’t involved in the study.

“The findings add to those from other studies, particularly animal research, which suggest that this and similar drugs might one day be prescribed to help people with addiction,” Field added.

How GLP-1 drugs alter the brain’s reward response

The researchers explained that GLP-1 medications interact with the mesolimbic system in the brain to reduce appetite and trigger satisfaction after eating.

They said the mesolimbic system overlaps with the brain processes that govern addictive behaviors.

According to a news release, the overlap suggests that GLP-1 RAs and similar drugs may change the reward-response pathways that are linked to substance misuse.

Leggio said that although more study is needed, the future looks promising for the use of these medications to curb addiction.

“The preclinical and human data we have so far suggest that these medications may be beneficial for addiction in general by curbing cravings and reducing alcohol drinking, opioid use, smoking, etc.,” Leggio said.

Field noted a word of caution about the findings. “The outcomes are very extreme instances of substance intoxication,” he said. 

“Those outcomes are very different from the outcomes used when researchers test new treatments for addiction, in which case we might look at whether the treatment helps people to stop taking the substance altogether (complete abstinence), or if it helps people to reduce the amount of substance they consume, or how often they consume it,” Field continued.

“Those things could not be measured in this study. This leaves open the possibility that while Ozempic may (for reasons currently unknown) prevent people from taking so much alcohol or heroin that they overdose and end up in hospital, it may not help them to reduce their substance use, or to abstain altogether,” Field noted.

What to know about alcohol use disorder

It’s estimated that nearly 29 million people ages 12 and older in the United States have alcohol use disorder. Around 17 million are male and 12 million are female.

“Alcohol use disorder is a medical condition characterized by an impaired ability to stop or control alcohol use despite adverse social, occupational, or health consequences,” according to the NIAAA.

The condition, considered a brain disorder, can be mild, moderate, or severe. Factors that can contribute to developing alcohol use disorder include:

• drinking at an early age
• genetics and family history
• mental health conditions
• history of trauma

Medical professionals generally ask people a series of questions to determine if they have developed alcohol use disorder. Among the questions:

• Have you had times when you ended up drinking more or longer than you intended?
• Have you ever wanted a drink so badly you couldn’t think of anything else?
• Have you ever continued to drink even though it was causing problems with family and friends?
• Have you found yourself in a situation while drinking that increased your chances of getting injured?

There are treatments available to treat alcohol use disorder. Three medications are currently approved by the Food and Drug Administration (FDA) to help treat alcohol misuse:

• naltrexone
• acamprosate
• disulfiram

Mental health resources like behavioral therapy and mutual support groups can also be helpful.

What to know about opioid use disorder

It’s estimated that about 4% of adults in the U.S. need some form of treatment for opioid use disorder. That is more than 9 million people.

In 2022, more than 80,000 opioid-involved overdose deaths were reported in the United States, the highest number on record.

Opioid use disorder, which is considered a brain disorder, is characterized by Yale Medicine as “continuing opioid use despite harmful consequences.”

The symptoms of being addicted to these pain medications include:

• physical dependence
• loss of control in taking opioids
• inability to complete tasks at home, work, or school
• skipping important events or meetings

Some medications are used to help treat opioid use disorder, including:

• methadone
• buprenorphine
• naltrexone

Leggio noted the current medications can be effective in treating addiction, but they need to be more widely available.

“These medications are not widely used as they should and indeed, it’s very important to increase efforts toward expanding the use of these approved effective treatments for our patients,” he said.

A growing number of health benefits for GLP-1 drugs

Recent research reported that GLP-1 drugs with the active ingredient trizepatide such as Mounjaro and Zepbound were effective in helping people maintain weight loss over three years.

Medications with the active ingredient semaglutide, such as Ozempic and Wegovy, are also proven to be effective in helping people lose weight over an extended period.

Experts have said this consistent weight loss may also help lower the risk of developing type 2 diabetes.

A 2023 study also indicated that weight loss drugs with semaglutide may help reduce the risk of some cancers.

Now, pharmaceutical companies are looking into the possibility that their GLP-1 medications may also help treat alcohol and opioid use disorders.

In addition to the new research, another recent study reported that Ozempic and Wegovy may help lower the risk of opioid overdose.

Takeaway

In a new study, researchers say people with alcohol use disorder who take GLP-1 drugs had a 50% lower risk of alcohol intoxication compared to people not taking the medications.

The researchers also reported that people with opioid use disorder taking GLP-1 drugs such as Ozempic had a 40% lower chance of an opioid overdose compared to people who aren’t taking the medications.

The study authors said GLP-1 drugs are effective in a part of the brain that can help suppress appetite. They said the medications may also work in other nearby parts of the brain to help curb addictive behaviors.

Experts say the study results are promising, but more research is needed.