Since leaving the Navy, 61-year-old Michael McCluskey has been known as a heavy drinker. On average, he drank four to five drinks a night.xt. Even drinking up to 10 drinks “wasn’t unusual.”a normal event,” he says.
But all this, chanfour years ago when he started taking Ozempic for weight loss. Along with weighing 110 pounds, McCluskey lost his cravings for alcohol—quickly and easily.layer. Now he drinks twice a year – when he holds science fiction conferences.
“It was like a switch flipped in my head,” said the man from Dartmouth, North Carolina. “No desire. That's all.”
His story is not unique. Studies analyzing data from past patients have found a similar association between glucagon-like peptide-1 receptor agonist (GLP-1 RA) drugs such as Ozempic, and loss of appetite not only for food. GLP-1 RAs weredue to the fact that people want and consume less of all kinds of vices, be it alcohol, nicotine, hemp or opioids. One study Looking at posts on social networks, it can be assumed that people have cut back about habits such as caffeine consumption and compulsive shopping too.
Scientists have no clear explanation for why drugs like Ozempic reduce cravings for vices, including addictive substances. But they have some ideas they're testing – some here in Canada, where any progress could help significantly as the country faces a growing opioid crisis.
New research
There have not been many randomized clinical trials, which are considered the gold standard for evaluating medical claims, on whether GLP-1 RAs reduce addictive behavior.
There is only a beeIn two such studies examining their effect on alcohol dependence, none opioid addiction and two – nicotine addiction, according to recent review published in the Journal of the Endocrine Society.
Christian Hendershawt, Canadian researcher from California, what-ohpierced one of these randomized controlled trialsrecently published in JAMA Psychiatr.yes, looking at alcohol consumption.
From gambling and alcohol to pornography, the drugs Ozempic and GLP-1 could soon be used to treat all types of addictions. Watch The Ozempi Effect: Beyond the Waist on CBC Gem.
In the study, he divided 48 heavy drinkers into two groups. One received weekly snapshot semaglutide, the active ingredient in drugs such as Ozempic and Wegovy, while another was given a placebo. He then tracked how much alcohol both groups consumed both at home and in a laboratory setting.
“The semaglutide group consumed significantly less alcohol,” said Hendershot, who formerly held the Canada Research Chair in Alcohol Use Disorders and is now a professor at the University of Southern California.
According to Hendershot, this discovery is especially striking because the items were notI'm going to cut down on alcohol consumption.
“The next step is to conduct clinical trials that can prove that these drugs are safe and effective in the clinical population,” he said.
However, Hendershot urges caution until larger, longer-term studies are conducted.
Dulled release of dopamine
Some scientists are studying the brain's reward system to try understand the mechanism of action that may explain why drugs such as Ozempic may reduce cravings or desires.
A key part of this system is dopamine, a neurotransmitter that is released when you do something enjoyable, such as eating a piece of cake or finishing an enjoyable workout. whatupon release essentially tells you, “This is great!”
It also encourages you to do it again, giving you the motivation to repeat the action. And while the dopamine rush you get after a workout may not be the same as the one you get after eating “Chocolate, there are some similarities in reward patterns,” says Dr. Rodrigo Mansur, a psychiatrist and researcher at Toronto Western Hospital at the University Health Network.
“Of course, there are significant differences in how [different rewards] regulated. But they do share neural circuits,” Mansour said.
Drugs like Ozempic can affect these neural circuits, he says.
GLP-1 RAs appear to blunt the reward mechanism, the release of dopamine that accompanies reward, say researchers like Mansour. It can change the way people feel desire, pleasure and motivation.
Mansour just completed a randomized phase 2 clinical trial. looking at how GLP-1 RAs influence motivation in 72 depressed individuals. He wants to find out how hard patients taking the drug are willing to work for money. prize by measuring how much energy they burn while taking a cognitive test. Anythingmonitors energy expended using a metabolic cart that analyzes the body as it inhales oxygen and exhales 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 believes his research could quantify people's motivation and whether GLP-1 changes it.
He is studyinggoing off medications to see how they affect patients with depression, who already tend to suffer from a lack of energy and motivation. But he also wants to learn more about how GLP-1 RA affect motivation and pleasure, which he hopes may be useful for people with mood disorders – and which may have further implications in the treatment of 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.”
Treatment options for addiction
Addiction researchers in Canada also say they are excited about the potential of GLP-1 RAs in their practice.ice. Substance use is a growing and complex problem across the country: approx. 15 percent people surveyed by Statistics Canada were at moderate to high risk of alcohol use disorder in 2023; for cannabis the figure was 13 percent. Since 2016 it has been carried out almost 54,000 opioid overdose deaths.
For this reason, researchers say they need more evidence.
The working hypothesis is that GLP-1 RAs may blunt the dopamine surge that talks about using an addictive drug – it's interesting because it touches on the 'core“The neural currency for all types of addictive behavior,” says James MacKillop, chairman of the Peter Boris Center for Addiction Research at McMaster University.
“The medications we have tend to be drug-specific: opioid medications to treat opioid use disorder, nicotine medications to treat tobacco use disorder.”
GLP-1 RAs, in contrast, appear to target a central pathway common to all psychoactive drugs, he says. But MacKillop cautions that we are still in the very early stages of the research.
“The hype outstrips the evidence”
If GLP-1 RAs are effective in treating addiction, researchers must also figure out for whom they are effective—and that's not yet clear, says Dr. Sanjeev Sokalingam, chief medical officer at the Center for Addiction and Mental Health (CAMH) in Toronto.
The center has proposed several studies examining GLP-1 RAs to treat nicotine and alcohol use, he said.
Except whether there will beThat the drugs can have side effects for those struggling with their mental health is also crucial – and Sokalingam says that while there is some preliminary data suggesting there are no serious side effects on mental health, he wants to see long-term studies.
Questions revolve around the use of semaglutide, commonly sold under the brand name Ozempic, for weight loss. CBC's Christine Birak explores the risks and benefits of off-label use of a drug traditionally used to treat type 2 diabetes.
“We just need to make sure there are no unintentional violations.consistency from their increased use in different settings,” says Sokalingam, who is cautiously optimistic. about the potential of drugs in the treatment of addiction.
McKillop agrees: He believes that while GLP-1 RAs are game-changers in many ways, there are very few “free lunches” when it comes to drugs. SoI'm on their side the effects are already well known, such as nausea, vomiting and constipation.
“Almost all drugs have some downsides, and it takes a while to really understand what they are,” he said. He is afraid that the excitement is not reflectedt full repetitionality.
“In many ways, these drugs are unproven,” he said. “The hype outweighs the evidence.”
whatThe truth is, he says, that one drug alone cannot cure addiction. Promoting a healthy lifestyle in which people can enjoy sports.Things like exercise, hobbies and friends are key to treating addiction, he said.
And, he worries, if GLP-1 RAs are an anti-desire drug, they could reducece motivating people to maintain these aspects of their lives.
“They can be drugs against pleasure or against desire. And that’s not necessarily a good thing in terms of promoting healthy recovery.”
