By P. Casey Arrillaga, LCSW, LCDC
Ozempic has been all over the news as the latest hot medication for weight loss. Treatment centers usually ignore these sorts of drugs unless they show addictive potential (Ozempic doesn’t so far). Nonetheless, at Windmill, we are always on the lookout for over-the-horizon treatment possibilities, the things that may be coming in the next few years. This brought Ozempic to our attention, because along with its more popular uses for diabetes and weight loss, it turns out that it may give people an edge when they are trying to get sober. This post will look at what we know so far about this possibility and what to make of this information.
What We Know So Far
Ozempic (generic name semaglutide) is in a class of medications called “GLP-1” that was developed to manage Type 2 diabetes. It works by lowering blood sugar in response to eating, which is extremely helpful, but not the sort of thing that usually makes headlines. It only started bursting into the public consciousness in the past year or so because of a completely different and unexpected side-effect. Users of the medication started reporting weight loss, but not because of nausea or anything else unpleasant. Instead, they said they just weren’t as hungry. Amphetamine-type weight loss drugs can depress a person’s appetite, but they can be very addictive and have serious health consequences (anyone remember Fen-Phen?). Instead, Ozempic users reported that they simply felt satisfied on much less food without feeling “amped up,” jittery, or having the heart palpitations associated with amphetamine use.
Essentially, GLP-1 medications create a feeling of feeling satisfied. They mimic a chemical released in the small intestine that tells us we’ve eaten enough, and also helps regulate blood sugar levels. This highlights why Ozempic and other GLP-1 medications help with diabetes and weight loss. What brought all this to the attention of researchers and others who are fighting addiction is that patients taking Ozempic reported another unexpected side effect: they found they had reduced cravings to use alcohol or other mood-altering substances.
This seems to be because Ozempic and other GLP-1 medications target the mesolimbic pathway, our brain’s reward circuitry that is central to all known addictions. This pathway is what everyone who is addicted tries to activate, whether they abuse drugs, sex, gambling, food, or shopping to do it. Thus, anything that reduces that mesolimbic pathway’s response, and more importantly reduces the feeling that it needs to be activated, is a potentially powerful ally in the battle against addiction.
This had led to a wave of explorational research. What has been found so far is that GLP-1 medications reduce alcohol and other drug use in rats and non-human primates. Early evidence suggests that these medications even have the potential to help with cocaine cravings and use. This is particularly exciting given that medications such as naltrexone have been shown to help reduce cravings for alcohol and opiates, but no effective drug has been found to help reduce cravings for cocaine and other stimulants.
Is Ozempic the Answer to Addiction?
While many medications and treatments have been touted as “the cure to addiction,” all have fallen far short of this promise. This is likely because there is a lot more to addiction than reducing cravings. Addiction is a complex brain disease that is exacerbated by unresolved trauma, subtle environmental cues, and low self-image among other factors. This is probably why so many previous “miracle drugs” have helped but have not solved the addiction. In fact, a common problem is that people often stop taking anti-craving medications when they are clearly helping, and sometimes they can’t give a logical reason why.
The most likely explanation is that there are deeper issues that need to be sufficiently resolved before a person is ready to stop relying on the addictive behavior. This is why treatment at Windmill centers on much more then medication management. We do genetic testing to find the right medications, but we spend much more time on finding the right therapy and recovery tools for each client. That way, they are able to make headway on the underlying issues that would otherwise undermine any medication or recovery effort, no matter how well intentioned.
It’s also vital to keep in mind that all the findings on Ozempic and addiction are preliminary and mostly speculative. It will likely take years to have solid research to say one way or the other whether this and other GLP-1 medications are effective enough to justify using on people with addiction.
The Bottom Line
Ozempic and other GLP-1 medications offer the promise of a potential new tool in the fight against addiction. They may reduce cravings and thus help people through a difficult time that might have led to relapse. Nonetheless, even if they do all that early results suggest, a full treatment and recovery program is still necessary.
About The Author
P. Casey Arrillaga is the Team Leader for Education at Windmill Wellness Ranch, and he is the author of books including “Realistic Hope: The Family Survival Guide for Facing Alcoholism and Other Addictions”. His book