Doctors Prescribe Weight-Loss Drugs to Combat Addiction Cravings

In a novel approach to addiction treatment, some physicians are prescribing weight-loss medications such as Zepbound and Ozempic to help patients manage cravings for illicit drugs and alcohol. While initial reports indicate potential benefits, research in this area remains limited.

In Miami, Susan Akin shared her experience with these medications, stating that her cravings for cocaine and alcohol have significantly diminished since she began using Zepbound earlier this year. Akin, who has struggled with addiction, credits the medication with helping her navigate everyday environments that previously triggered her urges. “I know when I’m due for my shot because I get a little antsy or irritable,” Akin explained. “But it has changed my life.”

The drugs in question belong to a class of medications known as GLP-1s, primarily intended for weight loss and type 2 diabetes management. While not federally approved for behavioral health use, physicians are increasingly prescribing them off-label, driven by early studies suggesting they may reshape addiction treatment strategies.

Research indicates that semaglutide, the active ingredient in Ozempic and Wegovy, has the potential to lower the risk of heart attacks and treat liver disease. These medications work by mimicking natural hormones that boost insulin production and curb appetite, contributing to a feeling of fullness. The precise mechanism by which GLP-1s may influence addiction is still under investigation. According to Kyle Simmons, a pharmacology professor at Oklahoma State University, the drugs may inhibit dopamine release, a neurotransmitter linked to pleasurable activities. “They appear to be turning down the gain on the reward circuitry in the brain,” Simmons noted.

Research into the off-label use of GLP-1s is expanding. Clinical trials are underway to explore their effectiveness in treating various forms of addiction, including alcohol and opioid dependence. For instance, studies by the National Institute on Drug Abuse are assessing how these drugs can help individuals struggling with alcohol cravings through controlled environments, including simulated bars.

Despite the promising preliminary findings, health insurers currently do not cover these medications for addiction treatment, which can cost patients up to $1,000 per month. Akin, who is nearing one year of sobriety, relies on her inheritance to afford her treatment. “It’s not a cure. We have to do the work,” Akin stated. “But it helps.”

The ongoing research into GLP-1s highlights a significant gap in addiction treatment options. With approximately 48 million Americans reported to have a substance use disorder last year, the need for effective treatments is critical. More than 80,000 people died from drug overdoses in 2022, and over 47,000 fatalities were attributed to alcohol complications, according to federal estimates.

Conventional medications for opioid addiction, such as buprenorphine and methadone, are effective but often carry social stigma. While the FDA has approved three drugs for reducing alcohol consumption, only 2 to 4 percent of individuals with alcohol use disorder receive treatment, according to researcher Lisa Clemans-Cope from the Urban Institute.

As research continues, there is hope that GLP-1s could become a valuable tool in addiction recovery. Steven Klein, a physician at Caron Treatment Centers and a recovering alcoholic himself, has begun prescribing GLP-1s to his patients. He believes in the potential benefits these drugs offer, especially given his own experiences with addiction and weight management.

Other organizations, like Open Doors in Rhode Island, are also exploring the use of GLP-1s in recovery programs, aiming to support individuals re-entering society after incarceration. “With this medicine, I’m hopeful,” said Open Doors Co-Executive Director Nick Horton.

While enthusiasm grows around the potential for GLP-1s to aid in addiction recovery, researchers urge caution. Long-term effects and the safety of these drugs remain under scrutiny, and their use in non-approved contexts is increasing. As the landscape of addiction treatment evolves, the exploration of GLP-1s may open new avenues for individuals seeking to overcome addiction, but more research is essential to solidify their role in therapeutic practices.