Semaglutide drugs such as Ozempic and Wegovy have become commonplace in weight loss treatment, but new research shows the drugs may also be useful in treating substance abuse.
Researchers at Case Western Reserve University's School of Medicine found that semaglutide, or GLP-1 agonists, are linked to reduced incidence and recurrence of alcohol abuse or dependence. Their findings were recently published in the Nature Communications science journal.
The current study started with comments posted in response to a New York Times article on the team's previous findings on the effect of semgalutide on suicidal ideation, said Dr. Rong Xu, professor of biomedical informatics and the study’s lead researcher.
"Some readers left comments about our future studies to say, 'Oh, after I took this medication, I no longer wanted to drink alcohol and my mental status significantly improved,'" Xu said. "So based on the comments left, we conducted a similar study to see semaglutide's association for decreased risk for alcohol drinking."
The study looked at records for nearly 84,000 patients, all of whom were medically obese. Those treated with semaglutide, compared to those treated with other anti-obesity medications showed a 50-56% decrease for both the initiation and recurrence of alcohol-use disorder in the following year.
"So there was a dramatic decrease in new diagnoses of individuals with alcohol use disorder," said Dr. Pamela Davis, study co-author. "That is, there seem to be a lot fewer individuals who were taking on enough alcohol to be diagnosed with a physician for alcohol use disorder."
The researchers then looked at records for nearly 600,000 patients with type 2 diabetes and determined similar results of consistent reductions in alcohol-use disorder diagnoses.
Davis noted that the study merely looked at the data, not the reason why semaglutide appears to reduce alcohol use disorder, but said it likely impacts the brain's reward system.
"The [drugs] have to do with the dopamine system and with the transmission of signals in the dopamine system, which are the reward system in the brain," Davis explained. "People who have alcohol use disorder get an internal brain reward for drinking, and we think that the semaglutide removes at least part of that sense of being rewarded for taking a drink."
Though the research is promising, Xu said it's merely an observational study from clinical trials, meaning more research is needed before her team makes any recommendations for prescribing semaglutide for substance use treatment.
"Hopefully this would provide the evidence for some future community trials," she said.
Researchers have also examined the effects of semaglutide on cannabis use and suicidal ideation in previous studies and found use of semaglutide in patients with obesity also reduced cannabis use disorder and the risks of suicidal ideation.
Now, Xu and her team are continuing their research on the impact of semaglutide on other mental health and substance use disorders, including opioids and nicotine.
"We suspect with semaglutides, probably there's some common mechanism that may involve pocketing the reward system, so they can improve mental health, reduce the desire to have food or other substances," Xu noted.
Xu also said she's hopeful this research can influence pharmaceutical companies like Ozempic manufacturer Novo Nordisk to lower costs for semgalutide. Researchers from Yale, Harvard and King's College determined in a study published to the Journal of the American Medical Association that Ozempic can be manufactured for less than $5 per month, but Novo Nordisk charges nearly $1,000 for a month's supply.
"There are many different pharmaceutical companies working in this field, so hopefully the price will come down significantly," Xu said.
Alcohol use disorder affects nearly 30 million people over the age of 12, according to the National Institute of Alcohol Abuse and Alcoholism. Cases lead to nearly 178,000 deaths in the United States each year, according to the Centers for Disease Control and Prevention.
