By now, semaglutides like Ozempic, Mounjaro, Wegovy and other brands have become widely known for their serious effects on people’s physical and emotional lives. The drugs, taken through periodic injections, have gained a rep for slimming the body, but maybe causing a droopy rear end or a hangdog face. And that’s before the ripple effects your physical and behavioral transformation might have on your marriage and friendships. The tendrils of this diabetes drug offshoot have grown into so many facets of contemporary life, why was I surprised when I read that there’s a promising link between Ozempic and alcohol use disorder? JAMA published a study of 48 people with moderate alcohol-use disorder who took very small doses of semaglutide for nine weeks. The result? They drank a lot less and had a lot fewer cravings for alcohol compared with people on a placebo.
Ozempic and Alcohol: Can GLP-1s Cure Addiction? I Asked the Experts
Including tough talk from an addiction specialist
Experts
- Cassie Moore, PhD is an Assistant Professor of Division of Behavioral Biology, Psychiatry and Behavioral Sciences at Johns Hopkins University School of Medicine. She won a 2024 Young Investigator Award from Cure Addiction Now, a nonprofit funding research into substance use disorder, in order to support her ongoing study evaluating semaglutide for reduction of opiod craving and withdrawal.
- Dr. Howard Samuels is a licensed therapist who founded and was formerly the CEO of The Hills Treatment Center, a substance abuse treatment facility, in Los Angeles. He holds a Doctorate in Clinical Psychology and is a Marriage and Family Therapist, specializing in addiction. Samuels has been clean and sober for 38 years and maintains a private clinical practice in Los Angeles.
- Jamie Winn is a Doctor of Pharmacy and Medical Director at Universal Drugstore, an online Canadian drugstore.
This idea of a drug potentially "curing" substance abuse marks a significant departure from longtime treatment orthodoxy which follows the 12-step teachings of Alcoholics Anonymous, which hasn’t changed its position since the 1930s, when it decreed: “Physicians who are familiar with alcoholism agree there is no such thing as making a normal drinker out of an alcoholic. Science may one day accomplish this, but it hasn't done so yet.” So…is this to be believed? I’d have dismissed the report had I not spoken with a pal who has lost a solid 20-plus pounds using a GLP-1. “I believe it,” he told me. “I remember going to the grocery to get a bottle of wine after I started the drug, because I’d heard keeping pre-Ozempic rituals was healthy. I stood for 15 minutes trying to will myself to buy a bottle of wine, but nothing looked good, and then when I got home, I didn’t even want to finish my glass.”
Now, my friend never had addiction issues, so his disinterest in wine wasn’t a big deal to him. But he’s not alone. In 2023, scientists analyzed anecdotal evidence acquired from Reddit to identify whether there might be a link between taking a GLP-1 medication and changes in alcohol drinking. In this study, 962 individuals made a total of 1,580 alcohol-related posts that included a GLP-1 drug from 2009-2023. The majority (71.7 percent) of the alcohol posts addressed reduced cravings, reduced usage and reduction of other negative effects due to drinking.
How Might Semaglutides Work with Alcohol?
“The receptor for GLP-1 (GLP-1R) is found all throughout the body, as well as the brain. Within the brain, there are GLP-1Rs in the areas that control how we process reward. Studies have shown that the GLP-1 drugs reduce the reward associated with food and food cues,” explains Moore. “And this may extend to rewarding effects of drugs and drug cues. Putting a brake on that reward can help people control their cravings/urges to eat high fat/high sugar food, drink alcohol or use drugs. There is also some evidence that insulin can modulate dopamine in the brain, so GLP-1 acting to stimulate insulin may rein in the dopamine signaling driving reward.”
“The same parts of your brain that drive your eating behaviors also drive the use of alcohol or other substances. GLP-1s may reduce the rewarding effects of alcohol by influencing these regions, specifically the nucleus accumbens, which plays a key role in reward processing, motivation, and pleasure,” adds Winn.
What Do Studies Conclude?
While preclinical studies using rats, mice and nonhuman primates have resulted in “a lot of promising data” that Ozempic-type drugs impact alcohol drinking, Moore says we need to wait for data from randomized clinical trials to know for sure how this drug affects addiction. “There are a number of these clinical trials underway to test GLP-1 agonists for the treatment of various substance use disorders, including nicotine, alcohol, opioids and cocaine,” she says, remarking that for alcohol, there has so far been only one trial that has posted results. In this study, a very short-acting GLP-1 called Exendin did not result in fewer heavy drinking days when compared to the placebo overall; however it did decrease heavy drinking in the GLP-1 participants where were obese (BMI>30). Moore says current studies are similarly testing semaglutide (Ozempic), a longer acting GLP-1.
What Does an Addiction Specialist Say?
“Bullshit,” says Samuels, a 30-plus year therapist who specializes in patients struggling with addiction. Samuels doesn’t deny that semaglutides reduce urges to drink in some people, he just doesn’t see it working for serious alcoholics and addicts. “Your friend who didn’t want the wine? I believe it. But let me tell you the difference between him and my clients. He isn’t an alcoholic, so he isn’t craving 4 or 5 glasses of alcohol,” Samuels explains. “When you are an alcoholic and you want to drink, these drugs don’t stop the need for the alcohol, it’s so intense.” Samuels says he bases his opinion on a handful of clients he has worked with who have used GLP-1s to successfully lose weight, although they still experienced cravings for alcohol. “Remember, the makers of this drug will always need to be coming up with new marketing tools and off-label applications,” he says, before musing that one day when a true anti-addiction drug is developed, “it will make so much money.”
Conclusion
After speaking with experts, I’ve come away with the conclusion that this is an ongoing investigation, not a “cased closed.” Preliminary reports about Ozempic and alcohol suggest it reduces drinking, which is a good thing according to the World Health Organization, who really came down hard on the practice with its 2023 edict that ”no amount of alcohol consumption is safe for our health.” As for problem drinkers, and by extension substance use disorders of all kinds, well, there’s lots of research being done that may end up being a part of a multi-modal treatment plan, or not. While this drug isn’t a magic bullet for alcoholism and drug addiction, I am anticipating that its applications will continue to evolve, along with the science.
What Happens to Your Sleep When You Start Taking Ozempic? I Asked a Sleep Neurologist
