Novel Research Into Weight Loss Drugs for Treatment of Addiction

I try to stay on top of any new research into mental health, addiction, and therapy, and I was fascinated by a recent conversation between Chris Hayes of MSNBC and Nick Reville, founder and Executive Director of the Center for Addiction Science, Policy, and Research, into the potential of glucagon-like peptide-1 receptor agonists (GLP-1s) in managing cravings, offering promising avenues for addiction recovery. Obviously, we all have probably heard of Ozempic, Wegovy, Mounjaro, and others - Novo Nordisk, the company that created Ozempic, has become one of the most valuable companies on earth off the back of their medication. Originally developed for diabetes treatment, GLP-1s surged in popularity once their ability to regulate appetite and create drastic weight loss emerged, and are now being explored for their effects on substance cravings.

Existing Medications Used in Addiction Treatment

Maybe it's helpful to start with an overview of the medications we already commonly use in the treatment of substance use disorders. One of the most common is naltrexone, an opioid antagonist that enhances the effects of the neurotransmitter GABA which inhibits the release of dopamine when cravings occur, which means it can be prescribed for almost any addictive substance or compulsive behavior. Acamprosate is often prescribed for alcohol use disorder, as it works to stabilize neurotransmitter levels in the brain, alleviating cravings. Disulfiram (Antabus) discourages alcohol consumption by causing severe discomfort when alcohol is ingested, creating a deterrent effect. For opioid cravings, buprenorphine and methadone have been commonly used. Buprenorphine acts as a partial opioid agonist, reducing withdrawal symptoms and cravings, while methadone, a full opioid agonist, is used to prevent withdrawal and reduce cravings in individuals with opioid dependence. These medications are typically used in combination with behavioral therapies for a comprehensive treatment approach.

Understanding GLP-1s and Their Mechanism

GLP-1s are hormones that play a crucial role in regulating appetite and glucose metabolism. They function by enhancing insulin secretion, inhibiting glucagon release, and slowing gastric emptying, leading to increased feelings of fullness and reduced hunger. This mechanism has been leveraged in medications like Ozempic and Wegovy to aid in weight loss.

GLP-1s in Addiction Recovery

Emerging studies suggest that GLP-1s may also influence the brain's reward pathways, which are involved in addiction. Research indicates that these medications can reduce cravings for substances such as alcohol and nicotine by modulating these pathways. For instance, individuals taking GLP-1 receptor agonists have reported a dampening of the urge to drink, indicating a potential benefit in managing alcohol cravings.

Implications for Addiction Treatment

Integrating GLP-1s into therapeutic and sober coaching practices could offer a new tool in a multifaceted approach to addiction recovery. By addressing both the physiological and psychological aspects of cravings, these medications as well as things like naltrexone may enhance traditional therapeutic interventions. However, it's essential to consider individual health profiles and consult healthcare professionals before incorporating GLP-1s and/or other medications into a recovery plan.

Conclusion

The exploration of GLP-1s in managing cravings represents an exciting development in addiction treatment. While more research is needed to fully understand their efficacy and safety in this context, these findings open new possibilities for supporting individuals on their recovery journey. As a person working in this space, I welcome any interventions that can help my clients so I am very curious to see where future research takes us on this. Meanwhile, we still have decades of success with substances with nalterexone, highlighting the importance of medication support as a possible pillar of your recovery!