A growing body of research suggests that GLP-1 medications, known primarily for weight loss, can significantly help people suffering from substance abuse disorders get clean and stay in treatment longer. This potential application comes at a critical time, as more than 450,000 Americans have died from overdoses in the past five years, and the medical community faces a historically devastating overdose epidemic.
Mechanism and brain effects of GLP-1s
GLP-1s interact with neural reward networks in the brain—structures that impact what people do to feel good and how often they do it. According to Dr. Christian Hendershot, director of Clinical Research at the USC Institute for Addiction Science, “There’s a kind of a satiety effect that is generated by these medications that is brain mediated. Reward-related centers of the brain are what we think leads to reduced cravings.” This neurological mechanism differs from their well-known appetite suppression effects. A 2023 study at Caron Treatment Centers in collaboration with Penn State University School of Medicine found “a pretty significant reduction in cravings at a much lower dose than the general population tends to be on, particularly for weight loss,” according to Dr. Adam Scioli, chief medical officer and program director at Caron. Since the study concluded, the center has treated 150 patients with GLP-1s for substance abuse disorders, with a large majority reporting significant reductions in cravings.
Barriers and advantages compared to traditional medications
Currently, only three major medications are FDA-approved for addiction treatment: buprenorphine, methadone, and naltrexone. In 2024, a CDC study found that of the estimated 10 million American adults needing treatment for opioid use disorder, only 25 percent were prescribed buprenorphine, partly due to social stigma. GLP-1s might circumvent these barriers because they are “widely accepted” and “actually very much in demand,” according to Hendershot. One significant advantage is keeping patients in treatment longer; studies show that about half of patients who start addiction treatment stay for more than six months, and patients who stop buprenorphine therapy are six times more likely to die in the following month.
Current limitations and future prospects
Despite promising results, the FDA has not approved any GLP-1s specifically for substance abuse disorder treatment, meaning doctors prescribe them “off-label.” Off-label GLP-1 prescriptions are much less likely to be approved by insurance companies. Concerns about long-term effects include bone density loss, gastrointestinal issues, and potential links to pancreatitis and kidney conditions. Only two real clinical trials have examined GLP-1 use for addiction, with the majority of available information being anecdotal. Dr. Carolina Haass-Koffler, an associate professor of psychiatry at Brown, emphasized caution: “We need to be careful.” Larger trials like the one led by T. John Winhusen at the University of Cincinnati, aiming to enroll more than 300 patients across 10 sites to study GLP-1s combined with buprenorphine, are critical for determining broader effectiveness.
This article is an AI-assisted summary. All facts and figures are drawn from the original report: https://www.rollingstone.com/culture/culture-features/glp-1-ozempic-opioid-crisis-1235538104/