Weight-loss drugs show promise in tackling opioid and alcohol abuse

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Ozempic and similar products cut opioid and alcohol abuse by up to half, according to research that adds to evidence of the hugely popular blockbuster drugs’ broad potential beyond tackling obesity and diabetes.

An analysis of more than 500,000 people with a history of opioid-use disorder showed that more than 8,000 participants who were separately prescribed so-called GLP-1 drugs, such as Ozempic, had a 40 per cent lower rate of opioid overdose than those who did not.

In the more than 5,000 participants suffering from alcohol abuse and using a GLP-1 drug, there was a 50 per cent lower rate of intoxication than for those without a prescription.

The study, published in the journal Addiction on Thursday, is the latest effort to find medicinal ways to combat addiction. It will provide further understanding of the ever-growing potential uses of GLP-1s and boost hopes of tackling the US opioid epidemic.

The findings “provide significant initial evidence that GLP-1 receptor agonists such as semaglutide are associated with reduced rates of overdose and intoxication in patients with opioid and alcohol use disorders”, said Fares Qeadan, associate professor of biostatistics at Loyola University Chicago and a lead researcher for the paper.

The results were based on analysis of electronic health records, and randomised controlled trials would be needed to establish a causal link, he added.

Matt Field, a professor of psychology at the UK’s Sheffield university who was not involved in the research, said the study addressed “very extreme instances of substance intoxication” rather than whether users stopped taking the substance altogether — an outcome often tested by researchers studying treatments for addiction.

Field added that while Ozempic “may prevent people from taking so much alcohol or heroin that they overdose and end up in hospital, it may not actually help them to reduce their substance use, or to abstain altogether”.

The study was published as the US continues to be ravaged by an epidemic linked to overprescription of opioids in the 1990s and the subsequent abuse of heroin and synthetic drugs such as fentanyl. There were more than 81,000 deaths involving opioids in the US in 2023, a drop of 3.7 per cent on the year earlier.

Researchers have already made progress in improving the effectiveness of naloxone, a widely used overdose treatment, as well as developing non-opioid based treatments to treat addiction. Qeadan said GLP-1s could potentially become a new treatment option, particularly for those who do not fully respond to existing drugs.

The GLP-1 receptors that Ozempic activated to stimulate insulin production and slow food passing through the stomach were also present in the brain’s reward system and were linked to cravings, Qeadan added. Researchers are also exploring GLP-1 effects on nicotine addiction and alcoholism in clinical trials.

However, there are challenges to expanding the use of GLP-1s. Their effectiveness has led to high demand and sustained supply shortages of Ozempic, Wegovy and other blockbuster drugs in the class of medications. Known side effects such as nausea and vomiting lead many users to stop using the drugs within a year.

Ozempic manufacturer Novo Nordisk is conducting a study into how a new experimental GLP-1 combining semaglutide with another compound, cagrilintide, could be used to treat alcohol use in patients with liver disease. The Danish company is also exploring whether semaglutide can tackle degenerative conditions, such as Alzheimer’s, in a sign of the wide-ranging potential drugmakers believe the drugs have.

Beyond semaglutide, participants in the latest study were using drugs including Eli Lilly’s weight loss and diabetes drug tirzepatide, the active ingredient in Mounjaro, and Novo Nordisk’s liraglutide, which is sold under the brand names Victoza and Saxenda to treat both diabetes and obesity.