Introduction to Treating Alcoholism and Smoking
The blockbuster drugs designed to control diabetes — now also widely used to help overweight people shed pounds — show great promise for tackling other prickly health problems: treating alcoholism, and perhaps smoking and other substance use disorders as well.
The Scope of the Problem
While overdose deaths from fentanyl and its sinister cousins have seized the spotlight for years — some 80,000 Americans died from drug overdoses in 2024 — alcohol-related diseases kill more than twice as many, at about 178,000 every year, according to the U.S. Centers for Disease Control and National Institute on Alcohol Abuse and Alcoholism.
Research and Findings
Drs. Bianca Robertson and Jonathan Vargas, addiction medicine specialists from UCLA, summarized the latest research on GLP-1 and related drugs for their brethren at the California Society of Addiction Medicine’s annual conference in Garden Grove on Friday, Aug. 15.
Studies on GLP-1 Drugs
A study of 153 adults with a body mass index of 30 or higher (obese), who were also current alcohol drinkers and used a GLP-1 drug for at least 30 days, found significant reductions in self-reported alcohol intake as well as in the number of drinks per drinking episode.
Observational Study in Sweden
A large, 17-year observational study in Sweden showed that among problem drinkers with both obesity and Type 2 diabetes, GLP-1 drugs “substantially decreased the risk for hospitalizations related to alcohol use disorder.”
Clinical Trial on Semaglutide
A recently-published clinical trial tracked 48 adults with alcohol use disorder who took relatively low doses of semaglutide (the key ingredient in Ozempic) once a week for nine weeks. Semaglutide significantly reduced alcohol consumption, and participants reported fewer drinks per day and reduced craving.
Reduction in Smoking
In a subgroup who smoked, there was a significant reduction in the consumption of cigarettes per day as well.
Mechanism and Potential
How GLP-1 Drugs Work
How does it all work? That’s not well understood just yet. It likely involves modulation of reward pathways in the central nervous system, and perhaps another mechanism: the slowed emptying of the gut that GLP-1 drugs impose (and the increased feeling of fullness from same).
Potential for Stimulant Use Disorders
There’s some suggestion that the drugs might work for stimulant use disorders as well, and Robertson’s eyes lit up with the promise all of that suggests.
Current State of Treatment
Medical Management
Medical management — that is, therapy that involves the use of drugs, not just talk — is the most effective approach to addiction, myriad studies have found.
Gap in Treatment
But only slightly more than half of treatment facilities in California offer any kind of medication-assisted treatment, according to data from the Substance Abuse and Mental Health Services Administration.
Need for Integration
Addiction treatment remains too separate from mainstream medicine, and an anti-medicine, “pull-yourself-up-by-your-bootstraps” mentality remains strong.
Conclusion
There’s much more investigation to be done, but great promise on the horizon, Robertson and Vargas said. The potential for GLP-1 drugs to treat alcoholism and smoking could be a game-changer, saving countless lives.
FAQs
Q: What are GLP-1 drugs?
A: GLP-1 drugs are a class of medications originally designed to control diabetes, now also used for weight loss and potentially for treating alcoholism and smoking.
Q: How do GLP-1 drugs work for addiction?
A: The exact mechanism is not fully understood, but it likely involves modulation of reward pathways in the central nervous system and the slowed emptying of the gut.
Q: What is the current state of treatment for addiction?
A: Medical management is the most effective approach, but there is a gap in treatment, with only slightly more than half of facilities in California offering medication-assisted treatment.
Q: What is the potential impact of GLP-1 drugs on public health?
A: The potential impact could be significant, with the possibility of reducing alcohol-related deaths and improving treatment outcomes for addiction.
