GLP-1 drugs like Ozempic and Wegovy curb bad habits, patients say

For years, scientists have known that the class of medicines called GLP-1s lessened the rewarding effects of addictive drugs, including alcohol, nicotine, and opioids, in laboratory rodents. Now, as the pricey medicines have become perhaps the world’s hottest pharmaceutical products — and Massachusetts has seen one of the country’s sharpest rises in prescriptions — a small but growing number of studies suggest that the same may be true in people.

“Right now it’s mostly anecdotal, but there’s a potential here for a bigger effect for these medications than what we’re using them for,” said Dr. Chika Anekwe, clinical director of obesity medicine at Massachusetts General Hospital. About 10 patients for whom she has prescribed GLP-1s in the past two years have volunteered to her that the medicines have reduced their use of alcohol, she said.

“They don’t desire it as strongly, and when they do drink, it’s less of a rewarding experience,” she said.

And it’s not just drinking habits that patients say the drugs are changing. Charlie Wallace, a 42-year-old internal auditor who lives in Boston, has been taking Wegovy off and on since 2023. Not only has he shed 45 pounds, he said, but the medication has also curbed his interest in gambling.

Wallace said he used to visit Encore Boston Harbor casino at least once a month to play the slot machines. “It was more social” than a habit, he said, but it was expensive: He estimates that gambling cost him about $3,000 to $4,000 a month.

Since he began taking Wegovy, he said, he still goes to Encore with his husband or friends, but he has little desire to play the slots.

“I don’t get that same dopamine spike,” he said, referring to the feel-good chemical created in the brain by pleasurable activities.

Similarly, he said, he used to go through 15 nicotine pouches a day, popping them into his mouth to get a hit of the addictive substance found in tobacco. Now he uses perhaps five pouches daily.

Researchers are still working to confirm on a larger scale what patients say they’re experiencing.

Early findings from a small recent clinical trial run by the University of North Carolina at Chapel Hill showed that low weekly doses of semaglutide, the active ingredient in Ozempic and Wegovy, both made by Novo Nordisk, reduced alcohol consumption over two months in volunteers with alcohol use disorder. The trial involved 48 participants who randomly received semaglutide or a placebo.

Last November, a Swedish study published in JAMA Psychiatry found that people with alcoholism and Type 2 diabetes were “substantially” less likely to be hospitalized for alcohol-related issues when taking GLP-1 drugs. The study analyzed data from 228,000 people in Sweden collected from 2006 to 2023.

And last February, researchers from the Penn State College of Medicine reported that the active ingredient in another GLP-1, Saxenda, significantly reduced opioid cravings in a study of 20 patients with opioid use disorder. Patients who received the drug experienced a 40 percent decline in their desire for opioids compared with those who got a placebo.

Scientists increasingly believe there’s an overlap between the brain mechanisms that regulate food consumption and those that regulate the use of alcohol and other addictive substances, said Dr. Christian Hendershot, an addiction expert who ran the UNC trial and now directs clinical research at the University of Southern California Institute for Addiction Science.

GLP-1 drugs mimic a hormone called glucagon-like peptide-1, which stimulates insulin and sends the brain signals of fullness. Researchers theorize that the drugs could work the same way to curb non-food cravings.

“We know these [GLP-1] medications induce satiety,” Hendershot said, and that feeling of fullness appears to extend to “things like alcohol use, nicotine intake, and cravings for drugs.”

The GLP-1 hormone “basically says stop” to the brain — and it wouldn’t be surprising if that message affects multiple addictions, said Dr. Sue Grigson, chair of neural and behavioral sciences at Penn State College of Medicine, who helped lead the opioid use study.

Scientists also believe that GLP-1 drugs may dampen levels of dopamine released by the brain when we eat junk food, quaff a beer, or inhale a cigarette. Those dopamine rushes yield feelings of satisfaction, which can reinforce unhealthy behaviors.

These potential effects could have a major impact in Massachusetts, where about 140,400 obese patients in Massachusetts were prescribed the medications in 2024, a 255 percent increase from 2023, according to a recent Globe analysis of insurance claims data compiled by Real Chemistry, a health analytics firm. Despite Massachusetts’ low obesity rate, the state saw the country’s third-highest increase in prescriptions, driven in part by broad insurance coverage for the drugs here, the Globe reported.

Hendershot said scientists need to run larger clinical trials on GLP-1s, but he believes the drugs could eventually win approval to treat alcohol use disorder, which afflicts nearly 29 million Americans, according to federal data. The Food and Drug Administration has approved only three medicines for the disorder, which Hendershot considered a paltry number compared with drugs for other common diseases, such as diabetes.

In the meantime, there’s no shortage of anecdotal evidence that GLP-1s used by Massachusetts patients are lessening appetites for alcohol, nicotine, and other vices.

A 34-year-old Worcester woman who has been on various GLP-1 drugs since April 2023 and now takes Eli Lilly’s Zepbound, says she has lost 80 pounds. The woman, who wanted to be identified only by her first name, Grace, because of the sensitivity of the subject, said the medications have also dramatically curtailed her compulsion to shop online.

Grace said that she used to spend 10 to 12 hours a week browsing Amazon for things to buy. She often purchased items she didn’t need: a motion detector that illuminated her toilet seat at night, a ceramic elephant that she now keeps in the closet, and a curling iron for her hair even though she already had similar products.

Since starting GLP-1s, her online purchases have plunged at least 80 percent, she said. She also has more time for healthier activities, including indoor cycling, weightlifting, and going out with friends.

“These drugs have freed up a lot of mental capacity that I didn’t realize was going toward things that weren’t really benefiting me,” Grace said.

Experts cautioned they need to see the results of more studies to determine whether GLP-1s might address a range of addictive behaviors. They also noted that the drugs are not without drawbacks. GLP-1s often have unpleasant initial side effects, including nausea and constipation.

And the drugs are expensive. In the United States, their list price can range between $936 and $1,349 before insurance and discounts, according to a survey last year by the Kaiser Family Foundation. And some insurers are limiting coverage.

Nonetheless, several scientists said they were optimistic that GLP-1s could eventually treat a variety of addictions.

“I’m excited and I’m hopeful,” said Dr. Kyle Simmons, a professor of pharmacology at Oklahoma State University who is running a trial testing semaglutide on people with alcoholism. “I’m just saying it’s premature for people to take these drugs off-label for the purpose of addiction.”

Jonathan Saltzman can be reached at jonathan.saltzman@globe.com.