The diabetes drug Ozempic has become a household name as a powerful weight-loss treatment. Its cousin Wegovy, specifically marketed for weight loss, contains the same active ingredient — semaglutide — and is similarly skyrocketing in popularity.
But some people say the drugs have helped them do more than lose weight — people struggling with addiction are reporting that the drug has caused them to completely lose interest in alcohol, drugs and even obsessive shopping habits, The Atlantic reported in May.
Though these anecdotes may seem random, they are actually supported by more than 20 years of research, experts told Live Science. Animal studies have found that drugs like semaglutide, which mimic a gut hormone called glucagon-like peptide 1 (GLP-1), seem to suppress drug-seeking behaviors. Other studies in humans have found that the drugs, called GLP-1 agonists, could help some people with alcohol use disorder drink less and people who smoke drop cigarettes.
However, animal studies are not always reliable in determining if a drug will work the same way in people, and formal clinical trials testing GLP-1 agonists as addiction treatments are ongoing. Yet, scientists have reason to be optimistic, with research pointing to the drugs’ effect on a major system in the brain involved in addiction: the reward pathway.
“Unfortunately, the translation [of new drugs] from animals to humans is always challenging,” said Dr. Lorenzo Leggio, a physician-scientist at the National Institutes of Health (NIH) who studies the effects of GLP-1 agonists on addiction. But he said scientists who study GLP-1 agonists “are definitely excited” about the drugs’ potential to help people with addiction.
As early as the 1980s, researchers recognized that GLP-1 wasn’t produced only in the gut but also in parts of the brain, specifically in a part of the medulla, or lower brain stem, according to a 1986 study. By the 2010s, researchers were beginning to conduct studies, like one from 2011, to investigate the role this hormone might play in the brain’s system of reward and motivation. This system is called the mesolimbic pathway or “reward pathway.”
Part of the medulla called the solitary nucleus, receives incoming sensory information from the body, like taste signals from the tongue, while brain cells with GLP-1 receptors in the mesolimbic pathway help determine if you like a taste and if you’d like to experience that taste again. During rewarding experiences, whether they come from a good taste or an addictive drug, structures in the mesolimbic pathway activate and send dopamine to a part of the brain called the nucleus accumbens.
This structure plays key roles in generating pleasurable sensations and motivating reward-seeking behaviors. However, it seems that rather than activating this system, GLP-1 imposes limits on it. The hormone, along with the artificial version of it found in drugs like semaglutide, limits the brain’s release of the neurotransmitter dopamine, often called a “happy chemical.”
Food, water, sweets and addictive drugs all “cause a release of dopamine in the nucleus accumbens in the brain,” said Patricia “Sue” Grigsono, director of the Penn State Addiction Center for Translation. Binding to GLP-1 receptors, then, should reduce that dopamine response.
“Published data show that substances of abuse do not elicit that dopamine release when you have a GLP-1 agonist on board,” she said. A 2020 study found some evidence that GLP-1 agonists might do this by impacting dopamine transporters in a brain region called the striatum, a main interface in the brain’s reward system, though they only found this effect in rats, not in mice and humans.
Studies on animal behavior also support the use of GLP-1 agonists to combat addiction. Grigson has been involved with several studies with the same basic design: A mouse or rat is trained to expect a drug, like alcohol or heroin, to be administered in response to certain cues. When the animal gets the cues but not the drug, the ones given GLP-1 agonists are less persistent in trying to seek out the drug. Animals that receive a “relapse” dose of the drug after having it withdrawn are even less likely to seek it out, Grigson said.
A2022 study Grigson co-authored showed that when given the GLP-1 agonist liraglutide, rats were less likely to seek out heroin in response to drug-associated cues, stress or a dose of the drug itself, which would also normally prompt further drug-seeking.
So far, tests of drugs like semaglutide for human addiction have been limited, but researchers have seen some promising results.
In a2021 study, people who took a GLP-1 agonist called exenatide in addition to using a nicotine patch were more likely to successfully quit smoking than those who used only the patch. A2022 study found that a weekly dose of exenatide reduced the number of heavy drinking days in people with alcohol use disorder and obesity, but it didn’t help participants of lower weights. Leggio said that researchers aren’t sure what might cause a result like this. One possibility, he said, is that some people with obesity have more overlap in their brains between the response to food and the response to addictive substances.
There are several ongoing clinical trials that may soon tell us more. Leggio and Grigson are both involved in such trials and are eagerly awaiting the results — Grigson said one of hers should conclude in a few months. She also said unpublished research, led by a student of hers, exploring how GLP-1 agonists affect the brain suggests they work to treat addiction in two ways: by lessening the brain’s reward associated with taking an addictive substance and by decreasing desire for the drug during withdrawal.
Although the stories from people who say semaglutide have helped them overcome addiction are encouraging, Leggio said, they are no substitute for actual research. Still, he appreciates the anecdotes.
“You cannot be a good physician-scientist if you don’t listen to your patients,” he said. “I’m excited for those people.”
VANCOUVER – Mayors and other leaders from several British Columbia communities say the provincial and federal governments need to take “immediate action” to tackle mental health and public safety issues that have reached crisis levels.
Vancouver Mayor Ken Sim says it’s become “abundantly clear” that mental health and addiction issues and public safety have caused crises that are “gripping” Vancouver, and he and other politicians, First Nations leaders and law enforcement officials are pleading for federal and provincial help.
In a letter to Prime Minister Justin Trudeau and Premier David Eby, mayors say there are “three critical fronts” that require action including “mandatory care” for people with severe mental health and addiction issues.
The letter says senior governments also need to bring in “meaningful bail reform” for repeat offenders, and the federal government must improve policing at Metro Vancouver ports to stop illicit drugs from coming in and stolen vehicles from being exported.
Sim says the “current system” has failed British Columbians, and the number of people dealing with severe mental health and addiction issues due to lack of proper care has “reached a critical point.”
Vancouver Police Chief Adam Palmer says repeat violent offenders are too often released on bail due to a “revolving door of justice,” and a new approach is needed to deal with mentally ill people who “pose a serious and immediate danger to themselves and others.”
This report by The Canadian Press was first published Sept. 16, 2024
The Canadian government says it will donate up to 200,000 vaccine doses to fight the mpox outbreak in Congo and other African countries.
It says the donated doses of Imvamune will come from Canada’s existing supply and will not affect the country’s preparedness for mpox cases in this country.
Minister of Health Mark Holland says the donation “will help to protect those in the most affected regions of Africa and will help prevent further spread of the virus.”
Dr. Madhukar Pai, Canada research chair in epidemiology and global health, says although the donation is welcome, it is a very small portion of the estimated 10 million vaccine doses needed to control the outbreak.
Vaccine donations from wealthier countries have only recently started arriving in Africa, almost a month after the World Health Organization declared the mpox outbreak a public health emergency of international concern.
A few days after the declaration in August, Global Affairs Canada announced a contribution of $1 million for mpox surveillance, diagnostic tools, research and community awareness in Africa.
On Thursday, the Africa Centres for Disease Control and Prevention said mpox is still on the rise and that testing rates are “insufficient” across the continent.
Jason Kindrachuk, Canada research chair in emerging viruses at the University of Manitoba, said donating vaccines, in addition to supporting surveillance and diagnostic tests, is “massively important.”
But Kindrachuk, who has worked on the ground in Congo during the epidemic, also said that the international response to the mpox outbreak is “better late than never (but) better never late.”
“It would have been fantastic for us globally to not be in this position by having provided doses a much, much longer time prior than when we are,” he said, noting that the outbreak of clade I mpox in Congo started in early 2023.
Clade II mpox, endemic in regions of West Africa, came to the world’s attention even earlier — in 2022 — as that strain of virus spread to other countries, including Canada.
Two doses are recommended for mpox vaccination, so the donation may only benefit 100,000 people, Pai said.
Pai questioned whether Canada is contributing enough, as the federal government hasn’t said what percentage of its mpox vaccine stockpile it is donating.
“Small donations are simply not going to help end this crisis. We need to show greater solidarity and support,” he said in an email.
“That is the biggest lesson from the COVID-19 pandemic — our collective safety is tied with that of other nations.”
This report by The Canadian Press was first published Sept. 13, 2024.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.
The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.
Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.
“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”
The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.
A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.
Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.
“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.
Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.
The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.
“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.
This report by The Canadian Press was first published Sept. 11, 2024.
