May Ozempic provide help to drink much less alcohol? Scientists are looking for out : Pictures

Through the COVID-19 pandemic, J. Paul Grayson was hit with an avalanche of well being issues — hypertension, prediabetes and a coronary heart arrhythmia.

He additionally gained 40 kilos to his 6-foot 3-inch body. “I felt like my weight was getting uncontrolled,” says the 73-year-old retiree, who lives on a ranch in Oklahoma. “I needed to begin taking all these drugs that I by no means needed to take earlier than. I truly felt fairly depressed about my well being.”

About six months in the past, Grayson started taking the favored weight-loss drug Ozempic. He knew the negative effects could possibly be tough, together with nausea, constipation and diarrhea. However he thought it will be value it if he may stave off additional coronary heart issues by shedding the additional weight.

“Instantly, I began consuming much less and shedding weight,” he says. That was anticipated. However what Grayson hadn’t anticipated was that the drug additionally instantly altered one in every of his different habits.

“I bear in mind going to dinner for the primary time [while taking Ozempic],” Grayson explains. “I ordered a beer, took a sip, and I could not end it,” he says. “You know the way typically you style a beer, and it is like, ‘Oh my God, this tastes so good that I wish to guzzle it.’ Properly, I did not really feel like guzzling. I simply actually felt like sipping it.”

And as an alternative of getting a number of beers with dinner, Grayson stopped at only one drink.

Previously yr, prescriptions for each the diabetes drug Ozempic and its weight-loss counterpart Wegovy have skyrocketed, even though every prices about $1,000 a month and a few well being insurers just lately stopped overlaying them. Each medicine comprise the identical energetic ingredient, semaglutide, which belongs to a category of medication referred to as GLP-1 (aka “glucagon-like peptide 1”). These medicine regulate your blood sugar and make you are feeling glad after consuming. Ozempic is authorized for treating diabetes and, in some instances, extra weight.

With the drug’s surge in recognition, docs and sufferers have begun to note a placing facet impact of those medicine: They seem to cut back individuals’s cravings for alcohol, nicotine and opioids. They could additionally cut back some varieties of compulsive behaviors, akin to playing and on-line procuring.

“There’s actually been a lot of medical and anecdotal stories coming in suggesting that folks’s ingesting behaviors are altering and in some situations fairly considerably whereas taking [Ozempic or Wegovy],” says Christian Hendershot, a psychologist and dependancy researcher on the College of North Carolina.

He is main one in every of six medical trials now underway geared toward understanding how semaglutide might alter individuals’s ingesting and smoking habits.

“All these stories, for essentially the most half, are anecdotal,” Hendershot provides. “On the identical time, it does seem to be there is a fairly robust sign right here.”

Scientists are hopeful {that a} new class of therapies for alcohol use dysfunction or smoking could also be on the horizon. Some docs have even began prescribing these medicine for this particular goal, although proof from giant, randomized managed trials are nonetheless years away.

Stopping at only one cookie or beer

To many docs and sufferers, like J. Paul Grayson, Ozempic’s impact on alcohol got here as a giant shock.

“Earlier than Ozempic, I may devour a complete bottle of wine in a night with out attempting actual arduous, together with a bag of candies,” he says, laughing. “However with Ozempic, even one beer did not really feel good to me someway.”

“I had no concept this may occur,” he provides. “No person informed me something in regards to the drug affecting alcohol, too.”

However for scientists who research GLP-1 medicine, this placing facet impact was precisely what they anticipated. “It is actually not shocking,” says pharmacologist Elisabet Jerlhag.

For greater than a decade now, Jerlhag and her colleagues on the College of Gothenburg in Sweden have been determining in nice element how GLP-1 medicine, akin to Ozempic, cut back alcohol consumption in rats.

She and different scientists have revealed practically a dozen research displaying how these medicine cease binge ingesting in rats or mice, stop relapse in “addicted” animals, and total lower their consumption of alcohol. “So we see a discount by over 50%, which is kind of dramatic,” Jerlhag says.

Different research in animals have additionally discovered that GLP-1 medicine cut back the consumption of nicotine, opioids, in addition to psychostimulants, akin to cocaine and methamphetamine.

So why would a weight-loss drug do that? Seems, these medicine (in addition to the GLP-1 hormone) do not simply work on blood sugar. “In addition they work in your mind,” says Dr. Lorenzo Leggio, who’s the medical director of the Nationwide Institute of Drug Abuse.

“The mechanism within the mind that regulates overeating overlaps with these answerable for the event and upkeep of dependancy, together with alcohol dysfunction,” he says.

The function of dopamine

Research in animals, in addition to a couple of in individuals, supply tantalizing clues to how this mechanism works for each meals and alcohol.

Think about for a second taking a chew of a chewy chocolate cookie. It is buttery and really candy.

That first chew triggers the discharge of dopamine contained in the a part of your mind that controls your motivation, says neuroscientist Alexandra G. DiFeliceantonio, an assistant professor at Virginia Tech. “That dopamine primarily tells you, ‘Hey, do this once more!’ Take one other chew.’ ” And also you need one other chew. Possibly even one other complete cookie. It is arduous to cease.

Now think about you are a beer lover and you are taking a giant gulp of a chilly IPA on a scorching day. It additionally triggers a dopamine spike within the motivation heart of the mind — similar to the cookie.

“Dopamine within the striatum [the brain’s motivation center] is the motivation and studying sign for every thing. Not only for meals,” DiFeliceantonio says. “All addictive medicine enhance dopamine there. That is a standard factor.”

And so after the primary style of beer, the dopamine tells you, “Do it once more! Have one other gulp.”

However research have discovered that in animals and folks, GLP-1 medicine cut back the discharge of dopamine on this area while you eat one thing candy and fatty, or while you devour alcohol. “The drug talks with our mind and says, ‘We have had sufficient meals right here. So let’s decelerate. Let’s have much less urge for food, let’s have much less meals. Much less alcohol,” says NIDA’s Leggio.

So you do not actually really feel like one other chew of cookie, or as J. Paul Grayson stated, “I did not really feel like guzzling. I simply actually felt like sipping it.”

Oftentimes, now, he does not even really feel like ingesting in any respect. “Once I nonetheless had wine or chocolate within the fridge, typically I might suppose, ‘Oh, I ought to have some wine. I ought to have some chocolate.’ However there simply wasn’t something that made me rise up and go to the fridge,” he explains.

The “horse has already left the barn”

Ozempic’s potential to cut back alcohol consumption is now so well-known that some persons are in search of out the drug to assist with their ingesting, says Christian Hendershot.

“We’re additionally listening to about clinicians prescribing for that cause,” he says. “In some ways that is actually form of the indication that the horse has already left the barn. That is one thing that is already showing to occur, whether or not we prefer it or not.”

However NIDA’s Leggio advises towards this off-label use of Ozempic and Wegovy. “It is too early,” he says. Ozempic might not work towards alcohol for everybody, together with individuals who do not have weight problems.

To date, there has solely been just one small randomized managed research, taking a look at whether or not one other GLP-1 drug may deal with alcohol use dysfunction in individuals typically, as in comparison with cognitive behavioral remedy. This drug, referred to as exenatide, is not as potent as semaglutide (Ozempic) at inducing weight-loss or penetrating contained in the mind. Within the research, the drug diminished ingesting in individuals with weight problems, but it surely truly elevated ingesting in individuals who do not have weight problems.

“We do not know why,” Leggio says. One speculation is that the semaglutide induced individuals to shed weight although that they had regular weight and that led them to hunt extra energy by ingesting, Leggio says.

“However that is solely hypothesis,” he provides. “Now we have to comprehend that no medicine goes to work for everyone, and it is crucial to establish the sub-class of sufferers for who this medicine would possibly work.”

And he notes, in the long run, perhaps a more moderen model of the GLP-1 medicine would possibly work higher for treating addictions than diabetes.

Elisabet Jerlhag on the College of Gothenburg notes that folks with weight problems are inclined to have much less extreme negative effects whereas taking semaglutide than individuals who do not have weight problems. “With these medicine there’s additionally a danger of growing pancreatitis,” she says. “An individual with alcohol use dysfunction could also be at [elevated] danger for pancreatitis. So a physician would want to observe that.”

Alternatively, when you have diabetes and also you wish to curb your alcohol consumption then undoubtedly discuss to your physician in regards to the choice of semaglutide, Leggio says. “Much more so when you have weight problems and alcohol use dysfunction. Completely. Communicate along with your physician.”

“Many days I do not drink in any respect”

That is precisely what Meg Johnston, age 37, did a couple of month in the past. Throughout COVID, she additionally gained weight. “I make this joke that meals was the one factor that introduced me pleasure,” she says. However she additionally drank way more. “I might drink out of boredom, simply complete boredom.”

So she started taking semaglutide on the finish of June. Part of her purpose was to curb ingesting. “I hoped that I might be one of many those that the drug affected this manner,” says Johnston, who’s an actual property agent in Washington, D.C.

And certainly, the drug has not disillusioned her. “Many days I do not drink in any respect,” she says. “It is arduous to clarify why. Alcohol simply does not sound as appetizing or interesting. And now my tolerance is decrease, too.

“This has been a welcome change for me,” she provides. “Throughout these first couple of weeks of taking the drug, I used to be very a lot centered on not vomiting and ensuring I proceed to have bowel actions. I simply knew alcohol was going to make me really feel horrible afterwards.”