An Ozempic (semaglutide) injection pen is seen on a kitchen table in Riga, Latvia, August 6, 2023.

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Heather Le Biller lost 9 pounds within the first week of taking Novo Nordisk’s blockbuster diabetes drug Ozempic – and then even more as she continued treatment.

Le Biller, a flight attendant living in France, noticed that her appetite decreased during the weekly injection. But also her desire for wine, a drink that, in her opinion, “almost goes with every dinner” in France.

“When I was at Ozempic, I didn’t want it as much,” Le Biller told CNBC. “I could have a few sips of wine and just be happy and carry on. I didn’t need multiple glasses a night, so it definitely seems to help with that.”

Le Biller is among several patients who took diabetes and weight-loss medications and also noticed an effect on their cravings for alcohol, nicotine, opioids or even some compulsive behaviors such as online shopping and gambling.

These drugs — including Ozempic and its weight-loss counterpart from Novo Nordisk, Wegovy — are called GLP-1 agonists, which mimic a hormone produced in the intestines to suppress a person’s appetite.

These anecdotal reports add to the growing list of potential benefits of GLP-1 that go beyond shedding unwanted pounds. Dramatic weight loss is the main reason these drugs have become increasingly popular in the United States, even though they can cost about $1,000 a month and some health insurers have stopped covering the cost altogether.

“We prescribe these medications and view this effect as a secondary benefit to patients. One of my patients even said that he doesn’t shop online as much, which helps his wallet,” said Dr. Angela Fitch, an obesity medication doctor and president of the Obesity Medicine Association. This group is the largest organization of doctors, nurses and other health care providers dedicated to the treatment of obesity.

A customer drinks a glass of wine at It’s Italian Cucina restaurant on April 5, 2023 in Austin, Texas. A new analysis of more than 40 years of research has found that moderate alcohol consumption has no health benefits.

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This striking effect of GLP-1 is not a new idea. Several studies have shown that certain GLP-1s reduce alcohol consumption in rodents and monkeys. More research needs to be done, particularly in humans, to prove that the drugs have this effect. That means it could be years before the Food and Drug Administration and other regulators around the world approve drugs like Ozempic and Wegovy as addictive drugs.

Manufacturers such as Novo Nordisk said they would not pursue this research.

“Pharma has this general lack of interest in investing in the addiction space,” which is due to a variety of factors, including the high stigmatization of substance use disorders among physicians, physicians and even patients, according to Dr. Lorenzo Leggio, clinical director of the National Institute on Drug Abuse, or NIDA.

Leggio and other scientists are working to close this gap – and have already made progress in confirming GLP-1’s potential as an addictive drug.

What do we know so far?

Scientists have published nearly a dozen studies showing how GLP-1s stop binge drinking in rats and mice, reduce their cravings for alcohol, prevent relapses in addicted animals, and reduce overall alcohol consumption.

Previous studies have examined older, less potent GLP-1 receptors such as exenatide, a drug approved for diabetes under the names Byetta and Bydureon.

But recent studies of semaglutide — the generic name for Ozempic and Wegovy — and another Eli Lilly drug called dulaglutide “are the most promising” because they reduced alcohol consumption in animals by 60 to 80%, according to pharmacologist Elisabet Jerlhag.

Studies have also shown that rats that stop taking dulaglutide, which is approved for diabetes under the name Trulicity, “take weeks before they start drinking again,” she said.

Jerlhag and her colleagues at the University of Gothenburg in Sweden have been studying the effects of GLP-1 on addictive behavior for more than a decade.

Boxes of the drug Trulicity, manufactured by Eli Lilly and Company, sit on a counter at a pharmacy in Provo, Utah, on January 9, 2020.

George Frey | Reuters

Other animal studies have also found that GLP-1 drugs reduce consumption of nicotine, cocaine, heroin and amphetamines.

Few human studies have been conducted, but six clinical trials are currently underway examining how semaglutide may change people’s drinking and smoking habits.

The reason for this anti-addiction effect of GLP-1, according to NIDA’s Leggio, is that these drugs also affect the brain, not just the gut.

“The mechanism in the brain that regulates overeating is also important for regulating addictive behavior,” Leggio told CNBC. “There are clear common overlaps. Therefore, it is possible that the drugs help people with addiction problems by acting on this specific mechanism.”

According to Dr. According to Dr. Steven Batash, a gastroenterologist who provides non-surgical weight loss procedures in Queens, New York, GLP-1 fatty acids specifically reduce the amount of dopamine that the brain releases after people engage in behaviors like drinking, smoking, or even eating one gave in to sweet desserts.

Batash said dopamine is a neurotransmitter that “enhances the pleasure” of engaging in these activities. When GLP-1s take away your pleasure, they also eliminate the motivation to do those activities.

What needs further research?

Still, NIDA’s Leggio recommends against using GLP-1s off-label to reduce addictive behavior “simply because there is not enough evidence that they work in humans.”

“The animal studies are very promising and what people are reporting is very, very important, but as a scientist I can also tell you that it’s not enough,” he told CNBC.

Leggio said scientists need to conduct more double-blind, randomized, placebo-controlled studies in people — or studies in which both participants and researchers do not know who will be randomly selected to receive a placebo or an actual drug. Such studies are “the gold standard” for proving whether or not a treatment produces a particular effect, he added

But even if these studies confirm that GLP-1 can reduce addictive behavior in humans, “it will most likely work for some patients and not for others,” Leggio said.

“In fact, we already know that these drugs, and all drugs as a whole, don’t work for everyone,” he said.

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For example, the only clinical trial in this area examined whether exenatide is suitable for treating alcohol use disorders in humans compared to cognitive behavioral therapy.

However, this 2022 study found that exenatide reduced alcohol consumption in a subset of participants with obesity, while the drug actually increased alcohol consumption in people without obesity.

The reason may be that “leaner patients” treated with exenatide experienced a greater drop in blood sugar, which could be associated with increased cravings for alcohol, the researchers wrote in the study.

But even this conclusion needs to be confirmed by further research.

It is also unclear how long the anti-addiction effects of GLP-1 last. This is already a complaint from patients when it comes to losing weight: People who lose weight after taking Ozempic or Wegovy tend to gain most of it back – or even more – within a few years.

“It is possible that some people will relapse and go back to drinking heavily if they stop taking the medication,” Leggio said. He added that some patients require ongoing treatment because addiction is a chronic disease.

However, Leggio said there is “nothing wrong” with a patient taking GLP-1 to treat diabetes or obesity in addition to an addiction disorder.

“If you want to see if Ozempic helps you better control your blood sugar but also helps you drink, that’s wonderful. You kill two birds with one stone,” Leggio said. “But if the only reason you want to take the drug is because of your alcohol or smoking, then you should wait for more evidence.”

It may take years, but scientists and other health experts hope a new class of treatments for alcohol addiction, smoking and other addictive behaviors are on the horizon.

“It may be that in three, four or five years you and I will say that GLP-1 agonists are wonderful for treating mild diabetes, wonderful for weight loss, and perhaps we will also say that they are wonderful for control “Addictive behavior,” Batash told CNBC.

But even if GLP-1 is approved to treat addiction, it’s unclear how many people would take it. The use of existing addictive medications is already low. In 2019, approximately 14 million American adults suffered from alcohol dependence – a disease associated with uncontrolled alcohol consumption. But only 1.6% used one of the three FDA-approved medications for the condition.

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