When the first drugs known as GLP-1s came to market in the mid-2000s, they were exciting enough for their potential in diabetes. Now that they’ve shown they can help people shed about 15% of their body weight, cut the risk of heart attacks as well as strokes and combat kidney disease, the sky’s the limit.
The latest excitement is about their potential ability to help alcoholics. Christian Hendershot, a clinical psychologist and professor at the UNC School of Medicine in North Carolina, is testing Novo Nordisk’s Ozempic (a sister medicine to Wegovy with the same active ingredient) to see if it reduces cravings for alcohol and cigarettes.
Some 30 to 40 volunteers will be poured their favorite drink and asked to rate their longing for the beverage at the start and at the end of the clinical trial Hendershot is overseeing. They will also keep a diary about their drinking habits. After nine weeks, Hendershot will assess whether their consumption has changed. The doctor and his colleagues say they can’t remember a time when their research generated this much buzz.
But not everyone is as enthusiastic. When it comes to research on alcoholism, Novo Nordisk, the Danish drugmaker behind Wegovy, isn’t involved. Neither is Eli Lilly, which makes a rival product. Big Pharma’s reluctance underscores why no new treatment has been approved for alcoholism in almost two decades: the commercial potential is uncertain, and pitfalls abound.
Novo wouldn’t supply scientists working in its hometown with Wegovy for a study into alcohol-use disorder, the medical term for alcoholism.
When asked about its lack of involvement, the company says that alcohol-use disorder isn’t one of its focus areas. Anders Fink-Jensen, the University of Copenhagen professor who oversees the Danish study on Wegovy for alcoholism, says there are other considerations, too. He describes the patients as a “fragile group” who are likely to have other illnesses, precipitating safety concerns that could taint the medicine’s image.
The treatments’ versatility stems from the way they work in the body.
The active ingredient in Wegovy, Ozempic, and Lilly’s Zepbound mimic a gut hormone called GLP-1 that the body produces after eating. While natural GLP-1 disappears quickly after a meal, the once-a-week injected pharmaceutical versions linger for days. The drugs slow the movement of food through the gut, but their impact is far broader. Among the many places where GLP-1 receptors are found is the brain, where the medicines are thought to affect dopamine, a neurotransmitter that helps regulate the flood of pleasure that comes from sex, a good meal or a glass of wine.
Patients have been telling their doctors about a diminished desire to drink alcohol ever since the first GLP-1 medicines went on the market more than a decade ago, but so far clinical trials haven’t managed to turn their observations into scientific fact. A recent case study on just six people gave the field a boost. These patients were given semaglutide — the active ingredient in Wegovy and Ozempic — for weight loss but they also suffered from alcohol-use disorder. They all saw a significant reduction in their symptoms.
Lorenzo Leggio, clinical director of the US National Institute on Drug Abuse, is another scientist working on investigating GLP-1s for alcoholism. In addition to measuring alcohol consumption by asking patients questions and performing blood and urine tests, Leggio’s team plans to expose participants to different stimuli, such as a bar-like room or cafeteria setting, to look for changes in cravings.
“It’s been the most exciting time,” Leggio says. “There’s a lot of momentum, a lot of interest in this target.” —Marthe Fourcade
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