Host: Let's talk about new research on GLP-1 drugs like Ozempic and Wegovy that suggests they may be able to treat addiction and possibly depression. One study involving patients with opioid use disorder found that GLP-1 medication reduced cravings by 40% over the course of 3 weeks. Another looked at the health records of more than a million people with alcohol use disorder or opioid use disorder. It found people taking GLP-1s had a 50% lower rate of alcohol intoxication and a 40% lower rate of opioid overdose. I sat down with Dr. Anna Lemi, professor and medical director of addiction medicine at Stanford University to learn more.

Host: Dr. Lemi, thank you so much for joining us on the rundown. How are you doing today?

Dr. Lemi: I'm doing well. Thanks for having me.

Host: Of course. Um as we noted some really good signs early signs uh when we look at GLP1s and sort of addiction. How would you characterize the promise uh with GLP1s and say Ozempic uh when it comes to treating addiction?

Dr. Lemi: Well, first of all, I think it's worth noting that we reached a point in human history when we actually need a medication to help us eat less. For most of human existence, we have spent the majority of our day looking for enough food. Now, we're struggling to resist food. And as a result, uh, molecules like GLP1s are a way to adapt to a an environment of abundance. And so, I think that in itself is fascinating. Um, the promise of GLP1s is enormous. uh the signal that we're seeing now in terms of helping people curb appetite, lose weight, uh normalize blood sugar is is just really really exciting. Um as well as its potential promise in treating addiction more broadly, alcohol addiction, opioid addiction, nicotine addiction. It's it's just really an exciting moment to have a new new tool in what is um a pretty limited toolbox at this point. help us understand the science here. How does it actually work?

Dr. Lemi: So, the GLP1s mimic a molecule that we make in our bodies that's released in the gut after we eat that signals to the body, okay, you've had enough food, you can stop eating. As well as leading to the release of insulin and other hormones which lower blood sugars and again contribute to that feeling of fullness. So they essentially augment or amplify something that our body does already.

Host: Are there any when we talk about the potential and its effectiveness, are they potentially more effective with certain types of addictions? Is there are we seeing it with alcohol? Are we seeing it with opioids?

Dr. Lemi: Well, remember they really originated to treat type 2 diabetes and related obesity. Um, and it's really kind of a serendipitous or secondary uh awareness that oh wow this their ability to help with uh decreasing food intake might actually help with other addictions as well. So the strongest early signal has been with alcohol, not surprisingly because alcohol is also a carbohydrate, right? And so that's calorie mediated. That wasn't really the hugest surprise, although you know, a welcome early signal. What has been surprising is some of the other potential effects of the GLP1s like its potential effect on an opioid addiction, a nicotine addiction, or even what we call behavioral addictions. These are like things that we do like, you know, a gambling addiction or a sex addiction. Uh, in that people are now looking at the possibility of GLP1s in that arena as well.