Do GLP-1s curb drug and alcohol addiction? And if they do, can they also help curb crime, homelessness and even child abuse and neglect?
A new $13 million clinical trial announced this week may start to answer these questions. With support from the Arnold Foundation, the Center for Addiction Science, Policy and Research (CASPR) and the Allegheny County Department of Human Services are launching a randomized controlled trial to test whether weekly injection of Ozempic or Wegovy, in addition to regular care, “can reduce alcohol and opioid use and reduce criminal-justice involvement while improving employment, health, and housing outcomes among people at elevated risk of criminal-justice involvement.”
It sounds like a tall order, but experts believe that GLP-1 drugs present the best hope in a long time to curb cravings for alcohol and drugs among chronic addicts.
These medications have several advantages. First, they are long lasting. It is easier to get people to decide to take a shot once a week, than to take methadone every day or to take naltrexone each time they are going to drink.
And GLP-1s don’t have the potential to be abused so they can be administered without the help of a medical professional. They have shown promise even with addictions for which we have no other medication available, like cocaine. The side effects of these drugs are mostly positive — including, weight loss, combating diabetes, lowering cholesterol, and reducing inflammation.
The truth is that we don’t have many long-term solutions for people suffering from addiction. There are plenty of 30-day rehab programs out there. Indeed, thanks to Obamacare it is very easy to get stays in detox programs paid for by the federal government — to the point that there is widespread fraud in the industry.
But curbing alcohol and drug addiction often requires a complete lifestyle change.
And if the addiction is so bad that people are regularly involved with the criminal-justice or the child-welfare system, they have probably already tried other solutions.
Sadly, our approach to addiction is lacking both support and accountability. The harm reduction model — in which we offer people clean needles, medical care and housing while which waiting for them to wake up and decide to get clean — has failed. It has left men and women homeless, unemployed, and dead. And it has left children suffering from maltreatment or without parents at all.
Especially if addicts are committing crimes or not caring for their kids we need to intervene in their lives and force them into treatment — either with the threat of incarceration or possibly removing their children. Addicts do respond to incentives. But they have a much harder time responding to those incentives when the cravings are getting in the way.
That’s why the GLP-1 findings are so exciting. Eliminating the cravings could help the patients respond to the incentives we already have in place.
CASPR ran a pilot program in Providence, RI, with these medications and found significant success. One mother, Jessica Massarone, had been using cocaine and opioids for more than a decade. Her three children had been removed to foster care. Thanks to GLP-1s, she told the Boston Globe, she no longer had the same urges.
The shot has “helped her navigate a minefield of daily triggers, including walking to work at a Subway shop through the same parking lot where she once met dealers and got high.”
Now, after almost two years sober, she is working on her relationships with her three children and their adoptive parents. “The medication has changed everything, every single thing,” she said.
Nicholas Reville, the head of CASPR, explains that “rather than feeling dragged down by cravings, whether it’s for sugar, alcohol, or drugs, GLP-1s help quiet that noise for many people.” He believes that “research on [GLP-1s] and addiction show that they can often help restore personal agency.” And when people are in control, they can make better decisions for themselves and their families.
Naomi Schaefer Riley is a senior fellow at the American Enterprise Institute.
