GLP-1 Drugs Like Ozempic Reduce Cocaine Cravings, Case Study Finds

Semaglutide, the active ingredient in popular drugs Ozempic and Wegovy, may also help people wean themselves off cocaine. A new case paper this week details a man whose cravings for cocaine significantly declined after he started taking semaglutide.

Doctor Vincenzo Maria Romeo wrote about the case, published Monday in the Journal of Medical Case Reports. Romeo’s patient, a 54-year-old man living in Italy, suffered from cocaine use disorder and obesity, both of which were treated successfully once he began taking semaglutide. The findings further bolster the idea that this class of medication can also be used to reduce people’s unhealthy dependence on drugs like cocaine and alcohol.

Semaglutide and other newer GLP-1 drugs are known to be far more effective at helping people lose weight or treating their type 2 diabetes than diet and exercise alone. Since their arrival, some doctors have begun to notice another possible but positive side effect of GLP-1 therapy: some of their patients have reported a declining urge to abuse recreational drugs or indulge in other potentially harmful compulsive behaviors like gambling or binge drinking.

Studies of this phenomenon have largely focused on alcohol and opioids. But when Romeo’s patient visited him with a history of cocaine abuse and obesity, he and his clinical team saw an ideal opportunity to see whether semaglutide could alleviate both conditions at once. With his patient’s consent, Romeo started him on a 12-week course of the GLP-1 drug.

By the end of the 12 weeks, the man had lost around 12% of his body weight, in line with typical results (10% to 15% average weight loss in trials). But he also experienced a 59% reduction in his symptoms of cocaine craving, based on a commonly used survey measurement. All in all, the man reported improved physical health, including feeling more energetic and having less joint pain, with only mild adverse effects like gastrointestinal symptoms early on in treatment (a common occurrence with GLP-1 drugs).

This is, of course, only a single case study. Overall, the research looking into GLP-1 therapy for substance use disorders is also very preliminary. Researchers aren’t exactly sure how GLP-1 drugs reduce cravings for substances and compulsive behaviors, though it’s suspected that GLP-1 receptors in the brain help regulate our response to potentially addictive stimuli.

But the evidence for this unintended effect being genuine is building. Just last week, researchers published findings from the first controlled clinical trial testing semaglutide for alcohol dependence; it found that people with moderate alcohol use disorder taking low-dose semaglutide experienced a significantly greater drop in cravings and drinks consumed than those on a placebo.

It will take more time and research to confirm the value of GLP-1 therapy for drug dependence, including studies looking directly at cocaine abuse. But for people like Romeo’s patient, experiencing obesity and a substance use disorder at the same time, semaglutide could very well be established as a potent treatment for both conditions in the near future.

“The findings suggest that semaglutide may be a promising therapeutic option for the management of substance abuse in patients with comorbid obesity,” Romeo wrote.