Ozempic has been called a “wonder drug” with a growing body of research showing that it may help treat a wide range of health problems. Now, a new study shows it may have yet another use: reducing the risk of overdose in people with opioid use disorder.
The results are preliminary, but the United States has been battling an opioid epidemic for decades. Therefore, any promising treatment option feels like a big step forward.
So, what is the connection between Ozempic and opioid use disorder? Experts break it down.
Meet the experts: Pat Aussem, director of consumer clinical content development at the Partnership to End Addiction. Medhat Mikhael, MD, is a pain management specialist and medical director of the passive program at the Spine Health Center at MemorialCare Orange Coast Medical Center in Fountain Valley, California. Tyler J. Varisco, PharmD, PhD, Assistant Professor in the Department of Pharmaceutical Health Outcomes Policy and Associate Director of Research Development in the Center for Drug Abuse Education and Research at the University of Houston College of Pharmacy. Gitanjali Srivastava, MD, chief of obesity medicine at Vanderbilt University School of Medicine.
What did the study find?
The study, which was published in JAMA Network Open on Sept. 25, analyzed six years of health records of nearly 33,000 people with opioid use disorder who also had type 2 diabetes. Researchers found that people prescribed semaglutide (the active ingredient in Ozempic and Wegovy) had a significantly lower risk of opioid overdose compared to people taking one of eight other diabetes medicines.
The results suggest that semaglutide has “potential therapeutic value for the prevention of overdose,” the researchers wrote in the study.
Does Ozempic reduce the risk of opioid overdose?
Possibly. It’s important to note that this is one study, and even the researchers noted in the paper that the relationship needs to be further explored.
Pat Aussem, vice president of Consumer Clinical Content Development at the Partnership to End Addiction, agrees. “These results are preliminary and based primarily on observational data,” she says. “We need more rigorous clinical trials to fully understand how semaglutide can be part of opioid use disorder treatment regimens.”
The study compared semaglutide to a wide variety of diabetes drugs, including other GLP-1 agonists (a class of drugs that can help control blood sugar), notes Tyler J. Varisco, PharmD, PhD, assistant professor in the Department of Pharmaceutical Health Outcomes of Policy and Associate Director of Research Development in the Prescription Drug Abuse Education and Research Center at the University of Houston College of Pharmacy. “Additional research, including clinical trials, is needed before we can make any practice decisions from this work,” he adds.
Aussem emphasizes that people with opioid use disorder have other proven treatment options. “While the potential for a new drug is exciting, we have drugs for opioid use disorder that work but are severely underutilized,” she says. “Instead of waiting for the controlled clinical trials needed to understand which addiction trials can benefit from semaglutides, we need to advocate for the widespread use of the ones we already have.”
Many “effective, safe, and cost-effective medications” exist that “reduce the risk of mortality in people with opioid use disorder,” such as buprenorphine, a drug that “has been shown to reduce the risk of overdose in clinical trials.” Varisco says. “I think we need to focus more on improving access to medications that work by changing policies and processes of care to better support patients with opioid use disorder.”
Why is there a link between Ozempic and opioid overdose?
The drug likely affects the cravings for pain relievers experienced by people with opioid use disorder, says Medhat Mikhael, MD, a pain management specialist and medical director of the passive program at the Spine Health Center at MemorialCare Orange Coast Medical Center in Fountain Valley. , California.
That’s a sentiment echoed by Nora D. Volkow, MD, director of the National Institute on Drug Abuse (NIDA) at the National Institutes of Health, who wrote an essay for Women’s health on the bright future of GLP-1 drugs (such as Ozempic) to treat substance abuse in March. There is “a lot of overlap” in the mechanisms that drive us to eat and those that drive us to take drugs – both involve the brain’s incentive and reward systems. Addiction, in effect, hijacks these pathways, activating the system more intensely than everyday rewards (such as eating food or socializing),” she writes.
But research has suggested that GLP-1 may also alter motivational pathways.
“So it stands to reason that if there are similar mechanisms that drive us to overeat and take drugs, and a GLP-1 agonist works on the person who is overeating, then a GLP-1 agonist could also potentially help disrupt the urge.” to abuse drugs,” Volkow writes.
When someone takes an addictive drug like an opioid, “they get a surge of dopamine,” Mikhael says, which can then lead to future cravings. “But semaglutide works on the same receptors that activate the reward system,” he says. “The desire is likely to change.”
Experts are excited about the possibility of using semaglutide to treat opioid use disorder in the future, with Gitanjali Srivastava, MD, chief of obesity medicine at Vanderbilt University School of Medicine, calling the study results “quite promising.”
If future studies confirm the findings, Aussem adds that semaglutide could become “a valuable tool in a holistic approach to addiction treatment” — but emphasizes that it won’t be a stand-alone solution.
“Addressing substance abuse often requires a combination of medication, treatment and community support,” she says.
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