[HN Gopher] GLP-1 therapeutics: Their emerging role in alcohol a...
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GLP-1 therapeutics: Their emerging role in alcohol and substance
use disorders
Author : PaulHoule
Score : 119 points
Date : 2025-10-28 02:00 UTC (1 days ago)
(HTM) web link (academic.oup.com)
(TXT) w3m dump (academic.oup.com)
| t-writescode wrote:
| Technology and discovery are so cool.
|
| One breakthrough and then a WHOLE BUNCH OF NEW STUFF happens all
| at once now that this new idea or new pathway is created.
|
| mRNA vaccines break away and now they're testing them in
| everything. GLP-1 showing signs of use in obesity and now it's
| being tested for a whole gamut of other things. All very
| exciting!
| fullshark wrote:
| This was the framing behind James Burke's Connections if I
| recall, a wonderful documentary series.
| tracker1 wrote:
| All I will say, is if/when you start noticing digestive issues,
| it's probably the GLP-1 even if it's after a year of taking the
| stuff... and woah boy, coming off the stuff is anything but fun.
| tanvach wrote:
| How so? Can you describe more of your experience if you don't
| mind sharing?
| tracker1 wrote:
| Started developing gastroparesis issues after about a year on
| Trulicity... over the pandemic, due to shortages I was
| switched to Ozempic for a few months which was less effective
| with my diabetes mgt. I didn't actually lose weight on the
| medication(s).
|
| After seeing several doctors about the issue including a
| couple specialists, only one of about half a dozen
| medications tried actually worked to help the gastro issues,
| which included fecal vomiting, rotted fermented food coming
| up, both regularly. No actual blockages. The medication that
| did work wasn't covered by my insurance. After a couple years
| of suffering, I saw a news report about the Trulicity lawsuit
| related to gastroparesis issues. Over the same period, I
| started to develop retina issues, several retina bleeds and
| regular injections to treat it.
|
| When I found out about the lawsuit, I stopped taking the
| medication going back to straight insulin injections (long
| and short) currently Lantis and Novalog. For close to a year
| after coming off, I experienced a feeling of starvation
| 24/8... didn't matter if I was physically full up to my
| throat, the ravenous feeling of hunger would not subside. I
| gained about 80# during this time (again, didn't lose weight
| on the meds).
|
| I'm a few years off and my digestion is inconsistent and
| unpredictable... sometimes I'll have a few days where things
| flow normally... others I'll be backed up for close to a week
| and have to take a heavy magnesium laxative to get things
| going again. I stay pretty close to carnivore as just about
| anything else can range from discomfort to pain. Not to
| mention legume allergies and really sensitive to wheat... I
| still cheat about once every other week, and I pay for it
| physically.
|
| Because I was on more than the one medication, I cannot
| participate in either the Trulicity or the Ozempic class
| action lawsuits. These medications have kind of ruined my
| life. I'm now about half blind and using 45" monitors to
| work, and even then have to zoom text and lean in to be able
| to function.
|
| Over the years, I've been on several drugs for diabetes that
| I'd built up a quick tolerance to, that may have had other
| negative effects... Byetta, Victoza and others... I've always
| had digestion sensitivities, these just turned it up to 11.
| When I started Trulicity, my insulin use was pretty minimal
| and I was already on a Keto diet and had been losing
| weight... I wish I'd stuck with that and never even heard of
| the stuff.
|
| Some of the recollections are a bit jumbled, apologies for
| that, I'm just kind of writing as it comes to mind.
|
| Aside: along with the medical issues has been some employment
| inconsistencies the past few years with a few contract roles
| spread a few months apart. I had hoped to maintain my income
| level as many available jobs were lower pay. Currently, my
| insurance is "emergency" coverage based, and doesn't even
| cover the 3 doctors I'm seeing regularly and doesn't help
| much with the medications I am still taking. Let alone the
| eye injections I haven't been able to get for about a year
| now ($7k/eye/injection). Tried working 2 jobs for a while,
| but couldn't keep up with the load after a few months. I'm
| depressed and angry. Prior to about 8 years ago, I never
| carried debt... now I'm maxed out and staring at bankruptcy.
| ArnoVW wrote:
| That sounds pretty awful. Hang in there. Hope you have a
| support network of sorts and find a way out.
| ogogmad wrote:
| Holy crap, I'm sharing this. Hang in there.
| titanomachy wrote:
| What was your comedown like? After 6 months of taking
| subcutaneous semaglutide, I just stopped taking it one day and
| it was fine. Need a bit more effort to be mindful of snacking
| now, though.
|
| EDIT: saw your other comment that you felt you were starving.
| that sucks. the whole thing experience sounds awful.
| sghiassy wrote:
| As an alcohol enthusiast on 12.5mg of Zepbound for the last
| several months, my ethanol consumption hasn't diminished much
| sghiassy wrote:
| I can also add I have little to zero side effects from Zepboubd
| if that adds anything
| bluescrn wrote:
| As a beer enthusiast drinking unhealthy amounts rather too
| frequently, my drinking went _way_ down when on Mounjaro.
|
| (Maybe it wouldn't have made the same difference if I was into
| whisky instead of beer - with beer, I suspect it's the
| relatively large volume of drink involved that may have made it
| less appealing?)
|
| Recently switched to Wegovy since the big Mounjaro price hikes
| here in the UK, and it seems rather less effective overall.
| Both beer and snacks are somewhat more appealing again :(
| dynm wrote:
| > A more recent RCT showed that low-dose semaglutide reduced
| laboratory alcohol self-administration, as well as drinks per
| drinking days and craving, in people with AUD [72].
|
| I think this quote is... wrong? Or at least extremely misleading?
| Here, citation 72 refers to a paper by Henderson et al. That
| paper did (sorta) reduced laboratory alcohol self-administration,
| but did _not_ find _any_ reduction in the amount that people
| drank. https://dynomight.net/glp-1/
| dynm wrote:
| OK looking at the original abstract:
|
| > Semaglutide treatment did not affect average drinks per
| calendar day or number of drinking days, but significantly
| reduced drinks per drinking day (b, -0.41; 95% CI, -0.73 to
| -0.09; P = .04)
|
| So they didn't find any reduction in (1) drinking, or (2) in
| the number of days that people drank, but they did technically
| find (3) a reduction in the number of drinks that people
| consumed on the days that they drank. So I guess what they said
| is technically correct... but I still think it's very odd not
| to mention the headline result that there was no actual
| reduction in _drinking_!
| wrs wrote:
| I don't understand the math here. The average per calendar
| day didn't go down, so the total drinking is the same. That
| total is distributed among the drinking days, which are also
| the same. So how can the drinks per drinking day have
| changed?
| hbosch wrote:
| Much has been said about the GLP drugs and their interactions
| with all kinds of addictive disorders. Alcohol, drugs, even
| gambling... Anecdotally, I "struggled" at times with gaming (not
| joking). I would find myself skipping meetings at times or
| ducking away to play online sometimes. It never became a real
| issue but I knew I did it and it was embarrassing.
|
| Once I started on tirzepatide, and then with retatrutide, the
| "urge" to swap over to my PC between meetings and load up a game
| is pretty much zeroed out.
|
| Is this an "addiction" or a form of "abuse" similar to alcohol or
| other drugs? I would have said no some time ago, but now I'm not
| sure. I definitely feel like, looking back, I was more or less
| "addicted" to video games. I don't want to romanticize it as some
| sort of "escape", it just is what it was.
|
| This was an unintended side effect (benefit?) of the drug for
| sure, in addition to acute weight loss of course.
|
| Unlike many others, even after titrating down and coming off the
| GLP's, I have not felt the urge to binge food, video games, or
| anything else. I maintain a healthy, active lifestyle and have
| kept my weight exactly where I prefer it. My relationship with my
| body and my time has massively improved. I feel like I am at risk
| of sounding like a complete shill, obviously, but in my mind
| these drugs can be something that absolutely has the potential to
| turn life around for many, many people.
| georgeburdell wrote:
| I'm going to put on my Boomer pull-yourselves-up-by-the-
| bootstraps hat, but are you concerned about the loss of grit
| resulting from changing your behaviors without the drug?
| afthonos wrote:
| Definitely not GP, but I think it's pretty clear that
| whatever grit there was to have, GP did not have it. "Die an
| early death due to being overweight or build the grit" is
| strictly worse than "lose the weight without building the
| grit, or build the grit", and it's even more so when you
| realize that "or build the grit" was never in the cards.
| Because then the choice becomes "die an early death or
| don't". Building the grit can be done on other, hopefully
| less lethal, projects.
| inopinatus wrote:
| Turns out that this attitude was bullgrit all along.
| hiddencost wrote:
| _wet farting noise_
| dalyons wrote:
| side question - has retatrutide been different enough to
| tirzepatide for you that you would recommend going to the extra
| effort to source it?
| Rudybega wrote:
| I think it's probably still useful to distinguish addictions
| with hardcore substance related barriers to quitting (think
| withdrawals) from addictions where the barrier is a lack of
| dopamine or serotonin or simple habituation.
|
| For people with normal executive function, the second category
| of problems should be fairly tractable to overcome, whereas the
| first is still quite difficult.
|
| The second only really becomes an issue when you have a bit of
| executive dysfunction.
|
| Maybe that distinction is important and one merits the term
| addiction while the other doesn't? Though both categories seem
| to be relatively treatable with drugs that massively improve
| executive function, so the parallels are pretty glaring.
| lordofgibbons wrote:
| I've noticed that when I'm on Zepbound 2.5mg, I don't have the
| strong urge to play video games and can focus on my projects.
| Even if I do play video games while on it, I lose interest after
| a maximum of half an hour.
| jtrn wrote:
| I hate these articles so much. The title should be: "Speculation
| on how GLP-1a drugs could theoretically reduce alcoholism while
| waiting for any real evidence".
|
| 99% of promising mice studies does not result in clinical
| practical application in humans. And theoretical associations and
| mechanisms of action should not be promoted without huge asterisk
| to contextualize how often such speculation are wrong.
|
| If you complain about AI slop and don't see how this is just as
| bad science slop, please go listen to Sabine Hossenfelder. This
| is just as bad, and create just as much useless noise as AI
| content does on the nett.
| jnsaff2 wrote:
| Just a single datapoint here. About 8 months after starting on
| semaglutide I took a month off alcohol and by the time the month
| was over had lost all interest for alcohol.
|
| Almost 2 years now. I'm not religious about it and will
| occasionally drink the celebratory glass of bubbles or a beer
| (alcohol free if available) when it's hot outside.
|
| Very interesting how it has worked.
| themafia wrote:
| I'm not trying to pick on you because I've seen this anecdote
| on many occasions; however, it strikes me that people are quite
| willing to walk past "personality changes" as a side effect of
| a drug.
|
| Does anyone else feel a slight sense of worry about this?
| jnsaff2 wrote:
| Worry about a positive side effect? No.
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