Taking Ozempic helped to reduce cannabis dependence and avoid relapse
Medical professionals in the United States have obtained the first preliminary evidence that taking an extremely popular weight-loss and diabetes remedy is associated with a reduction in cannabis cravings and helps prevent relapses. This is important because there is still no medication for cannabinoid addiction that is effective and has been approved by authorities.
Cannabis is the most widely cultivated, sold and abused drug. Marijuana accounts for half of all drugs seized in the world. According to the World Health Organization, at least 147 million people, or 2.5% of the world's population, use cannabis (the UN estimates that this figure will already exceed 200 million in 2020). In comparison, 0.2% of people are addicted to cocaine and the same number of people are addicted to opiates.
Despite the prevalence of cannabis, there are still no approved treatments for cannabis use disorder. Meanwhile, in countries where the drug has been legalized and the number of users is growing, the problem of addiction is acute: almost a quarter of US residents who smoke marijuana have a severe disorder that interferes with normal life. They are also prone to developing psychosis, self-harm and suicidal thoughts.
Treatment for cannabinoid addiction consists of reducing use, dealing with withdrawal symptoms (withdrawal syndrome) and cognitive behavioral therapy. All of these methods are not fully effective, so there is a need for medications that can help overcome addiction.
A new study by medical professionals from the Center for Science, Health and Society at Case Western Reserve University (Cleveland, USA) and the National Institute on Drug Abuse may help solve the problem. In a paper published in the journal Molecular Psychiatry, they described semaglutide, an agonist of the glucagon-like peptide-1 receptor (aGPP-1, GLP1R), as a medication for cannabis addiction. The scientists came to these conclusions after analyzing a large database of electronic medical records.
Semaglutide is also known as the active ingredient in drugs like the extremely popular Ozempic, which has been prescribed for type 2 diabetes since 2017 and for obesity since 2021. In addition, clinical trials of semaglutide as a treatment for alcoholism and nicotine addiction are ongoing.
"Preclinical studies have examined the effects of semaglutide or other agonists of aGPP-1 on addiction to nicotine, alcohol, cocaine, and opioids. However, little attention has been paid to the effects of these drugs on cannabis users, even though its prevalence is even higher than tobacco in certain demographic groups," the medics explained.
They examined data from 83,189 obese people who had seen a doctor between June 2021 and December 2022. Patients were prescribed either Wegovy brand semaglutide or non-AGPP-1 weight loss medications (bupropion, naltrexone, orlistat, topiramate and phentermine). Participants were divided into two groups: 44,445 who took semaglutide and 37,744 who were prescribed medications without aHPT-1.
The sample then included 2,034 patients who were not only obese but also had a cannabis use disorder. They, too, had to take either semaglutide or drugs without aHPT-1.
Another phase of the study analyzed data from 587,849 patients with type 2 diabetes. From December 2017 through May 2021, they were prescribed Ozempic brand semaglutide or, again, a drug without a glucagon-like peptide-1 receptor agonist. Additionally, they added information on 8,196 patients with diabetes and cannabis dependence who were treated with Ozempic or medications without aGPP-1 to the sample.
Researchers conducted separate analyses based on participants' gender, age, and ethnicity. Demographic factors, lifestyle, comorbidities and taking other medications were also taken into account.
The observations showed that over 12 months, taking Wegovy and Ozempic brand semaglutide correlated with a significantly lower risk of cannabis use disorder compared to other medications. The effect was also seen in diabetics and overweight patients who were not yet addicted to this psychoactive drug.
In those with a history of cannabinoid addiction, taking Wegovy and Ozempic correlated with a significantly lower likelihood of being re-diagnosed with a cannabis use disorder - compared to drugs without aGPP-1. However, this association weakened in the long term. The reduction in dependence was strongest in men over 55 years of age, with the exception of blacks (in the obese group).
The authors noted that because the study was observational and retrospective, it is not possible to establish causality. However, an analogy can be made to nicotine addiction, for example: preclinical testing confirmed that it's all about stimulation of glucagon-like peptide-1 receptors in a brain region called the habenula. It mediates the repulsive effects of nicotine, while a glucagon-like peptide-1 receptor agonist weakens the brain's reward circuitry with the release of dopamine, the "happiness hormone."
"Our results provided preliminary evidence for the possible benefit of semaglutide in cannabinoid addiction in a real population. However, further preclinical studies to understand the underlying mechanism and randomized clinical trials will be required," the medics concluded.