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Posted by PaulHoule 2 days ago

GLP-1 therapeutics: Their emerging role in alcohol and substance use disorders(academic.oup.com)
241 points | 164 commentspage 2
FrustratedMonky 6 hours ago|
What if work is the addiction? Or Solving Puzzles?

Does GPL-1 also dampen those? How much does it dampen just any fixed behavior?

testaburger 10 hours ago||
One thing i noticed being on ozempic at first and then mounjaro after, while mounjaro is better for weight loss in general, ozempic was better at tampering my desire to drink throughout the week (although i wouldn't say i had AUD on either). I think the reason for this is the half life: ozempic is 7 days, (enough to get you until the next once a week dose), while mounjaro is only 5 days (which means by day 6/7 less than half the dose your took at the beginning of the week is still in your system). This also applies to food as well: my craving were less for sweets etc by the end of the week before the next dose on ozempic vs now on mounjaro. Although I think because mounjaro has 2 mechanisms of action vs just 1 for ozempic, I still end up losing more weight. But this is subjective based on my experience.

However, Ozempic will be generic early 2026 in Canada, and there's no way in hell I would pay 4-5x the difference (I'm guessing) for mounjaro as the benefit is relatively minor already given the half life difference (right now the price is almost the same).

I’m not diabetic, so my insurance doesn’t cover it, meaning I have to pay full price, which only went up after Eli Lilly switched from vials to pens in Canada. I genuinely hate Eli Lilly for : 1) their pricing, 2) for eliminating vials in favor of pens, and 3) for how they handled my situation. I reached out to their customer service honestly, admitting I wouldn’t qualify for a discount (even though I’d seen countless Reddit posts from people lying on the form and getting approved anyway and told them this). I reached out and requested in good faith and was flat-out denied, basically brushed off by their support team. This destroyed a lot of goodwill i had initially towards them because of better results and any future brand loyalty I might have had.

baq 7 hours ago|
buy a share of LLY every time you buy a pen, you'll be selling the stuff to yourself soon.
teitoklien 6 hours ago||
i doubt it would help, their stock will probably go down as glp lose their patents globally in most countries and become generics
lordofgibbons 22 hours ago||
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.
SubiculumCode 2 hours ago|
I know this is late to this topic, but I was wondering. You say you have more time for your projects, but do you ALSO lose motivation to do your projects too?

I am in a career that I really enjoy, but which requires high motivation and productivity. I don't want to lose that along with the pounds.

jnsaff2 21 hours ago||
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.

clusterhacks 5 hours ago||
I was a light or social drinker for decades. Probably 3-5 drinks per week.

In November of 2024, I decided to avoid alcohol as a personal experiment - no GLP-1 medications involved. I have not consumed any alcohol since.

After 3-4 months, my interest in alcohol seemed to really fall off a cliff. I joked with friends that I was going "dry in 2025", but I am now more seriously considering taking 2026 off from alcohol as well before making a decision about whether to add alcohol back into my diet.

WXLCKNO 18 hours ago|||
As someone who doesn't really drink and never has alcohol at home, is it just that people buy beer/wine and drink on a daily basis for fun? The wine I feel like you can pair with food and feel classy as an excuse but beer that ain't the case.

I realize how completely dumb this question might sound.

virgildotcodes 17 hours ago|||
> As someone who doesn't really drink and never has alcohol at home, is it just that people buy beer/wine and drink on a daily basis for fun?

Yes, anything from a couple of drinks a night with dinner / tv to getting blackout drunk multiple times a week, alone, with your significant other, or with friends / roommates.

In the case of people in my social circle (late 30s early 40s) it's primarily still for fun, as well as just a large amount of momentum from your teenage years, 20s, 30s, etc. For a lot of people I know, the association between drinking and good times / relaxation has been deeply engrained since high school.

I've recently taken an extended break for my health, as I'm fully aware that it takes a toll on me, but I still love grabbing some drinks whether I'm relaxing alone in the evening or going out with friends and family.

While it's certainly true that many people get into a dark place with drinking and let it spiral into a self-destructive, depressive pursuit, I don't think it's quite the rule it's made out to be.

I have a good amount of family who live idyllic, full, happy, social lives, drinking heavily multiple times a week with their friends and family into their 70s/80s until death.

antinomicus 17 hours ago||||
Basically I think “a beer would be nice right now” and then I go to the store or local pub.
bluescrn 5 hours ago|||
When drinking small quantities, it's more to relax/unwind at the end of the day than to 'have fun'. Sometimes it's self-medication for stress/depression.

But it can easily escalate into a rather unhealthy habit. And even fairly small amounts can disrupt sleep.

themafia 21 hours ago|||
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?

neom 17 hours ago|||
I don't know much about the drug, maybe you're talking about something else... but FWIW, I got sober from years as a practicing alcoholic the traditional way, I had lots of personality changes, some good some bad, but who I was when I was drinking all day every day and who I am today are quite different people.
bloomca 6 hours ago||||
Yeah I am reading through this thread and it does feel that things can go wrong here. With alcohol/drugs it is very likely to be an extremely positive change (at least for the majority), but some people shared videogames, and while they can totally be addicting, I personally place them on the same level as books/shows/movies, and losing interest in all of that is definitely a big change.
jnsaff2 5 hours ago||
Things I have not lost interest for (very much incomplete list): books, food (tho it has changed), my cats, my spouse, my friends, nerdy stuff, etc etc.

I was not addicted to gaming before so can’t really tell the difference there.

cheald 18 hours ago||||
I don't think it's a personality change, at least insofar as personality is separate from neurochemistry. Ghrelin and dopamine are strongly linked, and dopamine is our central reward-seeking driver; GLP-1s generally reduce ghrelin production, which I suspect helps remove you from a state of being constantly primed for reward-seeking. I noticed this firsthand when I went hard keto for the first time, and could suddently for the first time tell a significant difference between "I want food because I'm hungry" and "I'm not hungry but want food because it's pleasurable".
matthewdgreen 18 hours ago||||
I worry about it. I do tend to wonder if it can change your relationship with addictive and maybe risky behaviors, does it also potentially make you into a more conservative (not politically) person? Does creativity and risk tolerance go down as well?
jnsaff2 21 hours ago||||
Worry about a positive side effect? No.
n8cpdx 19 hours ago||||
It has definitely come up in books and podcasts I’ve listened to, but given general cultural values and biases I don’t think it gets much traction.
mrguyorama 1 hour ago|||
I had a lot of fear about this when I resisted getting treated for my very bad Anxiety. I feared that it might change me. I feared that I would be a different person.

Guess what? That's a good thing. The anxious person I was drove me to struggle to do basic life things, struggle to do things I wanted to do, and caused me to drive away someone I loved and harm them.

Fuck that guy, I don't want to be him. I did change. I became able to try new things. I became able to accept other people without needing to impose what I considered "right" onto them. I became able to manage my stupid jealousy to stop it from hurting my relationships.

Now I can ride rollercoasters without having a panic attack. Oh what a shame I lost that guy.

The things that medications treat also cause personality changes. Significant mental or psychological problems consume parts of you, and drive your life negatively.

There's no such thing as a "true" you. You are just biological machines doing chemistry. That chemistry dictates YOU. That chemistry is literally affected by the food you eat. Drawing a line because we require you to get a chemical from someone with a special piece of paper is not reality.

Wearing the proper glasses will cause a personality change if you grew up vision impaired.

Don't deify a broken brain.

Other lies people insist on to avoid medication include "There's no silver bullet/magic pill"

Guess what? Sometimes there is! A low dose of a boring medication fixed my anxiety, as in, turned me from being a dysfunctional anxious wreck to someone who has a normal anxiety response. Even the "side effects" I experience have been positive outcomes.

Now if you do something like take anabolic steroids and it gives you roid rage? Yeah, avoid that, not because "It changed you" but because it made you demonstrably worse in a way you probably do not want

Do you know what else causes irreversible personality changes and will change who you really are?

Aging.

petesergeant 11 hours ago||
I think the calorific content of alcohol and general habituation are under-looked. I also basically never drink any more (and am on zep), but when I do occasionally have a craving, an alcohol-free beer 100% hits the spot for me.
crimsoneer 9 hours ago||
It's interesting how many people in the HN comments are on this stuff - here in the UK you can't get it unless your BMI is pretty high. Is it easier to get prescribed in the US or are people just buying the chemicals online?
daveoc64 5 hours ago||
It's estimated that 1.5 million people are taking them in the UK, most of them privately [0].

It's really easy to get them in the UK from a variety of online and high street pharmacies, including from well-known brands like Boots, Lloyds Pharmacy, or ASDA.

[0] - https://www.bbc.co.uk/news/articles/c981044pgvyo

pjc50 7 hours ago|||
Note that you can't advertise prescription drugs in the UK. There's also still a bit of a stigma about going private, and it's expensive.
raesene9 3 hours ago||
I'm not sure how true the stigma is for GLP-1 based drugs. There are lots of online options for getting it from major orgs in the UK including things like Asda who aren't really a well-known pharmacy brand here (https://onlinedoctor.asda.com/uk/weight-loss-treatment.html).

As to advertising, my perception is that it's wrapped in a "weight loss clinic" style presentation but you don't have to be on all the sites long before you get to the "buy $GLP-1" here :)

lebski88 8 hours ago|||
You only need a BMI of 30 to get a private subscription. That's a pretty large portion of the population (no pun intended).
fragmede 8 hours ago||
A side effect of healthcare being a for-profit system in the US means it runs the gamut, from a doctor you meet with in a clinic irl, to a doctor you never actually meet online, you just fill out some digital paperwork for, to the exteme where users get chemicals from sketchy websites and do chemical prep at home. The middle ground is to use an online "pill mill" that ships out from a compounding pharmacy, often not covered by insurance so paid out of pocket. Maybe $300/month? According to online sources aka reddit it's fairly accessible, just fill out an online questionaire and get a prescription from a doctor, followed by getting the medication shipped to you. It was a bit more open during Covid, but it's still relatively accessible. If you do have a high BMI then more mainstream sources are available to you though.
TriangleEdge 18 hours ago||
Why would a GLP-1 be used to dampen reward over an anti-psychotic?
neom 17 hours ago|
https://pmc.ncbi.nlm.nih.gov/articles/PMC8820218/

It seems it doesn't block dopamine generally, but does seem to act on dopamine spikes?

t-writescode 2 days ago||
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 22 hours ago|
This was the framing behind James Burke's Connections if I recall, a wonderful documentary series.
jtrn 21 hours ago||
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.

Mistletoe 19 hours ago|
https://jamanetwork.com/journals/jamapsychiatry/fullarticle/...

Once-Weekly Semaglutide in Adults With Alcohol Use Disorder

Results

Forty-eight participants (34 [71%] female; mean [SD] age, 39.9 [10.6] years) were randomized. Low-dose semaglutide reduced the amount of alcohol consumed during a posttreatment laboratory self-administration task, with evidence of medium to large effect sizes for grams of alcohol consumed (β, −0.48; 95% CI, −0.85 to −0.11; P = .01) and peak breath alcohol concentration (β, −0.46; 95% CI, −0.87 to −0.06; P = .03). Semaglutide treatment did not affect average drinks per calendar day or number of drinking days, but significantly reduced drinks per drinking day (β, −0.41; 95% CI, −0.73 to −0.09; P = .04) and weekly alcohol craving (β, −0.39; 95% CI, −0.73 to −0.06; P = .01), also predicting greater reductions in heavy drinking over time relative to placebo (β, 0.84; 95% CI, 0.71 to 0.99; P = .04). A significant treatment-by-time interaction indicated that semaglutide treatment predicted greater relative reductions in cigarettes per day in a subsample of individuals with current cigarette use (β, −0.10; 95% CI, −0.16 to −0.03; P = .005).

__alexs 11 hours ago|
We've finally invented Soma. Perhaps finally something the Republicans can agree to fund Medicare for?