Could weight loss drugs help curb drug addiction?
GLP-1 drugs, like semaglutide, may help people avoid developing addictions to alcohol, tobacco, and drugs such as cannabis and cocaine, a study has found.
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- A pilot program is testing GLP-1 medications, known for treating diabetes and obesity, to help combat substance use disorders.
- Participants in the program report that the medication has curbed their cravings for illicit drugs and alcohol.
- The Providence nonprofit OpenDoors launched the pilot for women recently released from prison or experiencing homelessness.
Jessica Massarone thought she’d made it.
After a childhood with parents addled by substance use, she made it to 26, earned a college degree, had her own apartment and a good job, working in child care at Brown University. She only dabbled with smoking cannabis, and she drank only on weekends.
Then, a boyfriend introduced her to cocaine.
“Benzos” followed.
And everything she’d worked so hard for – the apartment, the job – evaporated as her life became consumed by the very thing she’d tried so hard to avoid.
In 2019, Massarone overdosed. What she thought was cocaine ended up being fentanyl, and a stranger administered CPR and Narcan, bringing her back to life.
But then came the allegations that she had endangered her three children. She lost parental rights and landed in prison.
“I basically surrendered. I’m never going to see my kids. There’s no reason for me to live,” Massarone said.
Today, Massarone, now 43, lives with her dog, Gracie, in an apartment at the edge of the Pawtuxet River in Coventry. She’s the manager of a Subway sandwich shop. Her three children sleep over on weekends. She’s been drug-free for two years.
And she’s one of 20 participants in a pilot program through Providence-based nonprofit OpenDoors testing whether GLP-1 agonist medications can be used to help combat and control the urges that, for 17 years, overwhelmed her life.
She is thriving.
“I’m blown away about it. This addict is able to get through a drug craving without picking up,” said Massarone, whose smooth skin and clear eyes belie that she was in the throes of addiction not so long ago.
Why GLP-1s?
Evidence is now showing that GLP-1 medication, hailed for treatment of Type 2 diabetes and obesity, can ease desires to use alcohol and illicit drugs. They are proving to subdue the never-ending internal voices that urge users like Massarone to take just one puff, drink or pill. It’s offering a measure of hope for people battling substance use disorders.
“The feedback we’re getting is that it curbed their cravings and drug nightmares,” said Dina Bruce, deputy director of OpenDoors. “I think it’s easing their way.”
OpenDoors launched the GLP-1 pilot about a year ago after co-executive director Nick Horton came across promising research. The pilot was started for women who were newly released from prison or who were homeless. With funding from a Center for Addiction Science, Policy and Research, or CASPR, grant, Horton invited Massarone and other women to sign on.
The organization teamed up with Dr. Steven Klein, a doctor and researcher specializing in addiction medicine who works at Caron Treatment Centers in Pennsylvania. Caron has treated a star-studded clientele that includes Aerosmith frontman Steven Tyler and actress-singer Liza Minnelli.
“We wanted to be able to help people with fewer resources,” Horton said. “How can you help the people who need it the most?”
For decades, people had been relying on methadone and buprenorphine to stop opioid cravings, but there has been no treatment for cocaine or alcohol dependence.
Unlike methadone, which requires an individual to visit a clinic daily to receive a dose, GLP-1 medication can be administered privately at home through a weekly injection. Plus, they are nonaddictive and don’t leave people feeling as though they are under the influence, Horton said.
“Most importantly, it has these other benefits,” Horton said. The drug is known to control Type 2 diabetes, lead to substantial weight loss and improve cardiovascular health – big motivators for participation at the outset.
“We think what has happened so far is extremely compelling and promising,” Horton said.
Participants have experienced minimal side effects beyond nausea at the start, Horton said.
‘They quiet all the noise’
Klein, the doctor, was himself in recovery from drugs and alcohol and working in an emergency room during the pandemic when he found himself gaining excessive weight. He realized that the same internal voice talking to him about substances was now urging him to overeat, and he reverted to maladaptive coping skills.
The experience led him to take GLP-1s, transforming his burgeoning food addiction.
Over the last 15 months, he has prescribed a compounded version of the medication to about 450 patients, he said.
“I think this is an amazing opportunity,” Klein said. “Hope can come in many ways.”
Klein sees the OpenDoors pilot participants via telehealth and prescribes the compounded GLP-1 medication at a substantially lower cost.
“What I think we’re finding, across the board, they quiet all that noise and drive,” Klein said.
No longer were people making decisions based on past trauma; they were empowered to make choices in keeping with their values.
“I think the medications are giving people agency,” Klein said.
Another success story
Regina Roberts, of Cumberland, drank vodka from the moment she woke up until she went to sleep, only to rise, throw up and start again.
A two-time cancer survivor, she suffered from chronic pain and epilepsy that left her bored and unable to work. Her husband, James, joined her in indulging, and their house disintegrated around them as they drank their days away.
“We were low. We were both suffering, feeding off each other,” Roberts, 42, said.
James died 2½ years ago from problems with his heart. Roberts lost custody of her son, Griphin, due to the deplorable conditions of their home.
She detoxed at Rhode Island Hospital and stayed in hotels after her release. She lived in a series of recovery houses before making her way to sober living at OpenDoors.
There, she attended “lots and lots” of meetings. She got a job at Whole Foods and resumed visits with her son under Family Court oversight.
“I still really wanted to go out drinking,” said Roberts, who is diagnosed with bipolar depression.
The only way she could manage to stay sober was to hide away in her room. AA was not enough, she said.
Then, Horton approached her about the GLP-1 pilot.
“I jumped on it,” Roberts said, motivated in large part by the chance to get her son back.
Like Massarone, Roberts had gained weight as she put aside her substance of choice, making GLP-1s even more attractive.
As she went to buy cigarettes one day, the liquor store, just one block away, that had called to her for so long no had lost its allure. She walked in, bought a pack and walked out.
“Those voices quieted down. I suddenly found I could walk past it no problem,” Roberts said. “I was like, that’s cool.”
Breaking the cycle of addiction
It was a long road for Massarone to make it to where she is today. She spent years in and out of prison, only to use again within days. The death of her grandfather, who had long been a reliable landing spot, led her to live on the streets.
“‘At least I’m not homeless,’ I’d say, until I was,” she said.
Superior Court Magistrate John J. Flynn gave her multiple chances as he presided over Drug Court, even as she took hits in the courthouse bathroom, believing she was “untouchable.” He warned her she’d face serious jail time if she messed up again.
“On and off. On and off. I was really good at getting clean. I couldn’t stay clean,” Massarone said.
Finally, Flynn had enough. “He said, ‘Have fun sitting in prison,'” she recalled. “This time the judge wasn’t playing.”
She spent three months in prison. She missed her son Jacob’s voice change, her daughter Olivia’s 16th birthday and her youngest daughter, Sophia, falling in love. Her mind began to shift.
“Maybe I should do it. Maybe I should do Drug Court. Maybe it will change my life,” she recalled thinking.
This time, Magistrate Amanda Valentino was in charge. The judge hesitated.
“I said, ‘I just want to find myself again,'” Massarone said.
“Let’s do it,” Valentino said.
Massarone could have paid money to bail herself out of prison, but she warned that she’d just go get high. Two weeks later, she was released to OpenDoors.
Today, Massarone and Roberts live in tidy houses. They enjoy time with their children, moments they know their dependence nearly robbed from them. They are proud.
“I’m proud of myself. I’m not the person I was. I’m invested in my son. I’m invested in my house. At its worst, I didn’t care about anything,” Robert said.
She carries guilt for what she perceives as her role in her husband’s death and the temporary loss of custody of her 14-year-old son.
“I’m going to be recovering the rest of my life. I’m from a family of addicts,” Roberts said, adding, “I hope to God I’m doing right by him now.”
What’s ahead?
While both women are experiencing remarkable success and witnessing their confidence grow, both are nearing the end of their one-year participation in the pilot. They have limited doses of the medication left.
Massarone contemplates whether she’s strong enough to go without the medication but is preparing to pay if need be. Roberts wants to continue on GLP-1s.
Klein says he’s committed to prescribing the medication to the OpenDoors participants for as long as they want. He and Horton are hopeful that GLP-1 drugs will continue to drop in price and that, eventually, the government will approve its use in treating addiction. Insurance coverage would then follow.
They emphasize the societal costs of substance use in expensive prison stays, broken families and lives lost.
Roberts and Massarone are convinced.
“If you’re trying everything and you find you’re struggling, give it a try,” Roberts urges. “It might just be the foothold to climb the wall.”
