Geoff Bennett:
Growing evidence suggests that GLP-1 drugs not only help millions of Americans fight diabetes and lose weight, but they also prove effective in curbing some people’s desire for drugs and alcohol.
William Brangham reports on researchers testing whether these drugs can help combat the nation’s drug addiction crisis. This is part of the ongoing GLP-1s: Reshaping America series.
Dr. Steven Klein:
Hello, Jessica.
Women:
Good morning.
Dr. Steven Klein:
How are you doing?
Women:
Alright.
Dr. Steven Klein:
You are very beautiful.
William Brangham:
At Caron Treatment Centers in eastern Pennsylvania, Dr. Steven Klein knows firsthand what his patients are battling.
Dr. Steven Klein:
Are you trying to stop drinking and having trouble?
Women:
Before, yes.
Dr. Steven Klein:
But now?
Women:
No.
Dr. Steven Klein:
No?
William Brangham:
Klein has now been sober for nine years from an addiction to cocaine and alcohol.
Dr. Steven Klein:
Are you experiencing any side effects from the medication?
William Brangham:
And today, he is at the forefront of using GLP-1 for people who want to overcome their own addictions.
Dr. Steven Klein:
OK, so we can talk about maybe increasing the dose a little bit.
William Brangham:
He also takes a GLP-1 medication himself.
During the pandemic, Klein stayed sober, but while working as a pediatric resident in Philadelphia’s emergency room, he says he ate to cope with the pressure. He gained about 30 pounds and was prescribed a GLP-1.
Dr. Steven Klein:
And what’s truly remarkable is that after my first or second photo, I had a transformative experience. I identified at that time that I was probably addicted to food before I was addicted to drugs or alcohol.
And the voice that talked to me about food and ordering from Grubhub and DoorDash after a long day at work was the same voice that justified drinking that drink or that medicine after a long day at medical school.
William Brangham:
Although the FDA has not approved GLP-1s for any substance use disorder, the drugs can be prescribed what is called off-label. And Caron Treatment Centers says that’s exactly what they’ve done with more than 600 of their patients over the past two years.
Dr. Steven Klein:
I’ve talked to countless people on GLP-1 for diabetes or weight loss who find they’re drinking less, smoking less, or doing less that wasn’t intentional. And that’s a really remarkable side effect and now maybe just an effect of these medications.
Jessica Massarone, GLP-1 patient:
I thought when I was in active addiction that this was going to be the rest of my life. I didn’t think I would ever get out of it.
William Brangham:
Jessica Massarone is one of Dr. Klein’s patients, although she lives in Rhode Island, more than 300 miles from his practice.
Jessica Massarone:
And then the medicine is…
William Brangham:
I see.
Jessica Massarone:
…is here.
William Brangham:
She’s part of a grant-funded pilot program that is now using telemedicine and GLP-1 to try to help people overcome their addiction.
Jessica Massarone:
My boyfriend at the time introduced me to crack and I immediately fell in love. I was like, this is – this is it. And I can be… I can be anything. I thought I was untouchable, unstoppable. I thought I could do anything. And very quickly, it took over my whole life, I lost my job, I lost my apartment.
William Brangham:
She ultimately lost custody of her three children. She struggled for 17 years, cycling in and out of prison.
Jessica Massarone:
The judge would release me and I would go out and do the same thing every time, every time. And every time I did it, it was worse.
Dr. Steven Klein:
Nothing? That’s a good answer.
William Brangham:
In May 2025, Klein prescribed him and about 20 other people with substance use disorders a GLP-1 free of charge. At the time, she was living at a Rhode Island nonprofit called OpenDoors. It provides transitional housing to the homeless and those released from prison.
Nick Horton, co-executive director, OpenDoors:
Everyone who does this work is desperate. We are trying to fight an epidemic with very few tools.
William Brangham:
Nick Horton helps run OpenDoors. According to him, the results so far have been promising.
Nick Horton:
We saw very significant increases in self-reported well-being, very significant decreases in reported food cravings, and most people continued to take the drug. We’ve definitely seen people relapse. We’ve seen people relapse, stop taking their medications, and then start taking them again.
Jessica Massarone:
I was like, weight loss, absolutely, I’m a — I raised my hand.
William Brangham:
For Jessica Massarone, even though it is an addiction program, she initially signed up because she had gained weight while trying to stay sober.
Jessica Massarone:
It was slower with weight loss and instantly with cravings and addiction.
William Brangham:
Instant?
Jessica Massarone:
Instant. Days. Days.
William Brangham:
Now sober for more than two years, Massarone is rebuilding his life. She shares custody of her children with an adoptive family and has worked her way up to managing a Subway restaurant.
Jessica Massarone:
It’s been two years. I get up and go to work every day, every day.
William Brangham:
RIGHT. It’s a whole new life.
Jessica Massarone:
It’s a whole new life.
Regina Roberts, GLP-1 patient:
Life didn’t turn out at all as I hoped. But I guess I’m grateful to still be standing. Many addicts don’t understand this.
William Brangham:
Regina Roberts also raised her hand for this program. She says that over the past 17 years she has tried several times to stop drinking.
Regina Roberts:
Lots of different therapies, taking antidepressants, weekly or bi-weekly therapy sessions, going to AA meetings every day or every other day. And I still couldn’t silence these voices.
William Brangham:
In 2023, Roberts says she and her husband, James, were each drinking a bottle of vodka a day when her son, Griffin, found them both unconscious.
Regina Roberts:
My son tried to wake me up, but he couldn’t. Sure enough, James was dead and I was too sick.
William Brangham:
So Roberts tried to get sober again. And last year, Dr. Klein prescribed her an injectable GLP-1 once a week, along with regular counseling.
Today, she proudly admits she hasn’t had a drink in over 12 months and continues to stay the course for her son.
Regina Roberts:
It’s my star. It’s for him that I get up every morning. This is why I do everything.
Man:
Participants were presented with drug-related cues.
William Brangham:
These anecdotal stories are promising. But scientists at the National Institutes of Health in Baltimore set out to determine exactly how and why GLP-1 appears to work on addiction.
Dr. Lorenzo Leggio, National Institute on Drug Abuse: We don’t really understand how they work, yes, actually, not just for drug addiction. We also don’t fully understand how they work against obesity.
William Brangham:
Dr. Lorenzo Leggio is the clinical director of the NIH’s National Institute on Drug Abuse.
Man:
Pitcher of red wine here.
William Brangham:
He and a team of researchers are conducting clinical trials in which people with substance use disorders are given either GLP-1 or a placebo and then studied.
Oh, wow. ALL RIGHT.
Women:
Yes, many more options here.
William Brangham:
For privacy reasons, we weren’t able to film the actual participants, but we were able to see some of the ways they measured the effect of these drugs on participants’ cravings.
ALL RIGHT. I’ll have some rice.
Women:
It looks awesome.
William Brangham:
The scientists first watch participants choose their food in a virtual reality cafeteria. Apparently, how a person behaves in this simulated world tells you about their behavior in the real world.
And then they come here. This isn’t a typical NIH lab, a room designed to look like a real bar, intended to trigger a desire to drink.
Dr. Lorenzo Leggio:
No treatment, including GLP-1 therapies, will work for everyone. So we need to understand not only does a drug work, but we also need to understand which patients are most likely to respond to it?
William Brangham:
Although initial results from these trials will be released next year, a recent study of 600,000 veterans showed that GLP-1 helped reduce the development of substance use disorders such as alcohol, cannabis, nicotine, cocaine and opioids.
Dr. Lorenzo Leggio:
This is the most exciting time to truly make a difference in the natural history of addiction medicine.
William Brangham:
But concerns remain about whether people will relapse if they stop taking GLP-1, similar to what happens with weight loss. Studies have shown that when people stop taking these medications, on average, 60 percent of the weight lost is regained within a year.
But Dr. Steven Klein says there is a solution to this problem.
Dr. Steven Klein:
We prescribe many medications throughout people’s lives. If I put you on a statin, it is likely that you will take it for the rest of your life. So the idea that addiction is not a chronic illness and therefore does not merit chronic treatment is, in my opinion, just another tip of the stigma iceberg.
William Brangham:
However, Klein warns, GLP-1s alone will not solve the country’s drug crisis.
Dr. Steven Klein:
Recovery involves community, infrastructure, therapy, many things that are not equally accessible to everyone.
I think these medications level the playing field by giving people more time to access these services, get established and be on the road to recovery. I don’t think GLP-1s are a silver bullet for addiction.
GLP-1, and how do you feel your dose is going now?
William Brangham:
Rhode Island’s pilot program will likely end in a few months. And Klein says that without FDA approval for addiction, these drugs will remain too expensive because insurance won’t cover them.
But, until then, Jessica Massarone says she is saving. These medications helped her turn a corner, and she’s willing to pay hundreds of dollars each month to preserve the valuable gains she’s made.
Jessica Massarone:
Who’s to say if I stop taking the medication, will I get high immediately? Or — I don’t know. I can’t answer that, can I? But why do I want to know?
William Brangham:
RIGHT.
For the PBS News Hour, my name is William Brangham.
Gn bussni
