Jessica Massarone couldn’t concentrate in primary school: She was too preoccupied with her parents’ struggles with drug addiction. Sometimes, she’d find her mother passed out on the floor. “I was constantly worried about what I was going to come home to,” she said.
Despite being diagnosed with anxiety and depression in her teens, she earned an associate degree in child development and worked for seven years at a university child care center. At 26, she thought she’d escaped her family legacy — until a boyfriend introduced her to cocaine.
“The addiction part came really fast,” she said. She got pregnant, then sober. She’d recover for a few months, even a year, then relapse. She lost custody of her children.
In May, she began taking a drug similar to Ozempic while living at Open Doors, a Rhode Island nonprofit for formerly incarcerated and homeless people. She gets the medication, called a GLP-1, free through a pilot program testing the weight loss and obesity drugs as a treatment for addiction. Fifteen patients have started on the medication so far.
The drug helped Ms. Massarone, who had also battled obesity, lose 17 pounds. Critically, it also allowed her to overcome drug cravings in situations that had once defeated her. “I have a very strong faith,” she said, “but sometimes that’s not enough.”
Ms. Massarone has now been in recovery for 17 months. She recently left Open Doors to live in an apartment with a woman she met in that program. When we spoke, she was preparing for a weekend visit with her 13-year-old twins — a boy and a girl — and her 16-year-old daughter.
Stories like Ms. Massarone’s underscore why research into GLP-1s for addiction needs more investment. Unlike new drug compounds that take years to develop, GLP-1s are already approved and appear quite safe, which means they could reach people far sooner, while also offering broader health benefits. The only existing treatments that have proven to save lives from drug addiction, methadone and buprenorphine, were developed and approved thanks to a big push from the federal government.
The pilot program that includes Ms. Masserone is run by the Center for Addiction Science, Policy and Research, or CASPR, a nonprofit organization studying GLP-1 drugs for addiction. The group, which is not funded by pharmaceutical companies, wants to spur F.D.A. approval for such use, which the industry has shown little interest in pursuing. (The maker of Ozempic has one trial aimed at treating alcohol-related liver disease, but said explicitly that it isn’t focused on addiction.) Without formal approval as an addiction medicine, the drugs will remain unaffordable because insurance won’t cover them. For now, Open Doors provides the medication for free through support from CASPR, in hopes that the results will spur government and the pharmaceutical industry to take on the research.
Studies based on the medical records of millions of people taking GLP-1s for obesity or diabetes have revealed strong signals of their potential as addiction treatment. The research shows reductions of 30 to 70 percent in addictive behaviors, including heavy drinking, cannabis use disorder and opioid overdoses. There are also many anecdotes of people taking these medications and finding themselves drinking less, reducing other drug use and cutting back compulsive behaviors like gambling or shopping.
Clinical trial data is sparse. But in February, a trial of GLP-1s for alcohol use disorder showed significant reductions in heavy drinking among patients who weren’t trying to quit or even cut back. A small, unpublished pilot study for opioid use disorder found that people reported a reduction in drug cravings.
Open Doors uses much lower doses than those approved for diabetes or obesity to prevent unhealthy weight loss. So far, none of the participants have had this problem, said Dr. Steven Klein, an addiction physician who is prescribing the drugs for Open Doors.
Ms. Masserone tried to kick cocaine repeatedly in the past, participating wholeheartedly in treatment programs, aiming to be a good mother. Twice, she achieved around a year of abstinence and had full custody — and twice, she relapsed and lost it when she came across people and situations that reminded her of her past. The second time, she nearly died: Her cocaine was laced with fentanyl. After being jailed for 45 days for possession — and feeling hopeless about recovery — she agreed to an open adoption for her children. “I love them so much that I, yeah, gave them away,” she said.
At Open Doors, she got a fresh start. Her children’s adoptive parents support weekend visits, seeing how hard she’s working to change. “They’re so proud of me right now,” she said of the adoptive parents, “and that means everything to me.”
On medication, Ms. Masserone has navigated at least two situations that previously prompted relapses. Once, a former drug friend contacted her on social media. But rather than feeling driven to get high, she felt nothing. “I shut it down right away,” she said, recalling how she immediately blocked him. Another time, she saw a dealer she knew making a sale outside the Subway where she now works. Rather than being drawn back in, she was “disgusted,” she said. Again, no cravings. “And I was amazed by that, because for me, it’s a big deal.”
So far, many of the accounts of success with GLP-1 medications for addiction come from affluent people with ample resources for recovery, making it difficult to know how much of an advantage the medications really offer. Research shows that educated, employed and otherwise socially supported people are generally more likely to recover.
The project at Open Doors aims to see whether the drugs make a difference for people like Ms. Masserone, who’ve endured childhood trauma, homelessness and incarceration. Dr. Klein, who also prescribes GLP-1 drugs for the Caron Foundation rehab chain, which tends to have wealthier patients, said that he’s seeing benefits in both groups. “They feel more in control,” he said. One patient told him, “I feel like my brain listens to me now.”
Medications can’t supply a home or a job or a reason to live, of course. But if they can help a woman who wants to be there for her children to avoid relapsing, it would be criminal to allow only the rich to benefit. Both the government and the pharmaceutical industry need to engage as they did to make existing medication options available. We need to marshal those resources to find out as quickly as possible if GLP-1 medications actually are as good as they appear to be for addiction.
Maia Szalavitz (@maiasz) is a contributing Opinion writer and the author, most recently, of “Undoing Drugs: How Harm Reduction Is Changing the Future of Drugs and Addiction.”
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