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  • Writer's pictureDena Lampert

Is Ozempic the new Oxycontin?

In the mid-90s I was a young social worker who was relatively new to the field and working in an outpatient substance abuse treatment facility. I witnessed firsthand how dangerous Oxycontin was and how its use and abuse were potentially devastating to families. I also witnessed how difficult it is to recover from an opioid addiction and that most people are unable to achieve long-term recovery.

Fast forward to 2023, I decided to start watching a show on Netflix called “Painkiller”, which tells the story of Oxycontin and the role that the Sackler family and Purdue Pharma played in the opioid crisis, which we are still battling today. I recognize that I was watching a fictionalized show that is based on true events, but, remember, I was working in substance abuse treatment at the time, and some of what was portrayed rang true to me. I believe that Oxycontin was widely overprescribed and many doctors believed the sales pitch that this was a safe drug that provided effective relief for their patients who were struggling with chronic or acute pain. It did not take long before we learned otherwise.

One of the most damaging symptoms of addiction is denial. Not only does the addict go into denial about the extent of the problem they may have with a substance, but their families, friends, coworkers, and all the systems that they engage with, also go into denial. No one wants to believe that someone has a drug problem. Denial is damaging because it often prevents us from addressing a problem before it's too late. In the case of Oxycontin, patients, family members, healthcare providers, and many employees of Purdue Pharma (except for those who were well aware of the epidemic) were in extreme denial.

Now we have Ozempic and similar drugs, Wegovy and Mounjaro, which are drugs designed to help those with type 2 diabetes process sugar more effectively to reduce high blood glucose levels. Its side effect is weight loss. However, it seems to be widely prescribed (maybe overprescribed) for weight loss because doctors believe it is a safe drug that provides effective relief for patients struggling with obesity.

For many, obesity is the result of a food addiction that develops early on in life. Like any other addiction, there is usually a genetic predisposition to this, and like all other addictions, the most effective treatment is a multi-pronged approach that includes cognitive behavioral therapy, nutritional counseling, physical therapy/coaching, and medication. The treatment for food addiction must be for the underlying issues, not the symptoms. So in certain cases, these medications can be appropriate when combined with other therapies to effect long-term behavior change. I believe there is a group of people who fall into this category and can appropriately benefit from Ozempic.

However, last month, CNBC reported that there were 9 million prescriptions written for Ozempic in the last 3 months of 2022 which accounted for 65% of Novo Nordisk’s total prescriptions written in that time period, and the vast majority were written for weight loss. Medication alone will not help anyone achieve long-term weight loss because obesity is a very complicated issue that requires an intention to change in multiple areas.

What happens when you stop the medication? If you have not made any efforts to work on your underlying issues, you will return to old behaviors and gain all the weight back. How are your mood and self-esteem affected when you are actively losing weight? Or when you are actively gaining weight? Are we becoming dependent on a weight loss drug to change our mood? These medications are only addressing part of the problem and it seems that once the medication is discontinued, the weight comes back.

We are supporting a dependency on this medication to achieve weight loss which changes our mood. If these meds are prescribed without discussion about the underlying issues and therapies needed, what are we accomplishing? Are we creating a new kind of addiction?

This was a hard blog for me to write. I am genetically predisposed to being overweight and would love a magic pill that would make that problem disappear. However, magic pills do not exist. I am not against medication or the advancement of medically assisted treatments. However, prescribing medication for weight loss without taking the underlying mental health issues into account might be a way of substituting one addiction for another.

What do you think?


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