The Brief

During the COVID pandemic, J. Paul Grayson was hit with an avalanche of health problems — high blood pressure, prediabetes and a heart arrhythmia.

He also gained 40 pounds to his 6-feet 3-inches frame. "I felt like my weight was getting out of control," says the 73-year-old retiree, who lives on a ranch in Oklahoma. "I had to start taking all these medications that I never had to take before. I actually felt pretty depressed about my health."

About six months ago, Grayson began taking the popular weight-loss drug Ozempic. He knew the side effects could be rough, including nausea, constipation, and diarrhea. But he thought it would be worth it if he could stave off further heart problems by losing the extra weight.

"Right away, I started eating less and losing weight," he says. That was expected. But what Grayson hadn't expected was that the drug also immediately altered one of his other habits.

"I remember going to dinner for the first time [while taking Ozempic]," Grayson explains. "I ordered a beer, took a sip, and I couldn't finish it," he says. "You know how sometimes you taste a beer, and it's like, 'Oh my God, this tastes so good that I want to guzzle it.' Well, I didn't feel like guzzling. I just really felt like sipping it."
And, instead of having several beers with dinner, Grayson stopped at just one drink.

J. Paul Grayson experienced an interesting side effect when he started taking Ozempic: He lost his taste for alcohol.

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In the past year, prescriptions for both the diabetes drug Ozempic, and its weight-loss counterpart Wegovy, have skyrocketed, despite the fact that each costs about $1,000 a month, and some health insurers recently stopped covering them. Both drugs contain the same active ingredient, semaglutide, which belongs to a class of drugs known as GLP-1 (a.k.a. "glucagon-like peptide 1"). These drugs regulate your blood sugar and make you feel satisfied after eating. Ozempic is approved for treating diabetes and, in some cases, excess weight.

With the drug's surge in popularity, doctors and patients have begun to notice a striking side effect of these drugs: They appear to reduce people's cravings for alcohol, nicotine and opioids. They may also reduce some types of compulsive behaviors, such as gambling and online shopping.

"There's really been a large number of clinical and anecdotal reports coming in suggesting that people's drinking behaviors are changing and in some instances pretty substantially while taking [Ozempic or Wegovy]," says Christian Hendershot, a psychologist and addiction researcher at the University of North Carolina.

He's leading one of six clinical trials now underway aimed at understanding how semaglutide may alter people's drinking and smoking habits.

"All these reports, for the most part, are anecdotal," Hendershot adds. "At the same time, it does seem like there's a pretty strong signal here."

Scientists are hopeful that a new class of treatments for alcohol use disorder or smoking may be on the horizon. Some doctors have even started prescribing these drugs for this specific purpose, even though evidence from large, randomized controlled trials are still years away.

Stopping at just one cookie or beer

To many doctors and patients, like J. Paul Grayson, Ozempic's effect on alcohol came as a big surprise.

"Before Ozempic, I could consume a whole bottle of wine in an evening without trying real hard, along with a bag of chocolates," he says laughing. "But with Ozempic, even one beer didn't feel good to me somehow," he says.

"I had no idea this would happen," he adds. "Nobody told me anything about the drug affecting alcohol, too."

But for scientists who study GLP-1 drugs, this striking side effect was exactly what they expected. "It's really not surprising," says pharmacologist Elisabet Jerlhag.

For more than a decade now, Jerlhag and her colleagues at the University of Gothenburg in Sweden, have been figuring out in great detail how GLP-1 drugs, such as Ozempic, reduce alcohol consumption in rats.

She and other scientists have published nearly a dozen studies, showing how these drugs stop binge drinking in rats or mice, prevent relapse in "addicted" animals, and overall decrease their consumption of alcohol. "So we see a reduction by over 50%, which is quite dramatic," Jerlhag says.

Other studies in animals have also found that GLP-1 drugs reduce the consumption of nicotine, opioids, as well as psychostimulants, such as cocaine and methamphetamine.

So why would a weight-loss drug do this? Turns out, these drugs (as well as the GLP-1 hormone) don't just work on blood sugar. "They also work in your brain," says Dr. Lorenzo Leggio, who's the clinical director of the National Institute of Drug Abuse.

"The mechanism in the brain that regulates overeating overlaps with those responsible for the development and maintenance of addiction, including alcohol disorder," he says.

The role of dopamine

Studies in animals, as well as a few in people, offer tantalizing clues to how this mechanism works for both food and alcohol.

Imagine for a second taking a bite of a chewy, chocolate cookie. It's buttery and very sweet.

That first bite triggers the release of dopamine inside the part of your brain that controls your motivation, says neuroscientist Alexandra G. DiFeliceantonio, an assistant professor at Virginia Tech. "That dopamine essentially tells you, 'Hey, do that again!' Take another bite.' " And so, you want another bite. Maybe even another whole cookie. It's hard to stop.

Now imagine you're a beer lover and you take a big gulp of a cold IPA on a hot day. It also triggers a dopamine spike in the motivation center of the brain – just like the cookie.

"Dopamine in the striatum [the brain's motivation center] is the motivation and learning signal for everything. Not just for food," DiFeliceantonio says. "All addictive drugs increase dopamine there. That's a common thing."

And so after the first taste of beer, the dopamine tells you, "Do it again! Have another gulp."

But studies have found that in animals and people, GLP-1 drugs reduce the release of dopamine in this region when you eat something sweet and fatty, or when you consume alcohol. "The drug talks with our brain and says, 'we've had enough food here. So let's slow down. Let's have less appetite, let's have less food. Less alcohol," says NIDA's Leggio.

So you don't really feel like another bite of cookie, or as J. Paul Grayson said, "I didn't feel like guzzling. I just really felt like sipping it."

Oftentimes, now, he doesn't even feel like drinking at all. "When I still had wine or chocolate in the refrigerator, sometimes I would think, 'Oh, I should have some wine. I should have some chocolate.' But there just wasn't anything that made me get up and go to the refrigerator," he explains.

The 'horse has already left the barn'

Ozempic's potential to reduce alcohol consumption is now so well known that some people are seeking out the drug to help with their drinking, says Christian Hendershot.

"We're also hearing about clinicians prescribing for that reason," he says. "In many ways this is really kind of the indication that the horse has already left the barn. This is something that's already appearing to happen, whether we like it or not."

But NIDA's Leggio advises against this off-label use of Ozempic and Wegovy. "It's too early," he says. Ozempic may not work against alcohol for everyone, including people who don't have obesity.

So far, there has only been only one small randomized controlled study, looking at whether another GLP-1 drug could treat alcohol use disorder in people in general, as compared to cognitive behavioral therapy. This drug, called exenatide, isn't as potent as semaglutide (Ozempic) at inducing weight-loss or penetrating inside the brain. In the study, the drug reduced drinking in people with obesity, but it actually increased drinking in people who don't have obesity.

"We don't know why," Leggio says. One hypothesis is that the semaglutide caused people to lose weight even though they had normal weight and that led them to seek more calories through drinking, Leggio says.

"But that's only speculation," he adds. "We have to realize that no medication is going to work for everybody, and it's very important to identify the sub-class of patients for who this medication might work."

And he notes, in the end, maybe a newer version of the GLP-1 drugs might work better for treating addictions than diabetes.

Elisabet Jerlhag at the University of Gothenburg notes that people with obesity tend to have less severe side effects while taking semaglutide than people who don't have obesity. "With these drugs there's also a risk of developing pancreatitis," she says. "A person with alcohol use disorder may be at [elevated] risk for pancreatitis. So a doctor would need to monitor that."

On the other hand, if you have diabetes and you want to curb your alcohol intake then definitely talk to your doctor about the option of semaglutide, Leggio says. "Even more so if you have obesity and alcohol use disorder. Absolutely. Speak with your doctor."

'Many days I don't drink at all'

Meg Johnston's weight-loss medication has reduced her desire to drink. "Alcohol just doesn't sound as appetizing or appealing," she says.

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That's exactly what Meg Johnston, age 37, did about a month ago. During COVID, she also gained weight. "I make this joke that food was the only thing that brought me joy," she says. But she also drank much more. "I would drink out of boredom, just total boredom."

So she began taking semaglutide at the end of June. A part of her goal was to curb drinking. "I was hoping that I would be one of the people that the drug affected this way," says Johnston, who's a real estate agent in Washington, D.C.

And indeed, the drug has not disappointed her. "Many days I don't drink at all," she says. "It's hard to explain why. Alcohol just doesn't sound as appetizing or appealing. And now my tolerance is lower, too.

"This has been a welcome change for me," she adds. "During those first couple of weeks of taking the drug, I was very much focused on not vomiting and making sure I continue to have bowel movements. I just knew alcohol was going to make me feel terrible afterwards."

The Justice Department has begun to publish documents from the Epstein files in its possession regarding the life, death and criminal investigation of convicted sex offender Jeffrey Epstein.

NPR is reviewing the website the Justice Department created to make the documents publicly available. The Epstein Library includes documents broken into Court Records, DOJ Disclosures, FOIA Records and House Disclosures. Under the law, the DOJ was required to put the documents on a website and make them downloadable and searchable.

On Friday morning, Deputy Attorney General Todd Blanche indicated in an interview with Fox News "several hundreds of thousands" of pages would be released on Friday, with more to follow.

The release of the Epstein files is the latest development in a political saga that has dogged President Trump's second term in office and caused bipartisan backlash against Trump's conflicting and shifting commentary on the subject.

Trump amplified conspiracy theories about the files relating to his onetime friend Epstein on the campaign trail, vowing to publicize information about the financier's crimes and ties to powerful people that he alleged was being covered up by the government.

After he returned to the White House, Trump fought efforts by lawmakers and his supporters to release those files, calling Republicans who demanded transparency "stupid" and blaming Democrats for pushing a "hoax" before ultimately signing a law that was passed with near unanimous support.

The Epstein Files Transparency Act gave Attorney General Pam Bondi 30 days to publish "all unclassified records, documents, communications, and investigative materials" about Epstein available in a searchable and downloadable format. That deadline was Dec. 19.

The law also directed the Justice Department to share documents related to Epstein's accomplice Ghislaine Maxwell and "individuals named or referenced in connection with Epstein's criminal activities," information regarding plea deals and decisions not to charge Epstein for other alleged crimes, as well as records pertaining to his 2019 death by suicide in federal custody.

Over the summer, the FBI put out a memo that said their files include "a significant amount of material, including more than 300 gigabytes of data and physical evidence."

Some of that includes photos and videos of Epstein's accusers, including minors, and disturbing material that will not be made public. The bill from Congress also says anything "that would jeopardize an active federal investigation or ongoing prosecution" can be withheld or redacted, too.

Trump called on the Justice Department to investigate some Democrats and institutions he said were complicit in Epstein's crimes or mentioned in other documents made public, including tens of thousands of emails and private files turned over to the House Oversight committee under subpoena, FBI records and numerous court cases over the years.

"I will be asking A.G. Pam Bondi, and the Department of Justice, together with our great patriots at the FBI, to investigate Jeffrey Epstein's involvement and relationship with Bill Clinton, Larry Summers, Reid Hoffman, J.P. Morgan, Chase, and many other people and institutions, to determine what was going on with them, and him," Trump wrote on Truth Social in November.

In a separate Truth Social post announcing his signing of the Epstein Files Transparency Act, Trump said Democrats were using the issue to distract from what he says are victories for his administration.

"Perhaps the truth about these Democrats, and their associations with Jeffrey Epstein, will soon be revealed, because I HAVE JUST SIGNED THE BILL TO RELEASE THE EPSTEIN FILES!" he posted.

The president had the authority to release the files without congressional action.

Thousands of pages are already public

Jeffrey Epstein in Cambridge, Mass. in September 2004.

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****Xday's release of Justice Department files joins tens of thousands of other records made public over the years, including court cases, government document dumps and subpoenas from Congress.

Spread throughout roughly 23,000 documents released by the House Oversight Committee in early November, emails and texts revealed a list of powerful people in politics, academia and business that sought his counsel and friendship in the years after he pleaded guilty to state charges of solicitation of prostitution and of solicitation of prostitution with a minor under the age of 18 in 2008.

The people who consulted with Epstein in those documents rarely acknowledged the severity of the crimes that required him to register as a sex offender, though simply corresponding with Epstein does not implicate individuals in his criminal activities, convicted or accused.

There's an apparent letter of recommendation for Epstein from linguist Noam Chomsky, calling him a "highly valued friend," that recalled how Epstein connected him with former Israeli Prime Minister Ehud Barak — another frequent Epstein correspondent.

"Jeffrey constantly raises searching questions and puts forth provocative ideas, which have repeatedly led me to rethink crucial issues," the letter reads.

There's advice Epstein gave to Steve Bannon, Trump's former strategist, about ways to build a far-right political movement overseas.

"If you are going to play here, you'll have to spend time, [E]urope by remote doesn't work," Epstein wrote in 2018. "Lots and lots of face time and hand holding. Europe can be a wife not a mistress."

Former Harvard University president and onetime Treasury Secretary Larry Summers is documented numerous times having intimate personal chats with Epstein, including asking for romantic advice and joking about women's intelligence.

"I yipped about inclusion," wrote Summers in 2017. "I observed that half the IQ [in the] world was possessed by women without mentioning they are more than 51 percent of population...."

In the weeks since the latest Epstein emails release, he has resigned from the board of OpenAI and abruptly left his teaching role at Harvard, as the university announced a probe of "information concerning individuals at Harvard included in the newly released Jeffrey Epstein documents to evaluate what actions may be warranted."

Summers isn't the only high-profile Democrat who found himself in Epstein's orbit. Kathryn Ruemmler, former White House counsel in the Obama administration and current chief legal officer for Goldman Sachs, messaged with Epstein before and during Trump's first term.

"Trump is living proof of the adage that it is better to be lucky than smart," she wrote in August 2015.

"I regret ever knowing Jeffrey Epstein," Ruemmler told the Wall Street Journal in 2023.

Trump's name appears repeatedly

Trump was a frequent subject of emails and text messages in the latest private Epstein file tranche — well over a thousand different mentions — though mainly the subject of Epstein's near-obsession with his presidency, as the latter positioned himself as a Trump whisperer of sorts to his powerful associates.

In one 2015 email between Epstein and author Michael Wolff, the pair discuss a potential question from an upcoming CNN appearance about Trump and Epstein's personal ties.

"I think you should let him hang himself," Wolff wrote. "If he says he hasn't been on the plane or to the house, then that gives you a valuable PR and political currency. You can hang him in a way that potentially generates a positive benefit for you, or, if it really looks like he could win, you could save him, generating a debt."

Another email Epstein sent in 2011 to Ghislaine Maxwell, his associate who has been convicted on trafficking charges, called Trump the "dog that hasn't barked" and says Trump spent "hours at my house" with one of the alleged sex trafficking victims.

Still another is a 2019 message between Epstein and Wolff in which the disgraced financier wrote that "of course [Trump] knew about the girls as he asked Ghislaine to stop." The email does not elaborate any further.

"I have met some very bad people, none as bad as Trump," Epstein wrote in 2017 to Summers. "Not one decent cell in his body."

In September, House Democrats released more than 200 pages of a birthday book for Epstein created more than two decades ago that includes a lewd drawing and letter that appears to be signed by Trump.

The president, who has consistently denied any meaningful connection to Epstein, called the drawing and signature "fake."

In July, Trump told reporters that he and Epstein fell out because Epstein hired away young female employees who worked at the spa at Mar-a-Lago.
Copyright 2025 NPR

A program that aimed to bring thousands of Angelenos living with serious mental illness under court-led care remains far below initial participation projections, a review of county data shows.

LAist reported earlier this year that participation in the CARE Court program in Los Angeles County was relatively low — a little more than 380 petitions more than a year after its launch.

Now that the program has hit the two-year mark, there have been roughly 700 local petitions filed with the court, according to officials. That’s in a region where there thousands of people are estimated to be living with severe mental illness. And it's about 18% of the number the state projected for CARE Court’s first two years.

As of late November, six participants in L.A. County graduated from the program, according to data from the L.A. County Department of Mental Health.

Sergio Tapia, presiding judge of the Superior Court of L.A. County, said that number represented a kind of success.

“Did it meet the unrealistic expectations that were set up before CARE Court opened? Obviously it didn’t meet those expectations,” Tapia told LAist. “But I think those expectations were not realistic.”

He said it took up to six months just to get the first participants into the program.

But the low numbers and other concerns have caused some advocates for people with mental health diagnoses to doubt the program is viable.

“The program is not working,” said Monica Porter Gilbert, associate director and senior counsel of public policy at Disability Rights California.

She told LAist state data show that about half of participants statewide last year did not receive at least one of the services ordered for them, including therapy. (Tapia said he was not aware of any shortfalls in carrying out the CARE Court plans in L.A. County.)

Porter Gilbert also said she’s concerned about the expense.

An analysis from the state Assembly Committee on the Judiciary on CARE Court found that the cost per participant statewide during fiscal year 2023-24 was $713,000.

L.A. County officials working with CARE Court say the numbers are low because the work takes time, in some cases months just to locate people who may be unhoused.

And some state authorities agree.

Anne Hadreas, supervising attorney with Judicial Council of California, which organizes training programs for judges, said those who have started the program are making progress.

“Maybe the numbers aren’t what people expected, but there’s still been a lot of successes there,” she said.

How it’s supposed to work 

CARE Court allows family members, behavioral health workers, first responders and others to ask a court — by way of a petition — to step in with a voluntary care agreement for someone living with serious mental illness, like schizophrenia. If the agreement fails, a judge could order the individual to sign on to a treatment plan.

Between Dec. 1, 2023, and mid-December of this year, there were about 700 petitions filed in L.A. County, far below the roughly 3,800 state officials projected for the first two years of the program.

San Diego County, the second most populous in the state, received 445 petitions between October 2023 and November of this year. Orange County, the third most populous, received 206 petitions, according to our media partner CalMatters.

As of October, statewide data for the first two years of the program show that courts throughout California had received a total of 3,092 petitions, according to CalMatters. That’s still about 700 petitions short of what was expected just for L.A. County.

Martin Jones, a program manager with the county Department of Mental Health, said the six local graduations don’t tell the whole story. At least another 16 participants chose to stay in the program for an additional year.

Jones noted one recent CARE Court graduate who was subsequently able to get an apartment and a job.

“When you think about the impact on the individual — on their family, on their loved ones, on the community — the success is multiplied probably many times over,” he said.

But Porter Gilbert said family members of some CARE Court participants have told her they were sold false hope.

“Because many believed that their loved ones would finally get connected with meaningful services,” she said. “And instead they’re getting court dates that don’t lead to immediate housing or recovery-oriented clinical care.”

Data from the state’s CARE Act Annual Report showed that about 56% of participants statewide between October 2023 and June 2024 did not receive at least one mental health service that was ordered for them. The most common services ordered but not provided included medication supports and therapy services.

Porter Gilbert said CARE Court is failing to hold counties accountable for providing the services, even after they appear before a judge. And she said compelling participants into treatment through the court system can feel punitive for some participants.

“It’s blaming individuals for the failure of the system,” Porter Gilbert said.

Expanding eligibility

Next year, a new law signed by Gov. Gavin Newsom will expand eligibility for CARE Court to include people living with bipolar disorder who experience psychotic symptoms.

CARE Court currently only applies to people with schizophrenia spectrum disorders and a limited list of other psychotic disorders.

Marco Saenz, program director of the Independent Defense Council’s Office of L.A. County — which is tasked with representing CARE Court participants throughout the process — said the expansion is a good move.

“Hopefully these changes in the law that extend eligibility will see more people participating and getting the services that they desperately need,” he said.

Saenz also said the county and state need to do more outreach to increase the number of CARE Court petitions from first responders and other eligible petitioners.

About 67% of all petitions in L.A. County were filed by family members who sought to get their loved one into the program, according to data from the Department of Mental Health. Authorities said the county is working to get other eligible petitioners — like first responders and social workers — to file more requests.

“Many of these individuals are known to... fire or ambulance or other first responders. So it’s a matter of leveraging those relationships to really access the help that many of these individuals would benefit from,” said Jones, the program manager.

He and Hadreas at the Judicial Council said the program was still a work in progress, and they noted that while numbers remain far below what the state expected, many people are finding a door into mental health care through the petition process, even if CARE Court isn’t a good fit.

Hadreas said CARE Court was not intended to be a fast process, as many county workers must take time to build relationships with vulnerable people dealing with some of the most difficult times in their lives.

“It’s not an emergency process," Hadreas said. "It is about outreach and engagement and that can take months."

Californians will see the minimum wage increase to $16.90 per hour starting Jan. 1. The adjustment — a boost of 40 cents per hour — was calculated in August by the Department of Finance as part of its minimum wage annual review required by state law.

California has been raising its minimum wage over the past decade. Former Gov. Jerry Brown in 2016 signed a watershed law to increase minimum wage from $10.50 per hour to $15 per hour, plus annual adjustments for inflation.

The current rate of $16.50 per hour suggests that a minimum wage worker needs to work 98 hours per week to afford a one-bedroom rental at fair market rent in California, according to the National Low Income Housing Coalition.

California is one of 19 states to raise minimum wages in 2026, according to payroll company ADP. Cities and counties can also set their own minimum wages. This year, over two dozen local jurisdictions have increased local minimum wages. West Hollywood will have a $20.25 minimum wage starting in January — the highest of any California city, according to the UC Berkeley Labor Center.

Voters last November narrowly rejected a ballot measure that would have increased the minimum wage to $18 per hour. But some low-wage workers this year have successfully lobbied for bumps in pay in specific industries.

Under laws Gov. Gavin Newsom signed in 2023, fast food workers earn a minimum wage wage of $20 an hour and health care workers are on track to make $25 an hour.

That momentum extended to Los Angeles hotel and airport employees. Labor organizers in May secured a city minimum wage increase to $30 per hour for those workers by the 2028 Olympics. Large businesses fought back, arguing that wage hikes will only increase challenges for the tourism industry, which is still struggling to find its footing after the pandemic.

After failing to gather enough signatures for a ballot measure to repeal the new minimum wage, business groups later filed a different measure that could gut millions of dollars of revenue from the city’s general fund.

Following the move, Los Angeles City Council President Marqueece Harris-Dawson this month introduced a motion to delay the full wage increase from taking effect until 2030, according to reporting from the Los Angeles Times.

Labor leaders rebuked the motion, calling it “repulsive.” 

“You can’t threaten to blow a hole in our budget and then the only way to stop it is on the backs of workers,” said Kurt Petersen, co-president of the union that represents many hotel workers, UNITE HERE Local 11. “That kind of raw extortion and shakedown has no place in our city.”

According to Peterson, a coalition of community organizations and unions are beginning to collect signatures for a ballot measure that would raise the minimum wage to $30 per hour for all workers in Los Angeles.

“The power is everyone together,” said Peterson. “Working people need help and raising wages is the easiest, most straightforward thing to do. Going up 40 cents per hour in 2026 doesn’t move the needle at all.”

Cayla Mihalovich is a California Local News fellow.

This article was originally published on CalMatters and was republished under the Creative Commons Attribution-NonCommercial-NoDerivatives license.