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."

Andy Pages drove in two runs with a bases-loaded single in the seventh inning to give Los Angeles the lead, and the Dodgers beat the Atlanta Braves 4-1 on Wednesday night to clinch their NL Division Series.

The Dodgers won back-to-back games in Atlanta to take the best-of-five matchup 3-1 and advance to the National League Championship Series as they seek to become the first NL team to win three straight World Series.

Pages lined a 3-2 pitch from Robert Suarez up the middle to drive in Teoscar Hernández, who singled off starter Tyler Mahle, and pinch-runner Tommy Edman for a 3-1 lead. Didier Fuentes walked pinch-hitter Josue De Paula and Kyle Tucker to load the bases. Edman ran for De Paula.

Max Muncy’s solo shot off Raisel Iglesias in the ninth padded the lead and gave the slugger 19 postseason homers with the Dodgers, extending his franchise record.

Dodgers right-hander Tyler Glasnow, making his first start since Sept. 24, allowed only one hit but walked five batters in 4 2/3 innings. After he issued two walks in the fifth, left-hander Alex Vesia ended the inning on Matt Olson’s groundout to second base.

The missed opportunity left the Braves with 18 walks in the series, and none scored.

Glasnow and four relievers combined to give up just three hits. Tanner Scott pitched a perfect eighth before Edwin Díaz got three quick outs for the save.

Mahle, a native of Newport Beach, California, who grew up a Dodgers fan, allowed two runs — one earned — in 6 1/3 innings.

Michael Harris II hit Glasnow’s first pitch for a single before stealing second and eventually scoring from third on a wild pitch that bounced off catcher Will Smith’s chest protector.

The Dodgers pulled even in the second with the help of two Atlanta errors. Shohei Ohtani walked, stole second and advanced to third on catcher Sean Murphy’s errant throw into center field. Muncy’s pop fly into shallow left field was dropped by shortstop Mauricio Dubón for another error, allowing Ohtani to score.

Hernández crashed into the wall while attempting to catch Ozzie Albies’ double off Vesia leading off the sixth. Hernández pointed to his head and neck when talking to an athletic trainer but remained in the game.

Edgardo Henriquez stranded Albies at second. Henriquez allowed one hit in 1 2/3 scoreless innings for the win.

Injury report

Dodgers second baseman Miguel Rojas was held out after leaving Tuesday night’s 3-1 win during an at-bat in the eighth inning with lower back soreness. Los Angeles manager Dave Roberts said Rojas would not be available off the bench.

Ronald Acuña Jr. started in right field for Atlanta one day after being moved to designated hitter in a late lineup change due to right knee soreness.

Up next

The Dodgers will face Milwaukee or San Diego in Game 1 of the NLCS on Sunday.

The Democratic National Committee on Wednesday sued President Donald Trump’s administration for recent television advertisements that promoted his political message while costing taxpayers millions of dollars.

The complaint, filed in the U.S. District Court for the District of Columbia, alleges that the ads are illegal government-sponsored propaganda and accuses Trump of personally directing them. It asks the court to declare the ads illegal and stop the use of federal funds to pay for them.

Trump has faced bipartisan backlash for the ads, which glorify him and echo his campaign pitch as voters cast early ballots with the midterm elections less than a month away.

The spots, which began airing in September, already have cost more than $12 million to run, according to the media tracking firm AdImpact, and a total of $20 million in Homeland Security Department funding has been tapped to pay for them.

Responding Monday to the criticism, Trump defended the ads as “positive promotion for our Great U.S.A.” but said he’d pay for them using his MAGA Inc. super PAC going forward.

But on Tuesday, the fifth ad in the campaign began airing with the notice “paid for by the U.S. Government,” promoting Trump’s military actions in Venezuela earlier this year. The same day, Trump made it clear he hasn’t committed to reimbursing any money that has already been spent, telling reporters “we’ll decide.”

DNC Chair Ken Martin said in a statement that Trump is misusing taxpayer dollars in “a last-ditch attempt to save Republicans in November.”

“Americans deserve better than to have their hard-earned tax dollars used for Trump’s illegal schemes,” he added.

Legal experts have suggested the ads run afoul of a federal statute against congressionally appropriated money being used for “publicity or propaganda,” and potentially other federal laws. The Homeland Security money tapped for the ads comes from a $175 million package Congress gave to the department as part of Trump’s immigration enforcement agenda.

The White House has defended the ads as public service announcements akin to what past administrations have done to promote various policies. Legal experts have said the recent ads differ from many past public service announcements because they aren’t aimed at helping members of the public benefit from specific government programs.

The defendants in the lawsuit — Trump, the White House, DHS and the Office of Management and Budget — didn’t immediately respond to requests for comment.

Fall has only just begun, but it's already time to start thinking about the quintessential winter bug: the flu.

The annual flu season usually starts in October or November. But this year, it looks like the flu started to pick up in early September.

"There are enough signs pointing in the same direction to make me think, 'OK, yes. This is the start of flu season,'" says Caitlin Rivers, an epidemiologist at the Johns Hopkins Bloomberg School of Public Health.

The percentage of people testing positive for the flu in the West has been rising steadily since around the beginning of September, she says. And the number of people showing up in emergency departments because of the flu has also been rising for weeks, she adds.

"It's very uncommon to see flu activity rising this early. It's activity that we might normally see more like November or December," she says.

The timing of the flu season isn't the only thing that's odd. It's also unusual that flu activity seems to have started in Western states, such as California, Washington, Hawaii and Alaska.

"It typically starts in the South and then expands from there," Rivers says. "So two uncommon developments there."

Rivers stresses that the amount of flu activity is still very low in most parts of the country. But that's starting to change as the flu picks up nationwide.

It's unclear why flu activity would have started so early, and in such an unusual part of the country. But one clue might be a new variant that evolved a mutation, which appears to make it better at evading existing immunity, especially among teenagers.

"That's our best argument for what's going on right now in terms of this early flu season," says Dr. Alex Greninger, a virologist who heads infectious disease diagnostics at the University of Washington. Doctors there are seeing as much flu right now as they usually would around Christmas, and the mutated variant appears to be common, he says.

So Greninger, Rivers and others are urging people to think about getting their flu shot earlier than usual.

"It's crucial that people get an influenza vaccine," says Scott Hensley, a virologist at the University of Pennsylvania. "And this might be a year that people might want to get a vaccine early."

But the Centers for Disease Control and Prevention hasn't been promoting flu shots as it usually does. Health Secretary Robert F. Kennedy Jr., who oversees the CDC, is a long-time vaccine skeptic.

"It is disappointing that CDC is quiet given that flu kills of hundreds of kids a year and can result in tens of thousands of hospitalizations and tens of thousands of deaths," says Dr. Demetre Daskalakis, who resigned last year as the director of the National Center for Immunization and Respiratory Diseases at the Centers for Disease Control and Prevention to protest what he called political interference at the agency.

The CDC declined to make an official available to NPR for this story. In a statement, a CDC spokesperson said, "CDC is developing a communications strategy to provide clear, accessible information about influenza vaccination and other critical steps people can take to protect themselves during respiratory virus season. This includes information about the benefits and risks of vaccination to support informed decision-making."
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