GEOFF BENNETT: A growing body of evidence suggests that GLP-1 drugs are not only helping millions of Americans with their diabetes and weight loss, but they're also proving effective at curbing some people's desire for drugs and alcohol.

William Brangham reports on the researchers who are testing whether these medications can help tackle the country's addiction crisis.

It's part of the ongoing series GLP-1s: Reshaping America.

DR.

STEVEN KLEIN, Caron Treatment Centers: Good morning, Jessica.

WOMAN: Good morning.

DR.

STEVEN KLEIN: How are you?

WOMAN: Very good.

DR.

STEVEN KLEIN: You look amazing.

WILLIAM BRANGHAM: At the Caron Treatment Centers in Eastern Pennsylvania, Dr.

Steven Klein knows firsthand what his patients are battling.

DR.

STEVEN KLEIN: Do you try to stop drinking and you cannot stop?

WOMAN: Before, yes.

DR.

STEVEN KLEIN: But now?

WOMAN: No.

DR.

STEVEN KLEIN: No?

WILLIAM BRANGHAM: Klein is now nine years sober from a cocaine and alcohol addiction.

DR.

STEVEN KLEIN: Are you having any side effects from the medication?

WILLIAM BRANGHAM: And, today, he's at the forefront of using GLP-1s with people who want to overcome their own addictions.

DR.

STEVEN KLEIN: OK, so we can talk about maybe going up on the dose a little bit.

WILLIAM BRANGHAM: He's also on a GLP-1 medication himself.

During the pandemic, Klein was staying sober, but while working as a pediatric resident in a Philadelphia E.R., he says he ate to cope with the pressure.

He put on about 30 pounds and was prescribed a GLP-1.

DR.

STEVEN KLEIN: And really remarkably, after my first or second shot of taking that, I had a transformative experience.

I identified at that point I was likely addicted to food before I was addicted to drugs or alcohol.

And the voice that talked to me about food and ordering Grubhub and DoorDash after a long day of work were the same that used to justify having that drink or that drug after a long day of being in medical school.

WILLIAM BRANGHAM: While the FDA hasn't approved GLP-1s for any substance use disorders, the medications can be prescribed what's called off-label.

And the Caron Treatment Centers says it's done just that with more than 600 of their patients in the last two years.

DR.

STEVEN KLEIN: I have talked to now countless people on GLP-1s for diabetes or for weight loss who realize that they drink less, they smoke less, or they're doing something less that was unintended.

And that's a really remarkable, side effect and now maybe just effect of these drugs.

JESSICA MASSARONE, GLP-1 Patient: I thought, when I was in active addiction, that that was going to be the rest of my life.

Like, I didn't think I could ever come out of it.

WILLIAM BRANGHAM: Jessica Massarone is one of Dr.

Klein's patients, even though she lives in Rhode Island, more than 300 miles from his office.

JESSICA MASSARONE: And then the medication is... WILLIAM BRANGHAM: I see.

JESSICA MASSARONE: ... is right here.

WILLIAM BRANGHAM: She's part of a grant-funded pilot program that's now using telemedicine and GLP-1s to try to help people overcome their addiction.

JESSICA MASSARONE: My boyfriend at the time introduced me to crack cocaine, and I instantly fell in love.

I was like, this is -- this is it.

And, like, I can be -- I can be anything.

I thought I was untouchable, unstoppable.

I thought I could do anything.

And it really quickly took over my whole life, lost my job, lost my apartment.

WILLIAM BRANGHAM: She eventually lost custody of her three kids as well.

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 single time.

And every time I did, it got worse.

DR.

STEVEN KLEIN: Anything?

That's a good answer.

WILLIAM BRANGHAM: In May of 2025, Klein prescribed her and about 20 other people with substance use disorders a GLP-1 free of charge.

At the time, she was living at this Rhode Island nonprofit called OpenDoors.

It provides transitional housing to homeless people and to those coming out of prison.

NICK HORTON, Co-Executive Director, OpenDoors: Everyone who does this work is desperate.

We're trying to fight off an epidemic with very few tools.

WILLIAM BRANGHAM: Nick Horton helps lead OpenDoors.

He says, so far, results have been promising.

NICK HORTON: We found very significant increases in self-reported well-being, very significant decreases in reported cravings, and most of the people stayed on the medication.

We certainly have seen people relapse.

We have seen people relapse, get off the medication, then get back on the medication.

JESSICA MASSARONE: I was like, the weight loss, absolutely, I'm a -- I raised my hand.

WILLIAM BRANGHAM: For Jessica Massarone, even though this is a substance abuse program, she initially signed up because she'd put on extra weight trying to stay sober.

JESSICA MASSARONE: It has been slower with the weight loss piece and instantaneously with the cravings and the addiction.

WILLIAM BRANGHAM: Instantaneous?

JESSICA MASSARONE: Instant.

Days.

Days.

WILLIAM BRANGHAM: Now sober for more than two years, Massarone is rebuilding her life.

She shares custody of her kids 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 I 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 has not turned out at all the way I had hoped it would.

But I guess I'm grateful I'm still standing.

A lot of addicts don't get that.

WILLIAM BRANGHAM: Regina Roberts also raised her hand for this program.

She says, over 17 years, she repeatedly tried to quit drinking.

REGINA ROBERTS: Lots of different therapy, taking antidepressants, weekly, biweekly therapy sessions, going to AA meetings every day or every other day.

And I still couldn't quiet down those voices.

WILLIAM BRANGHAM: By 2023, Roberts says she and her husband, James, were each drinking a bottle of vodka a day when her son, Griffin, found them both unresponsive.

REGINA ROBERTS: My son tried to wake me up, 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 a once-weekly injectable GLP-1, plus regular counseling.

Today, she proudly admits she hasn't had a drink in more than 12 months and continues to stay the course for her son.

REGINA ROBERTS: He's my star.

He's the reason I get up every morning.

He's the reason I do everything.

MAN: Participants were shown drug-related cues.

WILLIAM BRANGHAM: These anecdotal stories are promising.

But scientists at the National Institutes of Health in Baltimore have been trying to determine exactly how and why GLP-1s seem to work with regards to addiction.

DR.

LORENZO LEGGIO, National Institute on Drug Abuse: We don't fully understand how they work, yes, actually, not just for addiction.

We don't fully understand how they work for obesity either.

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 running clinical trials where people with substance use disorders are given either a GLP-1 or a placebo and then studied.

Oh, wow.

OK.

WOMAN: Yes, a lot more options here.

WILLIAM BRANGHAM: For privacy reasons, we couldn't film the actual participants, but we were able to see some of the ways they measure how these medications affect participants' cravings.

OK.

I will take some rice.

WOMAN: Sounds great.

WILLIAM BRANGHAM: Scientists watch first as participants pick foods in a virtual reality cafeteria.

Apparently, a person's behavior in this simulated world tells you something about their behavior in the real one.

And then they come here.

This is not your typical NIH lab, a room designed to look and feel like an actual bar, one meant to trigger a craving to drink.

DR.

LORENZO LEGGIO: No treatments, including GLP-1 therapies, are going to work for everybody.

So we have to understand not only if a medication works, but we also have to understand, which are the patients who are more likely to respond?

WILLIAM BRANGHAM: While the initial findings from these trials will be reported next year, a recent study of 600,000 veterans showed GLP-1s helped reduce substance use disorders to alcohol, cannabis, nicotine, cocaine, and opioids from developing.

DR.

LORENZO LEGGIO: This is the most exciting time to really have a game changer in the natural history of addiction medicine.

WILLIAM BRANGHAM: But concerns remain about whether people will relapse if they stop taking GLP-1s, like what happens with weight loss.

Studies have shown that, when people stop these medications, on average, 60 percent of the weight they shed is back within a year.

But Dr.

Steven Klein says there's a solution for that.

DR.

STEVEN KLEIN: We prescribe lots of medications for people's lifetimes.

If I put you on a statin, the likelihood is you will be on that statin for the rest of your life.

So the idea that somehow addiction is not a chronic disease and therefore does not merit chronic treatment, I think is just another tip of the stigma iceberg.

WILLIAM BRANGHAM: However, Klein cautions, GLP-1s alone won't solve the country's drug crisis.

DR.

STEVEN KLEIN: Recovery involves community, infrastructure, therapy, a lot of things that are not equally accessible to everybody.

I think these medications even the playing field by giving people more time to get into those services and establish themselves and be on their recovery path.

I don't think GLP-1s are a silver bullet for addiction.

The GLP-1, and how do you feel like your dose is going now?

WILLIAM BRANGHAM: The Rhode Island pilot program will likely end in a few months.

And Klein says, short of FDA approval for substance abuse, these medications will remain too expensive because insurance won't cover them.

But, until then, Jessica Massarone says she is saving up.

These medications have helped her turn a corner, and she's willing to pay hundreds of dollars every month to preserve the precious gains she's made.

JESSICA MASSARONE: Who's to say, if I stop taking the medication, am I going to get high right away?

Or -- I don't know.

I can't answer that, right?

But why do I want to find out?

WILLIAM BRANGHAM: Right.

For the "PBS News Hour," I'm William Brangham.

GEOFF BENNETT: Tomorrow, the final story in our series on GLP-1s examines how the drugs are changing perspectives on body image.