Authored by Ann Bauer via Brownstone Institute,
I have loved many addicts in my life.
I have been exasperated, impoverished, and terrified by them. But also amused, warmed, enraptured, elevated…That’s the thing about addicts. They contain multitudes, all drama and extremes. They’re charismatic until they’re repugnant, joyful until they’re suicidal. Everything is in vivid, dangerous color. It’s part of the ride and the reason they exert such a pull on cautious, ascetic people like me.
Some of my addicts are gone. My closest friend and “Damn Good Food” co-author, Mitch Omer, died at 61. Others have found God and turned their lives around (they’re now exciting and dramatic people of faith). I love people who are addicted to alcohol, drugs, gambling, and food. Many surf between the four.
Recently, another category of people formed: the ones injecting themselves with GLP-1s, mostly to lose weight but also to control other impulses. It’s clearly great for the handful whose life and health were being destroyed by obesity. But for the others? I’m dubious.
Ozempic and its cousins (Mounjaro, Wegovy, Zepbound, et al.) modify the pleasure centers of the brain, making everything people crave—food, sex, smoking, alcohol, shopping, gambling, cocaine—less appealing. It doesn’t address the underlying problems of addiction, such as depression or dishonesty. It just eliminates the part of the person that enjoys and revels, the colorful, joyous side.
It’s a version of the drug in Robert Louis Stevenson’s Strange Case of Dr. Jekyll and Mr. Hyde, that the doctor ginned up to divide himself, creating a respectable man bound by reserve and a separate murderous, pleasure-seeking monster.
From Dr. Jekyll’s own account:
Hence it came about that I concealed my pleasures; and that when I reached years of reflection, and began to look round me and take stock of my progress and position in the world, I stood already committed to a profound duplicity of life. Many a man would have even blazoned such irregularities as I was guilty of; but from the high views that I had set before me, I regarded and hid them with an almost morbid sense of shame. It was thus rather the exacting nature of my aspirations than any particular degradation in my faults, that made me what I was and, with even a deeper trench than in the majority of men, severed in me those provinces of good and ill which divide and compound man’s dual nature. In this case, I was driven to reflect deeply and inveterately on that hard law of life, which lies at the root of religion and is one of the most plentiful springs of distress. Though so profound a double-dealer, I was in no sense a hypocrite; both sides of me were in dead earnest; I was no more myself when I laid aside restraint and plunged in shame, than when I laboured, in the eye of day, at the furtherance of knowledge or the relief of sorrow and suffering. And it chanced that the direction of my scientific studies, which led wholly toward the mystic and the transcendental, re-acted and shed a strong light on this consciousness of the perennial war among my members. With every day, and from both sides of my intelligence, the moral and the intellectual, I thus drew steadily nearer to that truth, by whose partial discovery I have been doomed to such a dreadful shipwreck: that man is not truly one, but truly two.
Of course, the doctor’s desire to split off his hedonistic self will have devastating consequences. The lesson of Jekyll and Hyde is that decoupling morality from desire is unnatural. It disrupts the natural order. My question for RLS, were he still with us to answer: Do GLP-1s pose similarly catastrophic risks?
I think they may. One reason is my Uncle Joe.
Joe was a quiet, careful religious man. He and his wife, Darla, had desperately wanted children but it just never happened. They raised boxer dogs that they treated like babies. Joe worked as a photographer in North Minneapolis in this little tufted studio from the 1930s that smelled like rose cologne and dust.
Some time in the late 1970s, Joe started shaking uncontrollably. Terrible thing for a photographer. He was diagnosed with Parkinson’s and put on a whopping dose of Levodopa, which flooded his brain with dopamine. This got the tremors under control. He and Darla were hugely grateful. They needed Joe’s income and now he could go back to work.
But over the next half-decade, my uncle changed. He became furtive and untrustworthy. Around the time Darla discovered she had cancer, she also discovered that her husband had nearly bankrupted them. This tidy man had developed a rabid gambling habit—cards, horses, sports—and he was a terrible bettor. I was just a kid, but I remember my father talking about what a dumb bastard Joe was, how he lied to his wife and spent the money she needed for her treatments.
Darla died a few years later, and Joe kept right on gambling. He sold his business and used the money for trips to Las Vegas. By this time, the Levodopa was having diminishing returns and his Parkinsonian shaking was back. Joe’s doctors kept ratcheting up the dose, believing they were doing so with impunity. But the drug only made him step up his gambling. And spending. And drinking. And God knows what else.
Shortly after Joe died, penniless, news started to eke out that Levodopa was causing previously straight-laced people to do all sorts of out-of-character things. They were visiting prostitutes and buying fancy clothes, snorting blow and placing bets. Joe was part of the first wave of Parkinson’s patients that were treated with this new ‘miracle’ drug and went off the rails. He died alone, having borrowed money from everyone he knew and burned all the bridges he’d spent a lifetime building.
What does this have to do with Robert Louis Stevenson’s story about chemical medicine? Not a lot—directly. In Jekyll and Hyde, the main character sets out to create a potion that will free him from his rutting, profane, dissolute self (and vice versa). In the case of my uncle, chemists were simply trying to control the symptoms of his disease, and it had the awful, unintended consequence of turning a once-refined man into – basically – Mr. Hyde.
But Joe’s story is information about what happens when you mess with brain chemicals and try to spark or dampen certain behaviors. He wasn’t an addict they were trying to control. In fact, he was the kind of orderly person who shined his shoes and set them out every night. Levodopa MADE people like my Uncle Joe into addicts. Collaterally. And scientists missed it for years.
GLP-1 drugs center around the very same brain chemical: Dopamine. Instead of raising patients’ levels as neurologists did with Parkinson’s patients, Ozempic and the rest ‘modulate’ (which simply means adjust) Dopamine levels, suppressing them [typically] to a point where the pleasure-seeking cravings for food, alcohol, nicotine, and on and on are weak enough for people to overcome.
The Free Press ran an article recently on a little-talked-about downstream effect of GLP-1s: apathy. “They Went on Ozempic—and Gave Up on Life” by Evan Gardner reports on people who lost weight on the injectable, along with their libido, ambition, and desire to participate in the world. One woman finally had the boyfriend of her dreams, thanks (in her mind) to her slender new body, but no desire to have sex.
This is the opposite of what happened to Parkinson’s patients in the ‘70s, ‘80s and ‘90s. The danger is that doctors are oblivious to (or ignoring) what’s happening because GLP-1s are easy, people want them, and they’re having the desired effect.
But what if the sum of becoming apathetic isn’t just laziness or low sex drive? What if it leads to something more sinister, such as a lack of empathy, the need for ever-more disruptive or violent entertainment, errors in high-risk high-stakes jobs, a dearth of parental love for a child….The list of potential ills goes on and on.
I ran this theory by a friend who works in the sober community, for a 12-step program, and he told me there are some professionals working in recovery who won’t accept people on GLP-1s into their programs. “A lot of us believe it’s an addiction if you’re relying on a drug that removes the need for spiritual work,” he said.
Robert Louis Stevenson warned about this very thing back in 1886. His story is about a drug made of phosphorus and salt and “some volatile ether” that allowed the addict, the rogue and criminal, to split off and wander free.
Today, we have a drug made of “salt forms of a glucagon-like peptide-1 (GLP-1) receptor agonist,” being pushed by physicians and television campaigns and sports heroes and celebrities nationwide that allows people to silence the addict within—the self that once “laid aside restraint and plunged in shame”—stuff them in a crawl space, slam the door shut, and trap them there.
Don’t tell me that a Hyde-like creature isn’t going to get out eventually. There will be consequences.
“Prepare for a dreadful shipwreck,” I imagine Stevenson would say.
