We live in a Dopamine Nation, a term that Stanford physician-scientist Anna Lembke, MD so accurately coined over five years ago in her blockbuster book. And since then, the various algorithms competing for our attention have only increased in power with the integration of AI into our social media feeds, the rise of online prediction markets and sports-betting, and the popularization of highly addictive kratom and 7-OH within regulatory grey areas. Our networks are overloaded.

Despite the continued proliferation of entire industries that exploit our reward systems, there is simultaneously a breakthrough in addiction medicine emerging: GLP-1 receptor agonists. Originally framed as diabetes medications, GLP-1s have expanded to weight loss, sleep apnea, and cardiovascular risk reduction. Now we can add addiction to that mix. Three randomized controlled trials suggest semaglutide (Wegovy®/Ozempic®) reduces alcohol use among people with alcohol use disorder. Multiple retrospective cohort studies find associations between GLP-1s and improved substance use outcomes. There are now over 50 trials registered on ClinicalTrials.gov exploring GLP-1s and various types of addiction.

What if GLP-1s could help restore a healthier balance that our society lacks?

After our own experiences with GLP-1s—Marlene substantially reduced her alcohol use and Steve experienced improved recovery capital after starting GLP-1s—this line of inquiry has become the focus of our work. What if the most common public health problems plaguing our country are actually the same underlying disease, a disease of reward pathway dysregulation? What if GLP-1s are not metabolic medications but brain medications? What if the problem facing America is not one of not-enough, but rather that of over-consumption? More money, more sugar, more ultraprocessed foods, more booze, more drugs, more more more. More dopamine.

Subscribe now

What if GLP-1s could help restore a healthier balance that our society lacks? This thesis led us to start Quel Health, a telemedicine platform that connects people from the privacy of their homes to addiction experts. Our affiliated clinicians create tailored treatment plans, including off-label GLP-1 receptor agonists if clinically appropriate. Caron Treatment Centers is our Founding Strategic Partner, and we are proud to continue Caron’s tradition of excellence, rigor, and research as we break into new territory.

As we build, we know the landscape will change. We’ll explore philosophical questions, understand and evaluate new research, consider newly approved medications, and confront regulatory changes on compounding and peptides. We’ll examine all this and more in this newsletter, documenting the successes and lessons learned as Quel takes shape. Please join us on this journey.