Substance use disorder is marked by a pattern of pathological behaviors related to use of the substance. As listed in the DSM, they include:
• Being unable to stop taking a substance, even when wanting to cut down or regulate use or having tried several times
• Worrying about the next dose or getting a consistent supply of the substance
• Experiencing intense cravings at any time, but especially in places where the drug was once obtained or used
• Devoting considerable time to getting, taking, or recovering from drug
• Neglecting roles and responsibilities such as work, school or home obligations
• Experiencing interpersonal problems as a result of substance use
• Changing social patterns, withdrawing from family, friends and activities in order to use a substance
• Facing risky situations to become intoxicated or maintain a supply of drug
• Using a substance despite knowing it causes physical or psychological harm to oneself
• Developing tolerance, requiring more drug to get an effect; a common but not invariable feature of addiction, sometimes called adaptation
• Developing the unpleasant physiologic symptoms of withdrawal—shakiness, sweating, queasiness or vomiting, headache—when unable to take the substance. Withdrawal is a highly variable sign of addiction; it occurs with use of some drugs (alcohol, for example) but not others (cocaine); however, it often drives continuing use. Withdrawal can require medical treatment when a person abruptly stops heavy substance use.
Along with the diagnostic signposts of addiction, those addicted typically display a number of other behavioral characteristics:
• Secretiveness about activities and relationships as well as private space, to conceal drug use
• Sudden changes in activity patterns, refusing participation in activities once enjoyed
• Lying about whereabouts, absences, consumption habits; making excuses for unusual behavior
• Loss of energy or motivation
• Neglect of appearance
• Stealing to support drug purchases.
Is Chocolate Craving A Sign Of Magnesium Deficiency? Expert Answers
Have you ever had an intense craving for specific foods, in particular chocolates? Did you wonder why that is? Science suggests there could be several reasons behind it, including magnesium. While more research is needed, Dr Edwina Raj, Head of Services, Clinic Nutrition and Dietetics, Aster CMI Hospital, Bengaluru, expands on the claim and explains if there is in fact a link between the two. Is There A Link Between Magnesium Deficiency And Chocolate Cravings?
“Cravings are directly linked to nutrient deficiencies, hormonal imbalances, and mood swings,” says Dr Raj.
Research notes that humans typically crave energy-dense foods, such as chocolates and other chocolate-containing foods, along with other high-caloric sweet and savoury foods.
Also Read: Your Hair Loss May Be Due To Magnesium Deficiency: Here’s How To Handle It
Many experts have noted that chocolate cravings are linked to low levels of magnesium due to the presence of cacao, which is said to have the highest amount of magnesium per gram. A study published in the Journal of the Academy of Nutrition and Dietetics says, “Chocolate may be used by some as a form of self-medication for dietary deficiencies (eg, magnesium) or to balance low levels of neurotransmitters involved in the regulation of mood, food intake, and compulsive behaviours (eg, serotonin and dopamine).”
Dr Raj shares, “Magnesium is one such mineral that is needed for normal blood sugar levels, strong bones, muscle, and nerve function, which is why deficiency in magnesium increases craving towards food or sugar.” However, she mentions that it does not specifically mean chocolate cravings.
“High stress levels, hunger pangs, and sugar cravings could be some of the other causes of chocolate cravings. High sugar gives a quick high and lifts one’s mood for a shorter duration but is not the right choice,” she adds. Role Of Magnesium
Magnesium plays a vital role in muscle function, nerve transmission, energy production, and bone health. It also contributes to heart rhythm regulation, DNA synthesis, and immune system support, making it essential for overall physiological well-being.
Low levels of magnesium can lead to weakness, stiffness, loss of appetite, muscle spasms, lack of sleep, headache, constipation and fatigue, with senior citizens being highly susceptible as it is hard for their bodies to absorb the mineral, says Dr Raj.
Also Read: Magnesium Deficiency: Warning Signs Of Low Magnesium LevelsFood Sources
“Magnesium is available in plant foods like nuts, figs, seeds, dark green leafy vegetables, legumes, pumpkin seeds, dark chocolate, whole grains, poultry, fish, avocado and bananas,” says the doctor, adding, “If you consume these foods, your body’s daily magnesium requirements are fulfilled, but a supplement may be needed if you are severely deficient.”
Dark chocolates in particular are said to be very rich in magnesium, with 65 mg in a 28-gram serving, which is about 15% of the Daily Value (DV). Bottomline
It’s important to recognise that cravings can have complex causes, and addressing them might involve a combination of factors, including managing stress, maintaining a balanced diet, staying hydrated, and practising mindful eating. Consult a healthcare professional or a registered dietitian if you cannot pinpoint the reason leading to your cravings.
Ozempic appears to curb patients’ cravings for booze, cigarettes and even GAMBLING
The breakthrough drug Ozempic that has helped over 50 million Americans lose weight has also helped smokers and problem drinkers curb their cravings.
A smattering of trials involving rats and humans, as well as a growing number of anecdotal reports, have shown that Americans prescribed semaglutide – the active ingredient in the diabetes drug Ozempic – saw their alcohol and nicotine use gradually drop off.
The drug has also been shown to help its millions of users curb other compulsive behaviors besides drug and alcohol use, from the seemingly innocuous like nail biting and binging sweets to potentially ruinous impulsive spending and gambling.
Scientists believe that the drug does more than just regulate blood sugar and make you feel satisfied quicker when eating. It can control the brain’s complex reward pathway that floods the brain with a rush of dopamine when something good happens, such as biting into a delicious cookie, and encourages you to eat more.
The potential use of the injectable weight loss aids for addictive behaviors would change the landscape of treatment, which is often limited to just a handful of government-approved medications that fail to prevent relapses long-term.
Henry Webb, from North Carolina, finished a two-month course of Wegovy after hitting his weight goal. In the past, he would consistently have a couple of drinks in the evening, but said: ‘On the medication I had zero desire for that’
Staci Rice (pictured), 40, said that she can no longer stomach coffee or Kit-Kats after using Wegovy
In 2022, more than 5 million prescriptions for Ozempic, Mounjaro, Rybelsus, or Wegovy were written for weight management, compared with just over 230,000 in 2019. This marks an increase of more than 2,000 percent, according to market research firm Komodo Health
Dr Chris Palmer, a Harvard psychiatrist who focuses on the connection between mental health and metabolism told DailyMail.com: ‘The exact same brain circuits that are regulating our food intake are also playing a role in our addictive behaviors.’
Medications like Ozempic and Wegovy that help people shed excess pounds are called GLP-1 agonists, which mimic the GLP-1 hormone naturally produced by the gut in response to eating.
This hormone curbs hunger and slows the the rate at which a person’s stomach empties, leaving them feeling fuller for longer. GLP-1 agonists might also decrease the brain’s response to rewarding stimuli, including delicious food and potentially other substances like alcohol and nicotine.
Dr Palmer added: ‘The general rule of thumb is substances that promote our survival and or ability to reproduce, trigger that [dopamine reward] system. Addictive substances trigger that system and in a way it becomes circular logic.
‘So what makes a substance addictive? If it triggers that system. And so all of those things – alcohol, nicotine, food, especially delicious food high in sugar and fat –those types of food tend to stimulate this system much more. Over time, if you’re stimulating it repetitively, or at a higher kind of intensity than it’s designed to be like cocaine would do, you actually are in a way, desensitizing the system.’
The most commonly reported side effects of semaglutide drugs marketed as Wegovy and Ozempic affect the gastrointestinal tract, causing constipation, nausea, and diarrhea.
Evidence of semaglutide’s anti-addiction properties in humans is scant, but there have been plenty of anecdotal reports of users suddenly losing their taste and tolerance for alcohol.
Henry Webb, from North Carolina, finished a two-month course of Wegovy after hitting his weight goal.
In the past, he would consistently have a couple of drinks in the evening, but said: ‘On the medication I had zero desire for that.’
Another semaglutide user named Staci Rice, 40, said that her favorite chocolate candy, Kit Kats, are now repulsive to her.
Meanwhile, Jamel Corona from Chicago successfully dropped 60 pounds on Wegovy after just 15 months.
Ms Corona went from being a social drinker, consuming a glass of wine after work or a few beers during a night out, to completely losing her tolerance from alcoholic beverages.
She told Today that alcohol is now a ‘hard pass’ for her, adding: ‘I can’t tolerate beer at all so I haven’t had any beer in months. … I don’t remember the last time I’ve had wine. It’s just too sweet.’
She recounted an incident at a brewery where she and friends were celebrating her husband’s birthday. She had three beers in a four-hour period and got violently ill, the first time she has ever gotten physically sick from alcohol.
Ms Corona said: ‘I just had a really horrible reaction to it. And I was like, I never want to feel like that again.’
Another Ozempic user saw their gambling addiction gradually subside, an addiction spurred on by heavy Adderall use.
The user said: ‘I first took Ozempic on January 15th. Almost immediately the thought of gambling seemed so obviously stupid – not just dumb financially but a waste of time. It actually seemed boring to me for the first time ever.
‘Now all the addictions are gone and I’ve lost 50 lbs and losing steadily. It’s been almost like a literal miracle for me!’
And while not every patient will see their penchant for smoking, drinking, or other compulsive negative behaviors taper off, it has happened enough that addiction researchers are paying attention.
Ozempic was initially approved for diabetes management while being prescribed ‘off label’ for weight loss. It has since become a drug worth tens of billions for its manufacturer, Novo Nordisk, which makes a higher-dose version called Wegovy
Wegovy and Ozempic work by triggering the body to produce a hormone called glucagon-like peptide-1 that is released naturally from the intestines after meals
Nearly 30 million American teens and adults struggle with alcohol use disorder while 24 million Americans are hooked on nicotine.
That means millions of people who engage in these problematic behaviors who do not necessarily have to drop pounds could potentially benefit from semaglutide.
And smokers who have long struggled to quit could soon see a light at the end of the tunnel.
A 2023 report in the journal Psychopharmacology reported that rats addicted to nicotine who were given a GLP-1 receptor agonist drug called liraglutide were less interested in nicotine, helped them avoid overeating when they stopped taking nicotine, and prevented them from gaining too much weight.
For now, the strongest evidence lay in animal studies. Another such study was published in the biomedical research journal JCI Insight in May 2023.
American and Austrian researchers set out to test how different amounts of semaglutide can affect the way mice and rats drink alcohol, particularly when binge-drinking. They hypothesized that semaglutide might make rats and mice drink less alcohol and sugary drinks without affecting how much non-sugary things they drink.
Semaglutide injections at all doses helped mice drinking sweetened alcohol drink less than those in the control group.
They also found that at certain doses – 0.003 mg/kg, 0.01 mg/kg, 0.03 mg/kg, and 0.1 mg/kg – semaglutide reduced alcohol intake compared to the control group.
Even mice who were injected with semaglutide but not given alcohol saw their consumption of sweetened drinks fall.
In another study reported just last month in the journal eBioMedicine, researchers at the University of Gothenburg tested semaglutide on dozens of rats which had been exposed to alcohol and had grown to enjoy it.
They were allowed to drink to their heart’s content. The rodents taking semaglutide consumed half as much alcohol compared to those on a placebo.
After a week deprived of alcohol in order to heighten their cravings, alcoholic rats given the medication still drank much less, which could hold massive potential for the treatment of alcoholism that often entails repeated relapses.