Telehealth Startups Market GLP-1 Drugs for Addiction Before FDA Review

Telehealth prescribing moves ahead of the evidence

Some telehealth companies are already offering GLP-1 drugs for addiction, even though the Food and Drug Administration hasn’t weighed in on their use for that purpose. That puts commercial prescribing ahead of both the evidence and regulatory review. The distinction matters: a treatment can attract serious scientific interest before researchers have established whether it works well, for whom it might work, and how its benefits compare with its risks.

GLP-1 medicines are best known to many patients as drugs used for obesity. Their possible role in addiction is a separate question, and one that remains under study. STAT’s Katie Palmer reports that the medicines show promise, particularly for alcohol use disorder. Promise, though, is an early signal rather than a settled clinical answer. It doesn’t by itself establish that a drug should become a routine option for people seeking help with substance use.

Startups Quel, Livelyhood and Choose Your Horizon are marketing off-label prescriptions of these drugs to people with substance use problems. Off-label prescribing means a clinician prescribes a medicine for a purpose other than the one for which it has been approved. That practice can put a treatment within reach before a new use has gone through its own regulatory review, but it also leaves patients and clinicians making decisions amid uncertainty. Some of these services also offer compounded versions that haven’t been approved by regulators.

What early promise can—and can’t—tell patients

Research suggesting that GLP-1 medicines might affect addictive behavior gives companies a reason to pay attention. It doesn’t answer the practical questions a patient needs answered before starting treatment. Does the effect hold up in clinical use? Which patients, if any, are most likely to benefit? What drawbacks might accompany treatment, and how should it fit with other forms of care? Those questions require evidence beyond an encouraging early signal.

Addiction is also not a single condition with one uniform treatment pathway. The source points particularly to alcohol use disorder, while the companies are marketing to people with substance use problems more broadly. That difference in scope deserves scrutiny: evidence about one condition can’t automatically settle whether a medicine helps with other forms of addiction. A service’s broad marketing language may reach further than the research that first made a drug seem promising.

Here’s the thing: the appeal of a new treatment can grow faster than the evidence supporting it. People looking for help may reasonably see an online prescription as a concrete next step, especially when a familiar class of drugs is being discussed for a new purpose. But a quick path to a prescription doesn’t make the underlying scientific question any less open. A promising idea still needs to be tested.

Telehealth changes the route to a prescription

Telehealth can connect patients with clinicians without requiring an in-person visit, and online services can make it easier to seek care. In this case, that access model also gives startups a way to offer prescriptions while research on the proposed use is still developing. The business model and the scientific timeline don’t necessarily move at the same pace. Companies can begin marketing a service before researchers have answers to the questions that would support wider confidence in it.

That gap places particular weight on how a service explains uncertainty. Patients need to understand that the medicines’ possible role in addiction is being studied, and that an off-label prescription isn’t the same as an FDA decision endorsing that use. The distinction can be easy to miss when a treatment is presented as a specific answer to a difficult problem. Clear explanations matter because the patient is being asked to make a decision while the evidence remains incomplete.

Compounded versions add another point of uncertainty. The source says some companies offer compounded products that haven’t been approved by regulators. That doesn’t, on its own, establish what any particular product contains or how it performs; those claims aren’t provided here. It does mean patients should be able to tell whether they’re being offered an approved product or a compounded version, and what that difference means for the proposed treatment.

(And this is the part most people overlook.) The question isn’t only whether a drug might help. It’s also whether a patient can tell the difference between a possibility described in research and a treatment presented in a commercial offering. When those are blurred, the marketing can sound more conclusive than the science.

The unresolved question for addiction care

The companies’ approach puts a live scientific question into a commercial setting before the FDA has weighed in on the use. That’s more significant than it looks. Early access can make a potential treatment visible and give patients another option to ask about, but it can also make an unsettled therapy feel established simply because it’s available for purchase. Availability is not proof of effectiveness.

If you’re working in this space—as a patient, clinician, or researcher—the useful distinction is between evidence that warrants further study and evidence strong enough to guide routine care. The source supports the first claim: GLP-1 medicines show promise for addiction, particularly alcohol use disorder. It doesn’t establish the second. Until research clarifies whether the drugs can help people with addiction, prescribing practices at these services are likely to face closer attention.

The next phase depends on what that research shows. If findings support a role for GLP-1 drugs, they could inform how clinicians discuss them and where they might fit in care. If the findings don’t support that role, commercial interest won’t fill the evidentiary gap. For now, the companies are betting that the early promise will hold up. A bet, still.