GLP-1 Agonists Show Promise in Treating Substance Use Disorders

In recent years, medications originally developed to treat Type 2 diabetes, obesity, and other weight-related conditions—such as semaglutide and liraglutide—are showing promise in treating substance use disorders (SUDs). These medications belong to a class of glucagon-like peptide-1 (GLP-1) receptor agonists and are marketed under brand names such as Ozempic®, Wegovy®, Victoza®, and Saxenda®. 

GLP-1 is a naturally occurring hormone produced in the gut and brain that regulates appetite, blood sugar, and satisfaction after eating. GLP-1 receptor agonist medications mimic these effects, which can reduce hunger, slow digestion, and stabilize glucose levels. 

Emerging evidence suggests that GLP-1 medications can also activate areas of the brain involved in reward, motivation, and impulse control—the same systems affected by substance use and addiction.   This overlap of neurocircuitry has sparked growing interest in using GLP-1 receptor agonists to reduce urges to use alcohol and drugs and improve recovery outcomes.

The Overlapping Biology of Addiction and Obesity

Research shows SUDs share biological and psychological similarities with overeating and obesity, with both involving dysregulation of the brain’s reward system (Srinivasan et al., 2025). From an evolutionary survival perspective, it was critical for seeking and eating food to be a rewarding and pleasurable activity so it would be repeated. Brain imaging studies have found similar changes in dopamine receptors, the neurotransmitter that creates a feeling of well-being and motivates us to repeat behaviors in people who overeat and use alcohol and drugs.

Since GLP-1 receptors are present in the same brain regions, medications regulating appetite and metabolism may also influence motivation,  reward,   and stress responses. By regulating these brain circuits, GLP-1 medications may reduce the obsessive drive to obtain and use drugs, reinforcing properties,  and cravings, which are the hallmark features of SUDs.

Research on GLP-1 Medications for Treating SUDs

Animal studies consistently demonstrate GLP-1 receptor agonists reduce alcohol, nicotine, and opioid consumption (Srinivasan et al., 2025). Results of limited research studies are promising in human studies.  

Much of the current evidence on humans comes from large observational studies using health record data rather than randomized clinical trials. Although these studies cannot prove causation, the consistent findings across large populations, systems, and countries provide compelling early evidence that GLP-1 medications could reduce alcohol and drug use and could play an important role in SUD treatment.

Below are recent studies on the association between GLP-1 medications and SUD outcomes.

Alcohol Use Disorder Outcomes

• A national cohort study in Denmark of 38,454 individuals showed that GLP-1 medications were associated with a reduced risk of alcohol-related outcomes after three months of treatment, which included fewer hospitalizations, registered alcohol use disorder treatment, and purchase of medications to manage alcohol withdrawal (Wium-Andersen et al., 2022).

• A 2024 study led by Wang, Volkow, and colleagues examined two cohorts totaling over 682,000 individuals with either obesity or type 2 diabetes and found the risk of new alcohol use disorder diagnoses was about 50% lower among those taking semaglutide compared to other anti-obesity or diabetes medications (Wang et al., 2024a). Among individuals with prior AUD, recurrence rates were also about 50% lower.

• A 2025 study of 228,000 individuals with obesity, Type 2 diabetes, or alcohol use disorder, semaglutide and liraglutide use was associated with a 36% and 28% lower risk, respectively, of alcohol-related hospitalizations (such as intoxication and withdrawal symptoms) compared to patients who weren't prescribed GLP-1 medications (Lähteenvuo et al., 2025).

• In another 2025 study by Qeadan and colleagues that used electronic health data from over 1.3 million individuals with a history of alcohol use disorder and opioid use disorder, researchers found that individuals with alcohol use disorder (n=817,309)  prescribed GLP-1 medications experienced about 50% fewer alcohol intoxication events over the 2-year period compared to patients who didn’t receive the medications (Qeadan et al., 2025).

Opioid Use Disorder Outcomes

• In another study by Wang, Volkow, and colleagues, which included roughly 33,000  individuals with Type 2 diabetes and opioid use disorder, semaglutide was associated with a 42-68% lower risk of opioid overdoses compared to other diabetes medications during the 1-year follow-up period (Wang et al., 2024b). 

• In the same 2025 study by Qeadan and colleagues, individuals with a history of opioid use disorder (n=503,747)  prescribed GLP-1 medications had about a 40% lower rate of opioid overdose events during the 2-year follow-up period (Qeadan et al., 2025).  

Tobacco Use Disorder Outcomes

• Wang, Volkow, and colleagues also conducted a study of 222,942 individuals with tobacco use disorder and type 2 diabetes, with findings showing individuals prescribed semaglutide showed a 32% lower risk of tobacco-related healthcare visits and were less likely to need smoking cessation medications or counseling during the 12-month follow-up period, with the most notable effects appearing within the 30 days (Wang et al., 2024c).

These findings suggest  GLP-1 receptor agonists may help reduce substance use and substance-related harms across alcohol, opioid, and tobacco use disorders. While these large-scale observational studies are encouraging, more research is needed, including randomized controlled trials to determine whether GLP-1 medications directly reduce substance use, including stimulant use, and improve long-term recovery outcomes. If confirmed, these medications could represent an important new tool in the treatment of substance use disorders.

References

Lähteenvuo, M., Tiihonen, J., Solismaa, A., Tanskanen, A., Mittendorfer-Rutz, E., & Taipale, H. (2025). Repurposing Semaglutide and Liraglutide for Alcohol Use Disorder. JAMA psychiatry, 82(1), 94–98. https://doi.org/10.1001/jamapsychiatry.2024.3599

Qeadan, F., McCunn, A., & Tingey, B. (2025). The association between glucose-dependent insulinotropic polypeptide and/or glucagon-like peptide-1 receptor agonist prescriptions and substance-related outcomes in patients with opioid and alcohol use disorders: A real-world data analysis. Addiction (Abingdon, England), 120(2), 236–250. https://doi.org/10.1111/add.16679

Srinivasan, N. M., Farokhnia, M., Farinelli, L. A., Ferrulli, A., & Leggio, L. (2025). GLP-1 Therapeutics and Their Emerging Role in Alcohol and Substance Use Disorders: An Endocrinology Primer. Journal of the Endocrine Society, 9(11), bvaf141. https://doi.org/10.1210/jendso/bvaf141

Wang, W., Volkow, N. D., Berger, N. A., Davis, P. B., Kaelber, D. C., & Xu, R. (2024a). Associations of semaglutide with incidence and recurrence of alcohol use disorder in real-world population. Nature communications, 15(1), 4548. https://doi.org/10.1038/s41467-024-48780-6

Wang, W., Volkow, N. D., Berger, N. A., Davis, P. B., Kaelber, D. C., & Xu, R. (2024c). Association of Semaglutide With Tobacco Use Disorder in Patients With Type 2 Diabetes : Target Trial Emulation Using Real-World Data. Annals of internal medicine, 177(8), 1016–1027. https://doi.org/10.7326/M23-2718

Wang, W., Volkow, N. D., Wang, Q., Berger, N. A., Davis, P. B., Kaelber, D. C., & Xu, R. (2024b). Semaglutide and Opioid Overdose Risk in Patients With Type 2 Diabetes and Opioid Use Disorder. JAMA network open, 7(9), e2435247. https://doi.org/10.1001/jamanetworkopen.2024.35247

Wium-Andersen, I. K., Wium-Andersen, M. K., Fink-Jensen, A., Rungby, J., Jørgensen, M. B., & Osler, M. (2022). Use of GLP-1 receptor agonists and subsequent risk of alcohol-related events. A nationwide register-based cohort and self-controlled case series study. Basic & clinical pharmacology & toxicology, 131(5), 372–379. https://doi.org/10.1111/bcpt.13776