Neurologist Sue Grigson, at Pennsylvania State University, got a surprising account from a man: he had gone without alcohol or drugs for the first sustained stretch of his life while taking semaglutide, the drug sold as Ozempic and Wegovy. Similar stories soon surfaced online and in clinics. Patients on GLP-1 medications described less desire to smoke, drink or use drugs.
Researchers are now testing whether those reports hold up. News.Az, citing Nature, described the diabetes and weight-loss drugs as unexpected candidates for treating addiction.
A study of 606,434 veterans
The largest evidence so far comes from Washington University School of Medicine in St. Louis. Its team analyzed electronic health records of 606,434 U.S. veterans with type 2 diabetes, tracking them for up to three years from the start of either a GLP-1 drug, mostly semaglutide, liraglutide or dulaglutide, or an SGLT2 inhibitor.
Among 524,817 veterans with no substance use disorder at the start, GLP-1 use was linked to a 14% lower risk of developing any such disorder. By substance, the reduction was 18% for alcohol, 14% for cannabis, 20% for cocaine and nicotine, and 25% for opioids. That worked out to seven fewer new diagnoses per 1,000 GLP-1 users.
The other group, 81,617 veterans, already had a substance use disorder. After three years, GLP-1 use was tied to a 30% reduction in emergency department visits, 25% in hospitalizations, 40% in overdose and 50% in drug-related deaths. That is 12 fewer serious harm events per 1,000 users.
“The revelation about GLP-1 medication is that it really works against all major substances,” said senior author Ziyad Al-Aly, a clinical epidemiologist at WashU Medicine. He said the effect appears uniform because the drugs are likely “acting against the craving itself.” People using them for obesity often describe a quieting of “food noise,” he said, and these results suggest the drugs may also quiet what he calls “drug noise.”
The study is observational, so it shows an association. Al-Aly said the findings support clinical trials of GLP-1 drugs as addiction treatments, including trials large enough to measure effects on overdose and drug-related death.
Why the brain responds
GLP-1 receptors sit in parts of the brain that govern reward, motivation and craving. Stimulating them lowers dopamine activity tied to pleasure and reinforcement, so rewarding experiences feel less compelling. Animal studies suggest the drugs can also dull the stress responses linked to withdrawal and relapse.
Swedish addiction biologist Elisabet Jerlhag Holm first showed in animals that GLP-1 therapies cut cravings for alcohol, nicotine and stimulants. Later work with Lorenzo Leggio at the U.S. National Institutes of Health tied GLP-1 pathways to human alcohol dependence.
Trials under way
Results so far are mixed. Older drugs such as exenatide and dulaglutide did little for heavy drinking or smoking cessation. Liraglutide reduced opioid cravings by about 40% in smaller studies. A randomized trial led by psychologist Christian Hendershot at the University of Southern California found weekly semaglutide injections cut drinking in people with alcohol-use disorder.
More than a dozen trials are running worldwide. A Danish study of high-dose semaglutide in more than 100 people with obesity and alcohol-use disorder has finished, with results expected in early 2026. In the United States, teams led by Leggio, W. Kyle Simmons and Joseph Schacht are testing injectable and oral semaglutide in moderate to heavy drinkers, using functional MRI.
Scientists stress the work is exploratory. Approval would need large trials showing lasting drops in substance use, and the drugs can cause significant, sometimes unintended weight loss. Anyone taking a GLP-1 medicine, or struggling with addiction, should talk to their doctor.
Sources
- GLP-1 medications get at the heart of addiction: study | WashU Medicine
- Diabetes drugs show promise in treating addiction | News.az
