By Umar Latif, MD, DFAPA
Chief Medical Officer, Enterhealth
GLP-1 medications are everywhere in the news lately. Drugs like semaglutide (Ozempic®, Wegovy®) and tirzepatide (Mounjaro®, Zepbound®) are rapidly changing how we treat obesity and type 2 diabetes.
Now, a new question is emerging in addiction science and mental health:
Can GLP-1 medications also help reduce cravings or support addiction treatment?
As an addiction psychiatrist, I pay attention when metabolic medicine begins to intersect with substance use disorders. That does not mean a new addiction treatment has arrived. It does mean patients and families deserve clear, balanced information instead of hype.
What Are GLP-1 Medications?
GLP-1 receptor agonists (often called “GLP-1 medications”) are drugs that mimic a natural hormone involved in blood sugar control and appetite regulation. They are currently FDA-approved for conditions such as type 2 diabetes and obesity.
In clinical practice, GLP-1 medications are used to:
- Lower blood sugar
- Slow gastric emptying
- Reduce appetite
- Support weight loss and metabolic health
These medications were never designed as addiction treatments. However, as more people started using GLP-1 drugs like semaglutide and tirzepatide, some reported unexpected changes in behavior, including:
- Less interest in alcohol
- Reduced urge to smoke
- Lower drive for compulsive snacking or “reward-based” eating
By themselves, patient stories do not prove that GLP-1 medications treat addiction. But they can raise important scientific questions—and that is exactly what has happened.
Why Researchers Are Exploring GLP-1s in Addiction
Researchers became interested in GLP-1 medications and addiction for three main reasons:
- Patient experiences. People began telling their physicians that cravings for alcohol or nicotine felt “muted” after starting a GLP-1 drug.
- Animal studies. In laboratory models, animals given GLP-1 agonists showed reduced drug-seeking behavior for substances like alcohol, cocaine, and nicotine.
- Observational data. Large health-record studies suggest that some people taking GLP-1 medications appear to drink less alcohol than expected.
Taken together, these patterns were compelling enough that major research groups began formally studying GLP-1 medications in alcohol use disorder and other addictions. Early studies showed reduced alcohol and drug intake in animal models, and researchers are now testing these medications in humans for alcohol, nicotine, cocaine, and opioid use disorders.
None of this means GLP-1 medications are ready to be prescribed as a frontline addiction treatment, but it does mean the idea is being taken seriously by the scientific community.
Where GLP-1 Addiction Research Is Focusing Right Now
The strongest human data on the effects of GLP-1s so far involves alcohol. A randomized clinical trial published in JAMA Psychiatry in 2025 reported reduced alcohol cravings and fewer heavy drinking days among people taking semaglutide compared to placebo, consistent with patterns noted in other emerging observational research and clinical reports.
Larger phase 2 trials (including studies like STAR-T) are now underway to better understand whether GLP-1 medications can safely and effectively reduce drinking. Preliminary signals are promising, but experts caution that many medications look encouraging in small trials, but never translate into reliable treatments in broader clinical use.
And while most of the current GLP-1 research in addiction focuses on alcohol use disorder, there is also research underway or in progress related to:
- Nicotine dependence
- Stimulants (such as cocaine and amphetamines)
- Opioids (mainly in early and preclinical stages)
What Early GLP-1 Addiction Studies Show Clinically
What stands out to me clinically is the consistency of the signal emerging around GLP-1 medications and addiction-related cravings.
In the aforementioned clinical trial published in JAMA Psychiatry, patients taking semaglutide reported meaningful reductions in alcohol craving and drinking intensity compared with placebo. Large population-based studies show related trends, including reduced alcohol-related hospitalizations among individuals prescribed GLP-1 medications.
Further, patients in real-world addiction treatment settings describe alcohol cravings feeling “quieter” or more manageable after starting a GLP-1 medication.
In addiction medicine, consistent patient-reported changes like these often represent an early signal of underlying neurobiological effects. While these findings do not yet support GLP-1 drugs as standalone addiction treatments, they do justify continued research and careful, individualized clinical consideration.
How GLP-1 Medications Might Affect Cravings
Researchers are still working to understand why GLP-1 medications may affect cravings or addictive behaviors. Several biological pathways are being studied, though they likely do not all contribute equally in clinical practice.
Metabolic & Appetite Effects
GLP-1 medications often lead to earlier satiety and, in some patients, mild nausea. For some individuals, this can make drinking less appealing—particularly alcohol, which is calorie-dense and frequently consumed with food.
While these effects may contribute to reduced intake, they are unlikely to fully explain the craving-related changes many patients report.
Reward Pathway Effects in the Brain
A more compelling explanation involves the brain’s reward system. GLP-1 receptors are present in regions that regulate motivation, reward, and reinforcement, including the ventral tegmental area, nucleus accumbens, and prefrontal cortex.
Preclinical studies from the National Institutes of Health (NIH) show that GLP-1 receptor agonists can modulate dopamine signaling in these circuits, reducing the reinforcing effects of substances such as alcohol and nicotine. Emerging evidence suggests these effects may occur independently of weight loss or appetite suppression.
Inflammation & Stress Pathways
Researchers are also examining whether GLP-1 medications influence systemic or neuroinflammation. Inflammation has been linked to impaired impulse control, heightened stress response, and increased vulnerability to addictive behaviors.
Reducing inflammatory signaling may be one way GLP-1 medications indirectly affect craving and substance use, though this area of research remains early.
What We Still Don’t Know About GLP-1 Medications in Addiction Treatment
This is where caution becomes essential. GLP-1 medications are not FDA-approved for addiction treatment, and several important clinical questions remain unanswered. While early data are promising, they are not yet sufficient to support routine use in substance use disorders.
Who May Benefit Most
One of the most active areas of research is patient selection. Early findings suggest that individuals with obesity or certain metabolic comorbidities may be more likely to experience reductions in alcohol use, but it remains unclear which patients with substance use disorders are most appropriate candidates.
Dosing & Duration for Addiction Care
Addiction treatment may require different dosing strategies than diabetes or obesity care. Some studies suggest that craving reduction may occur at lower doses than those typically used for metabolic indications, which is encouraging from a safety and tolerability standpoint. However, optimal dosing, duration, and treatment timelines for alcohol and other substance use disorders are still being defined through ongoing trials.
Direct Effects vs. Secondary Effects
It is not yet clear whether the observed benefits of GLP-1 medications are driven by direct effects on brain reward pathways, secondary effects related to reduced appetite and intake, or a combination of both. Clarifying these mechanisms will be critical to determining how these medications might be used clinically.
Long-Term Role in Recovery
Addiction is often a chronic condition, and it remains unknown whether GLP-1 medications would be used short-term during early recovery or as part of longer-term treatment strategies. This question has important implications for safety, adherence, and relapse prevention.
Safety, Side Effects, & Responsible Use
From a safety perspective, GLP-1 receptor agonists have a well-established profile supported by extensive real-world use in metabolic conditions. Emerging data also suggest potential protective effects on liver outcomes among patients with alcohol use disorder. That said, off-label use has already outpaced the evidence, increasing the risk of misuse, unsafe dosing, and unrealistic expectations. Careful patient selection, monitoring, and follow-up remain essential.
Recent scientific reviews have reached a similar conclusion. For example, a 2022 NIH-supported review highlighted promising preclinical findings across multiple substance categories while emphasizing the need for larger, well-controlled randomized trials before GLP-1 medications can be considered evidence-based treatments for addiction.
For Patients and Families: A Clear Bottom Line
When patients or families ask about GLP-1 medications for addiction, I tell them their curiosity is reasonable. The science is evolving, and patient experiences increasingly align with what research is beginning to show.
GLP-1 medications are FDA-approved for metabolic conditions and have a well-established safety record. While they are not currently FDA-approved specifically for addiction treatment, evidence supporting their potential benefit in reducing alcohol cravings continues to grow, and experts anticipate these medications may play a role for certain patients when used thoughtfully and under medical supervision.
What has not changed is the foundation of effective recovery. Long-term success in addiction treatment still depends on a comprehensive approach that includes:
- Medically supervised withdrawal management, when needed
- FDA-approved medications for specific substance use disorders
- Behavioral therapies
- Individual and group therapy
- Treatment for co-occurring mental health conditions
- Long-term relapse prevention strategies and support
In the future, GLP-1 medications may play a role as an adjunct—one tool among many in a comprehensive addiction treatment plan—but not a replacement for evidence-based treatment.
For readers interested in exploring related topics at the intersection of addiction, psychiatry, and emerging treatments, I also share additional clinical perspectives and commentary at https://blog.umarlatifmd.com/.
How Enterhealth Approaches Emerging Treatments
At Enterhealth, we closely follow emerging research on GLP-1 medications and addiction, along with other potential advances in neurobiology and pharmacology. Our clinical decisions are guided by:
- The strength and quality of available evidence
- Individual medical and psychiatric history
- Safety, side-effect profiles, and long-term risk
- How any new approach integrates with comprehensive, whole-person care
If GLP-1 medications eventually prove safe and effective for certain patients with substance use disorders, they would be considered as part of a broader, medically directed treatment plan—never as a standalone “quick fix.”
In the meantime, my advice to patients is straightforward: have this conversation with your treatment team. If GLP-1 therapy may be appropriate, it should be explored with proper medical guidance, monitoring, and follow-up. Addiction medicine is advancing, and our responsibility is to bring promising treatments forward safely, responsibly, and within comprehensive care.
Get Help Today with Enterhealth
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