Edith Hejberg
Drugs such as Ozempic, Wegovy, Mounjaro and Zepbound are prescribed to millions of Americans. They were first approved for diabetes and obesity.
Drugs used for diabetes and weight loss are now being studied as a possible treatment for addiction. Early research suggests GLP-1 medicines like Ozempic could influence the brain’s reward system.
Scientists say the evidence is still developing. But growing interest and new studies are raising hopes for a new approach to addiction treatment.
How GLP-1 medicines work
GLP-1 drugs mimic a hormone that regulates digestion, insulin and appetite. They slow digestion and help people feel full longer.
Many patients say the medicines quiet cravings and reduce what they call “food noise.” Researchers believe similar brain effects might also reduce substance cravings.
Already widely used medicines
Drugs such as Ozempic, Wegovy, Mounjaro and Zepbound are prescribed to millions of Americans. They were first approved for diabetes and obesity.
Researchers say their widespread use could make them especially impactful if they also work for addiction.
“If these drugs turn out to be safe and efficacious for treatment of substance-use disorder… they would just automatically… become the most widely prescribed pharmacotherapy for addiction,” said Dr. W. Kyle Simmons.
Early clues from research
Much of the early research has been done in animals. These studies suggest GLP-1 drugs affect brain circuits tied to reward and motivation.
Doctors have also heard many personal reports from patients who say their interest in alcohol or cigarettes declined after starting the medication.
Small human trials have shown promise, but larger studies are still needed.
New trials are expanding
Interest in studying GLP-1 drugs for addiction has increased rapidly. Several well-designed clinical trials are now underway.
Some of these studies focus on alcohol-use disorder and could release results within months, according to researchers.
A large study of veterans
A new study analyzed health records from more than 600,000 US veterans with type 2 diabetes. Researchers compared patients taking GLP-1 drugs with those taking another diabetes medication.
The analysis found lower rates of substance-use disorders among people using GLP-1 medicines.
Lower risk across multiple substances
Researchers looked at addiction related to alcohol, cannabis, cocaine, nicotine and opioids.
Over three years, GLP-1 users were about seven cases per 1,000 less likely to develop a substance-use disorder.
“What’s surprising is the breadth and consistency of effect across all of these different substances,” said study leader Dr. Ziyad Al-Aly.
Possible drop in overdose deaths
The study also examined people who already had substance-use disorders. Among them, GLP-1 users showed fewer severe outcomes.
Researchers reported a significant drop in drug-related deaths, about a 50% reduction in the dataset.
However, experts say more research is needed to confirm this effect.
Some experts remain cautious
Because the study was observational, it cannot prove the drugs caused the changes.
People who start GLP-1 medicines may also be more motivated to improve their health or receive more medical attention, which could influence results.
More clinical trials are needed
Randomized clinical trials are now underway to test the drugs directly for addiction.
Researchers are studying semaglutide for alcohol reduction, while other trials are examining treatments for cocaine, opioid and tobacco use disorders.
Safety findings so far
Earlier concerns suggested GLP-1 drugs might increase suicidal thoughts. European regulators opened an investigation in 2023.
Later studies found no link. The new VA study even showed what researchers described as “a 25% reduction in suicidal ideation.”
Many questions still remain
Scientists still do not fully understand how these medicines affect the brain long term. Questions remain about what happens if patients stop taking them.
“I think we have to be cautious here,” Al-Aly said. “We don’t know what we don’t know about these drugs.”
