Weight loss medications like Ozempic may also curb drug and alcohol addiction

These drugs, called glucagon-like peptide 1 receptor agonists (GLP-1RAs), could represent a hopeful new direction for treating alcohol use disorders and other substance use disorders.

“Early research in both animals and humans suggests that these treatments may help reduce use of alcohol and other substances,” said lead researcher Lorenzo Leggio, MD, of the National Institute on Drug Abuse (NIDA) and the National Institute on Alcohol Abuse and Alcoholism (NIAAA), both part of the National Institutes of Health (NIH) in Bethesda, Maryland. Some small clinical trials have also shown encouraging results.”

Current treatment options are limited

Substance use disorders are defined by four main patterns: physical dependence, risky behavior, social difficulties, and loss of control.

The widespread harm caused by these disorders extends beyond the health of individuals, affecting families, communities and societies around the world. Alcohol, in particular, is considered the most harmful drug in general, as it contributes not only to health problems, but also to traffic accidents and violent incidents, according to researchers.

Even with the scale of the problem, fewer than one in four people will receive treatment for alcohol or other substance use disorders in 2023.

The authors point to several barriers, including stigma and limited resources for patients and providers. “Current treatments for alcohol and other drug use disorders do not meet public health needs,” the study noted.

GLP-1 drugs and their potential role in addiction

GLP-1 drugs have recently gained popularity for their success in reducing appetite and promoting weight loss.

In addition to their effect on digestion, GLP-1 molecules play a key role in the brain. Activating GLP-1 receptors in the central nervous system helps regulate hunger signals, which prompts a person to eat when hungry and stop when full.

The study highlights that some forms of obesity share biological and neurological features with addiction, although this idea is still debated.

“Addiction-related pathways also contribute to pathological overeating and obesity,” the study says.

Recognizing this overlap, scientists have begun to explore GLP-1 drugs as a potential treatment for substance use disorders. Early studies in animals and humans suggest that these drugs may affect brain circuits that drive addictive behavior, potentially reducing cravings while also benefiting other existing health problems.

Evidence from early research

Studies examining the effects of GLP-1 on substance use disorders include:

• Alcohol use disorder (AUD): A randomized controlled trial with exenatide, the first GLP-1 receptor agonist approved for diabetes, showed no significant effect on alcohol consumption, although a secondary analysis suggested reduced alcohol intake in the subgroup of people with AUD and comorbid obesity. A more recent randomized controlled trial showed that low-dose semaglutide—a newer GLP-1 receptor agonist approved for both diabetes and obesity—reduced in vitro alcohol self-administration, as well as beverage per drinking days and craving, in people with AUD.
• Opioid use disorder: In rodent models, several GLP-1 receptor agonists have been shown to reduce self-administration of heroin, fentanyl, and oxycodone. Studies have also found that these drugs reduce recidivism of drug seeking, a rodent model of relapse in drug addiction.
• Tobacco use disorder: Preclinical data show that GLP-1 receptor agonists reduce nicotine self-administration, nicotine-seeking recovery, and other nicotine-related outcomes in rodents. Preliminary clinical trials suggest the ability of these medications to reduce the number of cigarettes per day and prevent the weight gain that often follows smoking cessation.

The way forward

Leggio and colleagues stress that more research is needed to confirm how effective GLP-1 drugs are in treating addiction and to understand the underlying biological mechanisms.

Despite the unanswered questions, researchers remain optimistic.

“This research is extremely important because alcohol and drug addiction are leading causes of illness and death, yet there are still only a few effective treatment options,” Leggio said. “Finding new and better treatments is critical to helping people live healthier lives.”

The authors of the other studies are Citizens M. Srinivasan of the University of Galway in Galway, Ireland; Mehdi Farrokhnia from Nidaa Waniya; Lisa A. Farnelli herself; and Anna Ferroli of the University of Milan and istuto di ricovero e curation a caratere scientific (irccs) multimedia in Milan, Italy.

Research reported in this article was supported in part by NIDA and NIAAA. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.