Diabetes drugs can transform addiction treatment

Interest intensified after neurologist Sue Grigson at Pennsylvania State University received a message from a man who said he achieved his first prolonged period without drugs or alcohol while taking semaglutide, widely sold as Ozempic and Wegovy. Similar accounts soon surfaced online and in clinics, describing diminished urges for smoking, drinking, and drug use among people prescribed GLP 1 drugs for diabetes or obesity.

These stories gained scientific support earlier this year when a randomized clinical trial led by psychologist Christian Hendershot at the University of Southern California found that weekly semaglutide injections reduced alcohol consumption in individuals with substance use disorder. More than a dozen additional clinical trials are now under way worldwide, with initial results expected soon.

How it works

GLP 1 receptors are present in brain regions that regulate reward, motivation, and craving. When these receptors are stimulated, dopamine signaling linked to pleasure and reinforcement is reduced, making rewarding experiences less compelling. This effect mirrors the drugs’ action on eating behavior and suggests a shared biological pathway across substance and behavioral addictions.

Animal research also indicates that GLP 1 drugs can suppress stress responses associated with withdrawal and relapse, potentially making abstinence easier to sustain. Researchers are exploring whether similar effects could benefit conditions involving cognitive or motivational dysfunction, including depression and dementia.

The scientific roots of this field trace back more than a decade. Swedish addiction biologist Elisabet Jerlhag Holm demonstrated in animal studies that GLP 1 therapies reduced cravings for alcohol, nicotine, stimulants, and relapse like behaviors, although her work initially attracted little attention. Collaboration with Lorenzo Leggio at the US National Institutes of Health later uncovered evidence linking GLP 1 biology to human alcohol dependence, including genetic associations and altered receptor levels in the brains of people with alcohol use disorder. Public interest surged after a 2023 magazine article highlighted patient reports of diminished addictive urges during semaglutide treatment.

Research

Early clinical trials delivered mixed results. Older GLP 1 drugs such as exenatide and dulaglutide showed little effect on heavy drinking or smoking cessation, although smaller studies were more encouraging, including a trial in which liraglutide cut opioid cravings by about 40 percent. Brain imaging also revealed reduced activity in reward related regions when participants viewed alcohol cues, prompting a shift toward testing newer, more potent drugs such as semaglutide and tirzepatide.

Current research is expanding. A Danish trial 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 USA, teams led by Lorenzo Leggio, W. Kyle Simmons, and Joseph Schacht are evaluating injectable and oral semaglutide in moderate to heavy drinkers while tracking brain responses with functional MRI. Similar approaches are being used in studies of opioid addiction.

Despite growing interest, researchers caution that the field remains exploratory. Regulatory approval would require large trials proving sustained reductions in substance use and real-world health benefits, alongside careful monitoring of risks such as unintended weight loss or malnutrition. Most studies therefore restrict enrollment to participants who are overweight and will need to determine whether benefits persist after treatment ends.

Earlier, Qazinform News Agency reported on how GLP-1-based drugs, such as Ozempic, Saxenda, and Mounjaro, are transforming the treatment of obesity and metabolic disorders.