GLP-1 Drugs for Addiction: Hype or Hope?
- Prathigna Thambi
- 5 hours ago
- 5 min read
Getting back to the gym after the holidays is always a challenge. In the depths of winter, it’s hard not to wish for a pill that could simply burn off those extra calories. While social media is filled with success testimonials by people using anti-obesity drugs like Ozempic to reach their weight goals, others highlight their surprising benefits in reducing addictive behaviours. Like me, if you’re wondering how one drug is impactful enough to act on so many different disorders, you’ve come to the right place.
Anti-obesity semaglutide drugs were originally developed to treat Type 2 diabetes, a metabolic disorder. Patients with this disorder often have impaired insulin secretion and function, leading to dysfunctional glucose metabolism. To combat this, semaglutide drugs mimic a natural hormone in the body known as glucagon-like peptide 1 (GLP-1). In normal physiology, GLP-1 is released post a meal, activating the GLP-1 receptors that then regulate blood sugar levels and promote satiety. In addition to signalling fullness to your brain, GLP-1 delays gastric emptying and aids in insulin production. In patients with type 2 diabetes, semaglutide drugs work as GLP-1 receptor agonists, helping them stabilise insulin levels and keep them feeling full for longer. Consequently, these patients require a lower food intake which often leads to weight loss.
"GLP-1 acts on the same brain regions that are involved in craving, reward, and motivation systems - largely driven by dopamine pathways."
Ozempic is a GLP-1 drug that has been a revolutionary development for diabetics, helping maintain glucose homeostasis while supporting weight loss. Due to the drug's ability to regulate reward and motivation, it has also been extended to people suffering from obesity and increased body mass, who often crave high calorie foods in an addictive manner. However, more recently, Ozempic has gained popularity and is being promoted as a cosmetic drug supplement for weight loss. In 2021, Ozempic was one of the top prescribed medicines in the United States, with over 9 million prescriptions by the end of 2022. Based on current trends, it is predicted to reach 24 million prescriptions by 2035 in the USA alone. Another well-known GLP-1 drug, Wegovy, manufactured by Novo Nordisk, has also been approved for weight loss all across America.
Interestingly, recent research has shed light on how GLP-1 drugs can also play a role in suppressing addiction in patients suffering from alcohol or substance use disorders. Some individuals taking ozempic for diabetes or weight loss have come forward to share their stories on how the drug also helped them with addiction. This was not particularly surprising for researchers, as GLP-1 acts on the same brain regions that are involved in craving, reward, and motivation systems - largely driven by dopamine pathways. Every little amount of alcohol, nicotine, or opioids activates the synthesis and transport of dopamine, allowing the user to feel a sense of reward promoting addictive behaviours. GLP-1 receptors are present throughout the ventral tegmental area (where dopamine is synthesised), nucleus accumbens (where dopamine is registered as a feeling of reward) and prefrontal cortex regions of the brain. Essentially, GLP-1 receptors are known to reduce the flow of dopamine and thus can make additive substances feel less rewarding. Through this link, GLP-1 drugs can play a role in regulating dopamine pathways that are highly relevant in addictive behaviours.
"Despite these promising findings, significant caveats remain, including side effects like nausea, a curb in appetite, and weight loss."
The first few trials conducted on rats and mice that were addicted to nicotine, alcohol, and other stimulants showed effective reduction in craving and relapse when treated with GLP-1 therapy. However, there have been contrasting results in human preclinical and clinical trials. A placebo-controlled trial run at the University of Copenhagen showed that exenatide (a GLP-1 drug) was not effective in reduction of alcohol use. In 2023, a similar trial in Switzerland did not show decline in nicotine-intake by administration of dulaglutide (another GLP-1 drug). On the other hand, a study with 20 participants including patients suffering from opioid use disorder achieved a 46% abstinence when treated with liraglutide. Similarly, a positive result was observed in patients with alcohol use disorder when administered with Ozempic at the University of South California. The main difference between the different trials conducted so far is the potency of GLP-1 drugs administered. Scientists are predicting that the more potent drugs, like Ozempic, will function more effectively than less potent first generation GLP-1 drugs. Three well known scientists in the field - Lorenzo Leggio, W. Kyle Simmons and Joseph Schacht - are currently leading independent randomised trials to uncover the power of second-generation semaglutides for addiction treatment. Pharma giants like Novo Nordisk and Eli Lilly have hopped on board to discover the potential of GLP-1 drugs in patients suffering from alcohol-use disorder.
Despite these promising findings, significant caveats remain, one of the main ones being the side effects like nausea, a curb in appetite, and weight loss. Whether the suggested administration of these drugs would require patients using these drugs to be obese is also an open question. Additionally, the length of treatment and the probability of relapse needs to be established before the regulatory approval of these drugs for addiction. Nonetheless, the year 2026 is expected to be pivotal in determining whether Ozempic-like drugs can be safely and effectively repurposed for addiction therapy, so watch this space!
References
O’Neill, Elizabeth S., et al. "Injectable weight loss medications in plastic surgery: what we know, perioperative considerations, and recommendations for the future." Plastic and Reconstructive Surgery–Global Open 12.1 (2024): e5516.
Constantino, A.K. Ozempic, Wegovy Drug Prescriptions Hit 9 Million, Surge 300% in under Three Years. CNBC. 2023. Available online: https://www.cnbc.com/2023/09/27/ozempic-wegovy-drug-prescriptions-hit-9-million.html
Dolgin, Elie. "Will blockbuster obesity drugs revolutionize addiction treatment?." Nature 648.8092 (2025): 20-22.
Egecioglu, Emil, et al. "The glucagon-like peptide 1 analogue Exendin-4 attenuates alcohol mediated behaviors in rodents." Psychoneuroendocrinology 38.8 (2013): 1259-1270.
Egecioglu, Emil, Jörgen A. Engel, and Elisabet Jerlhag. "The glucagon-like peptide 1 analogue, exendin-4, attenuates the rewarding properties of psychostimulant drugs in mice." PloS one 8.7 (2013): e69010.
Egecioglu, Emil, Jörgen A. Engel, and Elisabet Jerlhag. "The glucagon-like peptide 1 analogue Exendin-4 attenuates the nicotine-induced locomotor stimulation, accumbal dopamine release, conditioned place preference as well as the expression of locomotor sensitization in mice." PloS one 8.10 (2013): e77284.
Vallöf, Daniel, et al. "The glucagon‐like peptide 1 receptor agonist liraglutide attenuates the reinforcing properties of alcohol in rodents." Addiction biology 21.2 (2016): 422-437.
Klausen, Mette Kruse, et al. "Exenatide once weekly for alcohol use disorder investigated in a randomized, placebo-controlled clinical trial." JCI insight 7.19 (2022): e159863.
Lengsfeld, Sophia, et al. "Effect of dulaglutide in promoting abstinence during smoking cessation: a single-centre, randomized, double-blind, placebo-controlled, parallel group trial." EClinicalMedicine 57 (2023).
Freet, Christopher S., et al. "Efficacy of the GLP-1 receptor agonist, semaglutide, in abstinence from illicit and nonprescribed opioids in an outpatient population with OUD: a randomized, double-blind, placebo-controlled clinical trial protocol." Addiction Science & Clinical Practice 20.1 (2025): 89.
Hendershot, Christian S., et al. "Once-weekly semaglutide in adults with alcohol use disorder: a randomized clinical trial." JAMA psychiatry 82.4 (2025): 395-405.
This article was written by Prathigna Thambi and edited by Julia Dabrowska, with graphics produced by Saba Keshan. If you enjoyed this article, be the first to be notified about new posts by signing up to become a WiNUK member (top right of this page)! Interested in writing for WiNUK yourself? Contact us through the blog page and the editors will be in touch.