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Could Popular Diabetes and Weight-loss Drugs Also Treat Addiction?
What the Research Shows on GLP-1s and Alcohol
A study published in The New England Journal of Medicine in April 2025 examined semaglutide’s impact on alcohol consumption in a small group of participants.
In the study, researchers followed 48 adults diagnosed with alcohol use disorder. Half received low doses of semaglutide and the other half received placebo injections. Participants were monitored over nine weeks, including two carefully controlled sessions where they were offered their favorite alcoholic drinks.
The results? Participants who took low dose semaglutide:
- Drank significantly less alcohol during the study compared to the placebo group
- Drank less drinks on days they did drink
- Had fewer days of heavy drinking
These effects exceeded researchers’ expectations.
How Does It Work?
Researchers still aren’t entirely sure why semaglutide affects addictive behaviors, but one leading theory concerns the medicines’s effect on the brain’s reward circuitry. It’s possible that because semaglutide reduces the appeal of food, it does the same for alcohol.
In animal studies, semaglutide-like medicines were shown to inhibit the dopamine release triggered by alcohol — the same dopamine surge that fuels cravings and reinforces drinking behavior. Without that hit of pleasure, the desire to drink may simply fade.
Beyond Booze: Other Addictive Behaviors
Semaglutide’s surprising side effect doesn’t stop at alcohol, however. In a small subgroup of participants who smoked cigarettes, those taking semaglutide also reported smoking fewer cigarettes per day. Other patients say they feel less of an urge to gamble, overeat, or engage in compulsive behaviors.
A 2024 study of 227,866 diabetic patients seems to support this notion. While the focus of the study was determining the effects of semaglutides on Alcohol Use Disorder, it also found that those taking medicines like Ozempic had lower risks of developing substance use disorders — not just alcohol, but a range of addictive behaviors — compared to those on other diabetes medications.
Similarly, a 2024 study published in Nature Communications analyzed electronic health records from over 83,000 patients with obesity and nearly 600,000 with type 2 diabetes. Researchers found that those prescribed semaglutide had a 50% to 56% lower risk of developing or relapsing into alcohol use disorder compared to those on other anti-obesity or diabetes medications relapse.
What We Still Don’t Know
Despite the growing excitement, experts are urging caution.
GLP-1 medicines like Ozempic, Wegovy (semaglutide), Mounjaro, and Zepbound (tirzepatide) are often called “forever drugs” because you have to keep taking them to keep feeling the effects. It’s unclear, therefore, if people would maintain these reduced cravings to alcohol and other addictive substances if they stopped taking the medications.
It’s also unclear whether the drug would work for people without obesity or diabetes, and these people make up a significant portion of the population suffering from addiction.
What’s Next?
Researchers are continuing to explore semaglutide’s effects in larger and longer studies. If future trials confirm its benefits, semaglutide could make a big difference in treatment for alcohol use disorder and potentially other compulsive behaviors.
In the meantime, patients and providers are urged to proceed with care. Semaglutide is not yet FDA-approved for treating addiction, and its use for this purpose remains off-label.
But still — imagine a future where a single weekly injection could help people gain control over not just their appetite, but their cravings, impulses, and habits. For the millions battling addiction, that’s a future worth watching.
CONTRIBUTING EXPERT
Chandar Abboy, MD
Dr. Abboy is a physician board-certified in internal medicine, pulmonary disease, critical care medicine, and sleep medicine. He is a Principal Investigator at Care Access, overseeing multiple clinical trials.
SOURCES
- Hendershot, C.S. et al. (2025). Semaglutide for the Treatment of Alcohol Use Disorder: A Randomized Controlled Trial. New England Journal of Medicine.
- W. Kyle Simmons, PhD – Oklahoma State University, ongoing research on GLP-1 agonists and reward systems
- Schacht, J.P. et al., (2024). Semaglutide and Craving Reduction in AUD. University of Colorado research
- Ebrahimi P, Batlle JC, Ayati A, et al. Suicide and Self-Harm Events With GLP-1 Receptor Agonists in Adults With Diabetes or Obesity: A Systematic Review and Meta-Analysis. JAMA Psychiatry.
- Nature Medicine, 2024 – Associations of semaglutide with incidence and recurrence of alcohol use disorder in real-world population
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