GLP-1 Drugs: Could Diabetes Medication Treat Addiction?
A growing body of research suggests that popular GLP-1 medications, initially prescribed for type 2 diabetes, may significantly reduce the risk of substance use disorders and even lessen the severity of existing addictions. The findings, stemming from studies of veterans and observations by clinicians, are prompting a re-evaluation of the potential applications for drugs like Ozempic and Wegovy.
Ziyad Al-Aly, a clinical epidemiologist at Washington University in St. Louis and chief of the Research and Development Service at the VA Saint Louis Health Care System, began noticing an unexpected trend in his practice several years ago. Patients prescribed GLP-1s reported not only weight loss and improved blood sugar control, but likewise a diminished desire for substances like alcohol. “They would tell me, ‘you know, I started these GLP-1 medications and, suddenly, I lost the taste for alcohol,’” Al-Aly recalled. “I don’t drink anymore, I don’t smoke anymore.”
Initial anecdotal reports have been bolstered by larger studies. Researchers, including Al-Aly, analyzed the medical records of over 606,000 veterans with type 2 diabetes. The study, published in BMJ Medicine, found that those taking GLP-1 receptor agonists had a 14% lower risk of developing a substance use disorder compared to those taking sodium-glucose cotransporter-2 inhibitors (SGLT2), another class of diabetes medication. This translates to roughly six fewer cases of substance use disorder per 1,000 patients.
The benefits were even more pronounced for individuals already struggling with addiction. The research team associated GLP-1 medications with a 39% reduction in overdoses, a 31% decrease in emergency department visits related to addiction, a 26% reduction in addiction-related hospitalizations, and a 25% decrease in suicidal thoughts or attempts. Critically, the risk of death related to addiction was cut in half. The medication reduced dangerous events by twenty per thousand.
These findings align with earlier research demonstrating the cardiovascular benefits of GLP-1s, but also highlight a previously unappreciated impact on brain function. A separate study, published in Nature Medicine and involving over 2 million veterans, similarly indicated broad-ranging benefits and risks associated with GLP-1 receptor agonists. Al-Aly described this larger study as “the largest study on GLP-1 receptor agonists” to date.
The mechanism behind this effect is still being investigated, but researchers believe it may involve the impact of GLP-1 receptors in brain regions associated with reward, satiety, and impulse control. Anna Lembke, a psychiatrist and addiction specialist at Stanford University, who was not involved in the study, explained that the medications appear to reduce the overall “appetite” for addictive substances. “What we’re observing in the data… is that, for some people, [these medications are] very helpful in reducing overall craving, which is really interesting,” Lembke said.
GLP-1 receptor agonists mimic the effects of the naturally occurring hormone GLP-1, which is released by the body during digestion. The hormone stimulates insulin production, lowers blood sugar, and suppresses appetite. Originally approved by the Food and Drug Administration (FDA) in 2005 for treating type 2 diabetes, the medications gained widespread popularity in 2021 with the release of semaglutide-based drugs like Ozempic and Wegovy, specifically approved for weight loss. By the end of 2025, approximately 12% of U.S. Adults reported using a GLP-1 medication for weight loss or conditions like diabetes and cardiovascular disease, according to a KFF Health Tracking poll.
While the potential for GLP-1s to treat addiction is promising, experts caution against premature adoption as a first-line treatment. Concerns remain about the long-term effects of discontinuing the medication, and whether addictive behaviors will return with increased intensity. “Are the addictions or cravings going to come back with a vengeance?” Al-Aly questioned. “That’s an important question because that could negate the benefits or lead to more complex problems.”
Despite these uncertainties, Al-Aly indicated he will consider a patient’s risk of substance use when prescribing diabetes medication. “Let’s say he tells me, ‘Doctor, I’ve been trying to quit smoking for ten years and I can’t do it,’” Al-Aly said. “I know that by prescribing GLP-1 medications, I’m killing two birds with one stone.” Lembke is currently conducting a study on a non-veteran population that echoes Al-Aly’s findings, suggesting the medication could treat a wide range of addictions. She and other researchers are also exploring the potential of GLP-1s to treat behavioral addictions, such as gambling and sex addiction.