New research suggests that diabetes and weight-loss drugs known as GLP-1 receptor agonists may also help treat alcohol and drug addiction.
A widely used group of medications originally developed to manage diabetes and obesity may also hold promise for treating alcohol and drug addiction, according to new research published in the Journal of the Endocrine Society.
These drugs, called Glucagon-Like Peptide-1 Receptor Agonists (GLP-1RAs), are showing potential as a novel way to address alcohol and other substance use disorders.
“Early research in both animals and humans suggests that these treatments may help reduce alcohol and other substance use,” said lead researcher Lorenzo Leggio, M.D., Ph.D., 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, Md. “Some small clinical trials have also shown encouraging results.”
Current Treatment Options Are Limited
Substance use disorders are defined by four key patterns: physical dependence, risky use, social difficulties, and loss of control over consumption.
The widespread effects of these disorders extend beyond the individual, creating far-reaching challenges for families, communities, and public health systems. Research indicates that alcohol causes more overall harm than any other drug, contributing not only to health problems but also to incidents such as traffic accidents, gun violence, and domestic abuse, the study notes.
Despite the high prevalence and consequences of alcohol and other substance use disorders, less than a quarter of people received treatment in 2023.
Underutilization is due to a variety of barriers at the patient, clinician, and organizational levels, not the least of which is the stigma associated with substance use disorders, according to the study. “Current treatments for [alcohol and other substance use disorders] fall short of addressing public health needs,” the researchers wrote.
GLP-1s and Their Potential to Treat Addiction
GLP-1 therapies have gained widespread renown in recent years for their ability to address obesity and significantly reduce weight.
In addition to its inhibitory effects on gastrointestinal systems, GLP-1 has key functions in the central nervous system, the study notes. Among them, GLP-1R activation within the central nervous system curbs appetite and encourages individuals to eat when hungry and stop eating when they are full.
Some forms of obesity have been shown to present biochemical characteristics that resemble addiction, including neurocircuitry mechanisms, the study says, acknowledging that such conclusions are controversial.
“Pathways implicated in addiction also contribute to pathological overeating and obesity,” the study says.
With this pathway in mind, researchers in recent years have looked at GLP-1s as a potential therapy to address substance use disorders. Preclinical and early clinical investigations suggest that GLP-1 therapies modulate neurobiological pathways underlying addictive behaviors, thereby potentially reducing substance craving/use while simultaneously addressing comorbid conditions.
Studies that examine GLP-1 effects on substance use disorders include:
- Alcohol use disorder (AUD): A randomized controlled trial with exenatide, the first GLP-1receptor agonist approved for diabetes, showed no significant effect on alcohol consumption, although a secondary analysis indicated 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 laboratory alcohol self-administration, as well as drinks 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. The studies also found that these medications reduce reinstatement 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, reinstatement of nicotine seeking, and other nicotine-related outcomes in rodents. Initial clinical trials suggest the potential for these medications to reduce cigarettes per day and prevent weight gain that often follows smoking cessation.
Leggio and his colleagues caution that more and larger studies are needed to confirm how well these treatments work. Additional studies will help unveil the mechanisms underlying GLP-1 therapies in relation to addictive behaviors and substance use.
But that hasn’t dampened the optimism for these therapies to address the serious problems found in substance use disorders.
“This research is very important because alcohol and drug addiction are major causes of illness and death, yet there are still only a few effective treatment options,” Leggio said. “Finding new and better treatments is critically important to help people live healthier lives.”
Reference: “GLP-1 Therapeutics and Their Emerging Role in Alcohol and Substance Use Disorders: An Endocrinology Primer” by Nirupam M Srinivasan, Mehdi Farokhnia, Lisa A Farinelli, Anna Ferrulli and Lorenzo Leggio, 9 October 2025, Journal of the Endocrine Society.
DOI: 10.1210/jendso/bvaf141
The research was supported in part by NIDA and NIAAA.
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3 Comments
What an awkward thing to call a drug for a lethal disease “popular”. Does it have fans?
A very long time ago, I, while sympathetic, would look down on those who had ‘allowed’ themselves to become addicted to hard drugs or alcohol. Although I’ve not been personally or familially affected by the opioid overdose crisis, I suffer enough unrelenting PTSD symptoms (etcetera) to know, enjoy and appreciate the great release by consuming alcohol or THC.
In the book (WHAT HAPPENED TO YOU? Conversations on Trauma, Resilience and Healing) he co-authored with Oprah Winfrey, Dr. Bruce D. Perry (M.D., Ph.D.) writes in regards to self-medicating trauma, substance abuse and addiction: “For people who are pretty well-regulated, whose basic needs have been met, who have other healthy forms of reward, taking a drug will have some impact, but the pull to come back and use again and again is not as powerful. It may be a pleasurable feeling, but you’re not necessarily going to become addicted. Addiction is complex. But I believe that many people who struggle with drug and alcohol abuse are actually trying to self-medicate due to their developmental histories of adversity and trauma.”
Societally neglecting, rejecting and therefore failing people struggling with crippling addiction should never be an acceptable or preferable political, economic or religious/morality option. They definitely should not be consciously or subconsciously perceived by sober society as somehow being disposable. But the more callous politics that are typically involved with lacking addiction funding/services tend to reflect conservative electorate and representatives’ opposition, however irrational, against making proper treatment available to low- and no-income addicts, including safe(r) drugs.
Typically, societally overlooked is that intense addiction usually doesn’t originate from a bout of boredom, where a person consumed recreationally but became heavily hooked on a (self)medicating substance that eventually destroyed their life and even those of loved-ones. The unfortunate fact about self-medicating is: the greater the induced euphoria or escape one attains from it, the more one wants to repeat the experience; and the more intolerable one finds their non-self-medicating reality, the more pleasurable that escape will likely be perceived. In other words: the greater one’s mental pain or trauma while not self-medicating, the greater the need for escape from one’s reality — all the more addictive the euphoric escape-form will likely be.
Too often the worth(lessness) of the substance abuser is measured basically by their ‘productivity’ or lack thereof. They may then begin perceiving themselves as worthless and accordingly live and self-medicate their daily lives more haphazardly. Especially when the substance abuse is due to past formidable mental trauma, the lasting solitarily-suffered turmoil can readily make each day an ordeal unless the traumatized mind is medicated.
There is a real need for emphasizing that pharmaceutical-industry huge-profit greed, as opposed to genuine concern for its product consumers’ wellbeing, creates a very worrisome conflict of interest. Society used to have the barbaric psychiatric facilities; now, it/we have the sedation industry running largely wild and free.
Besides ‘treating’ mental illness, pharmaceutical companies (a.k.a. the sedation industry) greatly profit from the continual and even addictive tranquilization and concealment, via antidepressants and/or tranquilizers, of symptoms of cerebral disorders such as ADHD and higher-functioning autistic spectrum disorder, along with the notable anxiety and/or depression that often accompany them — especially when there’s related adverse childhood experience trauma. Also, I wouldn’t be surprised if profit-motivated industry representatives have a say in the composition, including revisions/updates, of the Diagnostic and Statistical Manual of Mental Disorders.
In Canada at least, it’s also a case of relatively few physicians integrating adverse childhood experience or other PTSD science into their diagnoses and treatments of patients. Meantime, the only two health professions’ appointments for which Canadians are fully covered by the public plan are the two readily pharmaceutical-prescribing psychiatry and general-practitioner fields. Such non-Big-Pharma-profiting health specialists as counsellors, therapists and naturopaths (etcetera) are not covered at all by the public healthcare plan. Psychotherapy, for example, costs $150-$200 an hour, for who-knows-how-many sessions, which likely makes it inaccessible for most Canadians, including me.
… Over the last 18 years or so, Health Canada has dramatically diverted a large portion of its resources from consumers’ health/wellbeing and onto the pharmaceutical industry’s business interests. Health Canada places about four times more of its resources, such as staffing and funding, toward getting new drugs onto the market than it does on consumers’ safety, the latter which includes monitoring and recording adverse effects caused by the drugs.