By Ademola Adekusibe
15th, November 2025.
A new review published in the Journal of the Endocrine Society says medications originally developed for obesity and type 2 diabetes may also help treat alcohol and substance use disorders.
The review, conducted by researchers from the National Institutes of Health and international partners, examined growing evidence that GLP-1 receptor agonists (GLP-1RAs) such as semaglutide, liraglutide, exenatide, and dulaglutide can reduce cravings and substance-seeking behaviors.
Preclinical studies in rodents and primates showed marked reductions in alcohol intake, dopamine release, and addictive behavior. Human findings point in the same direction. A Danish national cohort linked GLP-1RA use to fewer alcohol-related events, while a randomized trial of semaglutide reported lower daily alcohol consumption and reduced cravings in individuals with alcohol use disorder. Exenatide also reduced cigarette smoking among participants compared with placebo.
For opioids and stimulants, several GLP-1 drugs decreased heroin, oxycodone, and fentanyl self-administration in animal models, while epidemiologic data suggested a reduced risk of opioid overdose among human GLP-1RA users. In cocaine-related studies, GLP-1 activity in brain reward circuits diminished drug-seeking behavior, though human trials remain limited.
Researchers say GLP-1 receptors in regions such as the ventral tegmental area, nucleus accumbens, and prefrontal cortex may explain why the medications influence reward, stress, and impulse pathways tied to addiction.
Clinicians believe the findings could reshape treatment options for patients with both metabolic conditions and substance-use disorders. While the drugs have established safety profiles in diabetes and obesity care, the review cautioned that side effects such as gastrointestinal symptoms and possible muscle loss must still be considered in addiction treatment.
Dr. Lorenzo Leggio of the National Institute on Drug Abuse said early results are promising but emphasized the need for more data. “Randomized controlled trials are critically needed to investigate the safety and efficacy of GLP-1RAs in patients with substance use disorders,” he noted.
Multiple clinical trials are under way to determine dosing, safety, and how GLP-1 drugs may fit into future addiction therapy.
